644 research outputs found
Prophylactic Total Gastrectomy: Techniques
No full textProphylactic total gastrectomy (PTG) represents the treatment of choice for carriers of pathogenetic CDH1 mutations in the context of hereditary diffuse gastric cancer (HDGC) syndrome. PTG consists in a total gastrectomy: it could be performed both through open or minimally invasive surgery depending on the surgeon’s expertise, but the higher rate of postoperative complications reported after laparoscopic procedures should be taken into account especially in the specific context of a prophylactic surgery. The intra-operative control of resection margins with frozen section is mandatory to exclude residual of gastric mucosa. D1/D1+ is suggested but D2 dissection can be considered. Roux-en-Y reconstruction is preferred. Long-term follow-up shows a good quality of life after this type of surgery despite the weight loss
I FUNGHI IPOGEI RACCOLTI INSIEME A TUBER AESTIVUM
No full textLo studio è stato condotto nell’anno 2008, presso l’Azienda Urbani Tartufi s.r.l (Santa Anatolia di Narco, Perugia), in occasione dello stage previsto dal Master in Micologia Agroalimentare organizzato dall’Università degli Studi di Bologna
Seismic vulnerability assessment of existing Italian hospitals: The case study of the national cancer institute “G. Pascale foundation” of Naples
No full textIntroduction: A large portion of the Italian built heritage is characterized by a significant seismic vulnerability since many structures were designed with outdated criteria, i.e., without accounting for seismic actions. This aspect is particularly relevant for strategic structures and infrastructures, whose functionalities are crucial in case of seismic events. Objective: The main aim of the present paper is to share the key findings related to the seismic vulnerability assessment of the National Institute for the Study and Treatment of Cancer (IRCCS) “Giovanni Pascale Foundation” in Naples. In particular, the main evidences could be easily extended to existing hospitals realized in the last century, with the main reference to: construction techniques, quality of constructional material, overt and convert seismic vulnerabilities and possible intervention strategies for risk mitigation. Methods: In the present paper, the assessment methodologies adopted for such a strategic hospital complex are provided, focusing in particular on: i. preliminary research of original design documents and on-site investigation for determining constructional details; ii. material tests on structural elements; iii. vulnerability seismic assessment by means of non-linear FE analyses (push-over and capacity spectrum method); iv. recommendations on retrofitting measures and cost estimations. Results: The conducted study puts into clear evidence the inadequacy of the investigated buildings to face the design seismic actions provided by the current Italian code and thus showed the significant seismic vulnerabilities affecting the Institute “G. Pascale Foundation” of Naples. Among these, particular attention has also been focused on the so-called intrinsic vulnerabilities, namely the ones not measurable explicitly and interesting non-structural elements (e.g., connection of shelves, stained glass windows, facilities, etc.). Conclusion: The presented case study highlights the strong seismic vulnerability affecting structures realized in the past century, despite their strategic functions. On the whole, the examined structures can be considered as representative of this building typology, and the adopted calculation criteria, as well as the assumptions of the assessment process, could be easily extended to similar case studies
Elderly at time of COronaVIrus disease 2019 (COVID-19): possible role of immunosenescence and malnutrition
No full textThe unprecedented COVID-19 pandemic is rapidly and unpredictably evolving and the majority of deaths are occurring in older people. A partial description of the magnitude of the scenario is provided by numbers and statistics, which probably underestimate the ongoing tragedy. In the present opinion paper, we have focused our attention on the evidence of the relationship among malnutrition, immunosenescence, and the higher morbidity and mortality in elderly patients. In particular, we propose the intriguing hypothesis that correction of nutritional deficits may attenuate the age-dependent alterations of the innate and adaptive immune system which participate in the increased susceptibility and worse outcome observed in the elderly COVID-19 patients
A Simplified Procedure for Seismic Risk Assessment of Existing Italian School Buildings
