University of Verona
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Through-the-Needle Biopsy Revisited: How Patient Selection and Standardization Reduce Adverse Events in Pancreatic Cyst Evaluation
No full textBackground/Objectives: Pancreatic cystic lesions (PCLs) are increasingly being detected due to the widespread use of cross-sectional imaging. Endoscopic ultrasound (EUS) is the preferred modality for evaluating their nature and malignancy risk, yet fluid analysis and cytology offer limited sensitivity. Through-the-needle biopsy (TTNB) has emerged as a more accurate diagnostic tool, though it is associated with higher adverse event (AE) rates. In 2021, our center implemented a selective TTNB protocol excluding frail or elderly patients and suspected IPMNs and standardizing the procedure to two passes, complete cyst aspiration, and selective antibiotic prophylaxis. This study aimed to compare AE rates before and after protocol implementation, evaluate safety factors including antibiotic use, and assess TTNB adequacy and diagnostic accuracy. Methods: We retrospectively analyzed consecutive patients referred for TTNB at AOUI Verona between March 2016 and March 2025, dividing them into two groups: before (Group A) and after (Group B) protocol adoption. Patients not punctured due to technical issues, lack of indication, or presumed pseudocystic nature were excluded. Results: Of 970 patients evaluated by EUS, 190 underwent TTNB (100 in Group A and 90 in Group B). Lesions were mainly located in the pancreatic body or tail, with a significantly larger size in Group B. The overall AE rate was 6.3%, significantly higher in Group A (11%) than in Group B (1%). Antibiotic prophylaxis was not associated with AE occurrence. TTNB adequacy was 88.9%, and diagnostic accuracy was 75.3%. Among 68 surgical cases, TTNB was accurate in 79.4%. Conclusions: A selective and standardized TTNB approach significantly reduces AEs while maintaining high adequacy and diagnostic accuracy
The Genetic Background and Culture Medium Only Marginally Affect the In Vitro Evolution of Pseudomonas aeruginosa Toward Colistin Resistance
Get PDFBackground/Objectives: Colistin is a last-resort treatment for Pseudomonas aeruginosa multidrug-resistant infections, but resistance to it is emerging. While colistin resistance in P. aeruginosa is typically associated with chromosomal mutations inducing lipopolysaccharide (LPS) aminoarabinosylation, other mutations unrelated to LPS modifications have been proposed to influence the extent of colistin resistance. Here, we examined whether the genetic background and culture conditions affect the evolution of high-level colistin resistance in this bacterium. Methods: We performed in vitro evolution experiments in the presence or absence of increasing colistin concentrations with two phylogenetically distant reference strains in a standard laboratory medium and in two media mimicking P. aeruginosa growth during lung or systemic infections. Resistance-associated mutations were identified by comparative genomics, and the role of selected mutated genes was validated by allele replacement, deletion, or conditional mutagenesis. Results: Most colistin-resistant mutants carried mutations in genes belonging to four functional groups: two-component systems controlling LPS aminoarabinosylation (PmrAB, PhoPQ), LPS biosynthesis, the production of the polyamine norspermidine, and fatty acid metabolism. No mutation was exclusively and invariably associated with a specific strain or medium. We demonstrated that norspermidine is detrimental to the acquisition of colistin resistance upon PmrAB activation and that impaired fatty acid biosynthesis can promote colistin resistance, even if it increases susceptibility to other antibiotics. Conclusions: The evolution of colistin resistance in P. aeruginosa appeared to be only marginally affected by the genetic background and culture conditions. Notably, mutations in fatty acid biosynthetic genes represent a newly identified genetic determinant of P. aeruginosa colistin resistance, warranting further investigation in clinical isolates
Corpus Analysis of News Discourse
No full textThis paper addresses historical and contemporary news discourse from a Corpus
Linguistics (CL) perspective and with English in focus. I first illustrate the main changes undergone by news discourse since its early development to the present time, particularly with reference to “who” has been conveying news, namely its producers and purveyors, and to “how” news has been conveyed, namely its modes and channels. Special attention is dedicated to the interre-
lations between independent and governmentally/institutionalized journalism. Then I address general-purpose corpora comprising news discourse, among other genres, and special-purpose corpora and archives/databases featuring exclusively journalistic texts. In so doing, I also illustrate the main directives of CL research in historical and contemporary news discourse
The role of Language Centres in the development of EMI: Pedagogical procedures and perspectives
