The assessment of the vulnerability of a site to tsunami events should take into consideration the geomorphological setting, which is strongly determined by the stratigraphic framework of the area. ...Lampedusa island is located in the central portion of the Sicilian Channel (Mediterranean Sea, Italy), where a significant incidence of tsunamis (with wave runup above 15 m) caused by earthquakes and submarine landslides has been historically documented. This work shows the geomorphological and stratigraphic differences between the western and south-eastern sectors of Lampedusa island. This update to the geological characterization of the island was used to create 3D flooding maps according to runup steps of 5 m, 10 m, and 15 m, thus showing a homogeneous involvement of the south-eastern sector of Lampedusa. Furthermore, our study aims to provide a geomorphological-stratigraphic base for a mathematical-statistical model to create coastal flooding maps due to tsunami waves. As such, this tool is useful for evaluation of strategic infrastructure for the security of the island and the improvement of risk management in civil protection.
Tectonic, paleoenvironmental, and paleoclimatic unstable conditions preceding the onset of the Messinian Salinity Crisis (MSC) highly affected marine life. Changes in calcareous plankton association ...are overall registered in the Mediterranean. They consist of a general transition from abundant and well-diversified planktonic associations to strictly oligotypic assemblages that precede their total disappearance at the onset of evaporitic precipitation. In this work, an accurate quantitative analysis of calcareous plankton, both foraminifers and nannofossils, has been carried out in the Torrente Vaccarizzo Section of Sicily (southern Italy). The aim is to independently define a chronostratigraphic pattern of bioevents preceding the MSC in the absence of magnetostratigraphic or radiometric constraints. The fluctuating abundance of the genus Orbulina fits well with the 100 ky Eccentricity maxima, and it is successfully applied to build an astronomically calibrated age-model for the section. On this basis, all the biohorizons have been recalibrated and discussed with regard to the previous literature. Abundant influxes of selected species demonstrated to be of local significance since they are highly affected by paleoenvironmental and paleoclimatic conditions. A chronological sequence of foraminifer and nannofossil events marks the onset of the MSC with a derived age of 5.957 My, which agrees well with previous findings from other Mediterranean sections. This methodology and the new biostratigraphic events may be useful for future studies on pre-evaporitic successions of the Mediterranean.
The quantitative analysis of the calcareous nannofossil content yield in the 600 m thick succession drilled at ODP Site 1123 (offshore New Zealand), considered as a reference section for the Southern ...Ocean region, allowed the recognition of 43 bioevents distributed along the last 20 Myr. The correlation with the excellent magnetostratigraphic record resulted in the attribution of numerical ages for the position of the detected horizons. Many of the marker species used in previous zonation were detected also at ODP Site 1123, but others revealed to be absent or of scarce applicability. On the other hand, the good applicability of additional events was verified and proved to be useful for the biostratigraphic subdivision and correlation. The obtained average bio- and chronostratigraphic resolution is about 0.6 Myr along the whole section, which increases to about 0.3 in the Pliocene–Holocene time interval. The final result is a detailed southern mid-to-high latitude nannofossil biochronology for the last 20 Myr, which confirms that the ODP Site 1123 succession represents a reference section for the Southern Ocean.
Highlight ► Markers of immuno-senescence such as changes in T cell activation markers, memory and CD56+ cell counts relate more to a senior’s mood state than to aerobic power or strength.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPUK
Abstract Background Particulate contamination due to infusion therapy (administration of parenteral nutrition and medications) carries a potential health risk for infants in neonatal intensive care ...units (NICUs). This particulate consists of metals, drug crystals, glass fragments, or cotton fibers and can be generated by drug packaging, incomplete reconstitution, and chemical incompatibilities. In-line filters have been shown to remove micro-organisms, endotoxin, air, and particles in critically ill adults and older infants, but its benefits in newborn remain to be demonstrated. Moreover, 50% of inflammatory episodes in the setting of NICUs are blood culture-negative. These episodes could be partly related to the presence of particles in the infusion lines. Methods A multicenter randomized single-blind controlled trial was designed. All infants admitted to NICUs for which prolonged infusion therapy is expected will be enrolled in the study and randomized to the Filter or Control arm. All patients will be monitored until discharge, and data will be analyzed according to a “full analysis set.” The primary outcome is the frequency of patients with at least one sepsis-like event, defined by any association of suspected sepsis symptoms with a level of c-reactive protein (CRP) > 5 mg/L in a negative-culture contest. The frequency of sepsis, phlebitis, luminal obstruction, and the duration of mechanical ventilation and of catheter days will be evaluated as secondary outcomes. The sample size was calculated at 368 patients per arm. Discussion This is the first multicenter randomized control trial that compares in-line filtration of parenteral nutrition and other intravenous drugs to infusion without filters. Sepsis-like events are commonly diagnosed in clinical practice and are more frequent than sepsis in a positive culture contest. The risk of these episodes in the target population is estimated at 30–35%, but this data is not confirmed in the literature. If the use of in-line filters results in a significant decrease in sepsis-like events and/or in any other complications, the use of in-line filters in all intravenous administration systems may be recommended in NICUs. Trial registration ClinicalTrials.gov, NCT05537389, registered on 12 September 2022 ( https://classic.clinicaltrials.gov/ct2/show/results/NCT05537389?view=results ).