No full textSeismic risk assessment of school building heritage is a relevant topic in Italy, as most of them were built several years ago and were not designed using anti-seismic criteria. In addition, a large portion of existing school structures is characterized by a bad state of conservation, mainly due to the lack of maintenance and structure deterioration. Seismic risk evaluation of these buildings has to take into account the combination of seismic hazard, structural vulnerability and exposure considering the mainly characteristics. In the last decades, to this aim, many methods have been introduced, which differ from each other by the refinement of the applied methodology of analysis. At national level, in order to provide a tool to solve this problem, a specific database called “Sistema Nazionale delle Anagrafi dell’Edilizia Scolastica (SNAES)”, which consists of a census of the entire school building heritage, has been developed. Such database contains many parameters related to the consistency, degradation state and functionality. In this paper, starting from the existing methods and considering the parameters and the information actually present in the school building files of SNAES, a simplified and fast methodology for assessing the seismic risk of both masonry and reinforced concrete schools is provided. This procedure can be applied to a large number of structures and in this paper it is analyzed with reference to a sample of school buildings located in the Caserta Province
Integration of energy commodity prices in US and in Europe
No full textThis paper analyzes the price dynamics of crude oil, natural gas and
electricity and investigates the relationship between them. Given the
regional nature of energy commodity markets the analysis is performed
separately on the US and the Europe market. The aim of the paper
is to measure the level of integration existing within each energy com-
modity market using an ECM framework. To measure the relationship
existing between oil, gas and electricity represents a crucial issue for
risk management, given the role correlation plays in the pricing of
derivative contracts
Assessing the effective connectivity of premotor areas during real vs imagined grasping: a DCM-PEB approach
No full textThe parieto-frontal circuit underlying grasping, which requires the serial involvement of the anterior intraparietal area (aIPs) and the ventral premotor cortex (PMv), has been recently extended enlightening the role of the dorsal premotor cortex (PMd). The supplementary motor area (SMA) has been also suggested to encode grip force for grasping actions; furthermore, both PMd and SMA are known to play a crucial role in motor imagery. Here, we aimed at assessing the dynamic couplings between left aIPs, PMv, PMd, SMA and primary motor cortex (M1) by comparing executed and imagined right-hand grasping, using Dynamic Causal Modelling (DCM) and Parametrical Empirical Bayes (PEB) analyses. 24 subjects underwent an fMRI exam (3T) during which they were asked to perform or imagine a grasping movement visually cued by photographs of commonly used objects. We tested whether the two conditions a) exert a modulatory effect on both forward and feedback couplings among our areas of interest, and b) differ in terms of strength and sign of these parameters. Results of the real condition confirmed the serial involvement of aIPs, PMv and M1. PMv also exerted a positive influence on PMd and SMA, but received an inhibitory feedback only from PMd. Our results suggest that a general motor program for grasping is planned by the aIPs-PMv circuit; then, PMd and SMA encode high-level features of the movement. During imagery, the connection strength from aIPs to PMv was weaker and the information flow stopped in PMv; thus, a less complex motor program was planned. Moreover, results suggest that SMA and PMd cooperate to prevent motor execution. In conclusion, the comparison between execution and imagery reveals that during grasping premotor areas dynamically interplay in different ways, depending on task demands
Interhemispheric interplay between the left and right premotor cortex during grasping as assessed by dynamic causal modelling
No full text: Research on the contribution of the ipsilateral hemisphere to unilateral movements, and how it is mediated by transcallosal connections, has so far provided contradictory findings. By using dynamic causal modelling (DCM) and Parametric Empirical Bayes analyses applied to fMRI data, we sought to describe effective connectivity during pantomimed and imagined right-hand grasping within the grasping network, namely the anterior intraparietal sulcus, ventral and dorsal (PMd) premotor cortex, supplementary motor area and primary motor cortex (M1). The two-fold aim of the present work was to explore a) whether right and left parieto-frontal areas show similar connectivity couplings, and b) the interhemispheric dynamics between these regions across the two hemispheres. We detected a network architecture comparable across hemispheres during executed but not imagined grasping movements. Furthermore, during pantomimed grasping the interhemispheric crosstalk was mainly driven by premotor areas: we found an inhibitory influence from the right PMd toward the left premotor and motor areas and excitatory couplings between homologous ventral premotor and supplementary motor regions. Overall, our results support the view that dissociable components of unilateral grasping execution are encoded by a non-lateralized set of brain areas complexly intertwined by interhemispheric dynamics, whereas motor imagery obeys different principles
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