No full textEMI (English-Medium Instruction) refers to the use of English to teach academic subjects in contexts where the first language is not English. As one of the consequences of the internationalisation process of higher education, EMI can improve the global visibility of universities, attract a diverse student body and prepare graduates for their future careers. Despite its potential, EMI poses challenges to both lecturers and students, including language barriers, increased complexity in dealing with intercultural settings, and the need to make pedagogical adjustments to lecturers’ teaching styles. At the academic level, Language Centres have become increasingly important in providing support to teachers and students, in the form of training programmes and language courses, to help them meet these challenges. Drawing on recent research and informed by both literature and practical experience, this article explores how Language Centres may support teachers and students by providing practical tools to improve their pedagogical effectiveness and self-awareness. It also considers the importance of integrating elements of intercultural communication and adopting technologies to facilitate classroom interactions in increasingly multicultural contexts. For these reasons, two structured self-assessment tools are proposed as a systematic and accessible means for lecturers and students to engage in continuous reflection, increasing both linguistic self-monitoring and pedagogical awareness. The study concludes with recommendations for building inclusive learning ecologies and outlines future research directions in the evolving field of EMI
The effect of GRC Systems on Environmental Decoupling
No full textThis study investigates the influence of Governance, Risk, and Compliance (GRC) systems on the phenomenon of environmental decoupling, defined as the misalignment between firms’ environmental disclosure and actual performance. Drawing on agency and stakeholder theory, we examine whether board oversight of climate risks, crisis management systems, and an-ti‐corruption procedures reduce the disclosure–performance gap. Using a panel of 924 Europe-an companies across 20 countries and 18 industries (2015–2024), we find that board oversight and crisis management systems are positively associated with environmental decoupling, suggesting symbolic rather than substantive governance. In contrast, anti‐corruption procedures significantly mitigate decoupling, highlighting the importance of binding and enforceable governance mechanisms. The findings contribute to the debate on the credibility of sustainabil-ity reporting and offer implications for scholars, practitioners, and regulators seeking to strengthen the alignment between communication and operational realities
Il canto delle parole. Note marginali sul dialogo-duello tra Luciano Berio e Italo Calvino
No full textBerio e Calvino vengono confrontati in ase a come lavorano con le parole, le note musicali e gli scritti letterari in riferimento soprattutto a La vera storia, composizione di teatro musicale che hanno scritto insieme e, poi, in riferimento alla rottura del loro rapporto rispetto all'altra opera cui hanno collaborato, Un re in ascolto
Le principali problematiche poste dai criteri di priorità nell’esercizio (obbligatorio) della azione penale
No full textIl contributo affronta le principali problematiche costituzionali connesse alle scelte sui criteri di priorità nell'esercizio della azione penal
ASO Visual Abstract: Operative and Oncological Outcomes of Vascular Resection and Reconstruction for Perihilar Cholangiocarcinoma
No full textOperative and Oncological Outcomes of Vascular Resection and Reconstruction for Perihilar Cholangiocarcinom
La liquidazione giudiziale di società cancellata
No full textIl contributo considera le implicazioni di diritto concorsuale e di diritto societario legate all'insolvenza della società cancellata e dell'impresa cessat
Korea, Japan, Europe, and the United States: Why are guidelines for gastric cancer different?
No full textAs a global health concern, gastric cancer management has been systematized by individual countries and regions into regimented guidelines. To explore international differences, we examined the guidelines of Korea, Japan, Europe, and the United States. Guidelines are created by experts in the field, focusing on evidence-based recommendations to standardize and improve patient care, but the methodology for guideline creation, incorporation of new innovations, and review differs significantly. National and regional differences within the guidelines are apparent, stemming from various factors including local incidence, stage, presentation, patient preferences, and governmental influences. Differences include the use of neoadjuvant chemotherapy, criteria for endoscopic resection, and extent of lymphadenectomy. Nonetheless, fundamental treatment principles remain universal, and the goals of national guidelines are uniform: standardizing patient care, providing the highest quality treatments, incorporating cutting-edge clinical trial results, and consensus in guidelines to help formulate governmental policies. This review highlights how the guidelines are constructed, the unique elements of each guideline, how they differ, and why they differ