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Neoadjuvant chemotherapy (NAC) has a profound impact on surgical management of breast cancer. For this reason, the Italian Association of Breast Surgeons (ANISC) promoted the third national Consensus ...Conference on this subject, open to multidisciplinary specialists.
The Consensus Conference was held on-line in November 2022, and after an introductory session with five core-team experts, participants were asked to vote on eleven controversial issues, while results were collected in real-time with a polling system.
A total of 164 dedicated specialists from 74 Breast Centers participated. Consensus was reached for only three of the eleven issues, including: 1) the indication to assess the response with Magnetic Resonance Imaging (79 %); 2) the need to re-assess the biological factors of the residual tumor if present (96 %); 3) the possibility of omitting a formal axillary node dissection for cN1 patients if a pathologic Complete Response (pCR) was confirmed with analysis of one or more sentinel lymph nodes (82 %). The majority voted in favor of mapping both the breast and nodal lesions pre-NAC (59 %), and against the omission of sentinel lymph node biopsy in cN0 patients in the case of pathologic or clinical Complete Response (69 %). In cases of cT3/cN1+ tumors with pCR, only 8 % of participants considered appropriate the omission of Post-Mastectomy Radiation Therapy.
There is still a wide variability in surgical approaches after NAC in the “real world”. As NAC is increasingly used, multidisciplinary teams should be attuned to conforming their procedures to the rapid advances in this field.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPUK, ZAGLJ, ZRSKP
Purpose
Proper evaluation of polyphenols intake at the population level is a necessary step in order to establish possible associations with health outcomes. Available data are limited, and so far no ...study has been performed in people with diabetes. The aim of this work was to document the intake of polyphenols and their major food sources in a cohort of people with type 2 diabetes and in socio-demographic subgroups.
Methods
We studied 2573 men and women aged 50–75 years. Among others, anthropometry was measured by standard protocol and dietary habits were investigated by food frequency questionnaire (EPIC). The intake of polyphenols was evaluated using US Department of Agriculture and Phenol-Explorer databases.
Results
The mean total polyphenol intake was 683.3 ± 5.8 mg/day. Non-alcoholic beverages represented the main food source of dietary polyphenols and provided 35.5% of total polyphenol intake, followed by fruits (23.0%), alcoholic beverages (14.0%), vegetables (12.4%), cereal products and tubers (4.6%), legumes (3.7%) and oils (2.1%); chocolate, cakes and nuts are negligible sources of polyphenols in this cohort. The two most important polyphenol classes contributing to the total intake were flavonoids (47.5%) and phenolic acids (47.4%). Polyphenol intake increased with age and education level and decreased with BMI; furthermore, in the northern regions of Italy, the polyphenol intake was slightly, but significantly higher than in the central or southern regions.
Conclusions
The study documents for the first time the intake of polyphenols and their main food sources in people with diabetes using validated and complete databases of the polyphenol content of food. Compared with published data, collected in people without diabetes, these results suggest a lower intake and a different pattern of intake in people with diabetes.
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DOBA, EMUNI, FIS, FSPLJ, FZAB, GEOZS, GIS, IJS, IMTLJ, IZUM, KILJ, KISLJ, MFDPS, NLZOH, NUK, OBVAL, OILJ, PILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, SIK, UILJ, UKNU, UL, UM, UPUK, VKSCE, VSZLJ, ZAGLJ
The aim of the COGNIDAGE study was to examine the association between 25(OH)D and cognitive status in a group of elderly patients with vitamin D deficiency and high burden of comorbidities attending ...Geriatric Outpatient Clinics.
We studied the relationship between 25(OH)D and cognitive functions taking into account comorbidities and cognitive functions assessed by MMSE (Mini Mental State Examination), CDT (Clock Drawing Test) and CIRS (Cumulative Illness Rating Scale), in 132 consecutive elderly patients with low levels of 25(OH)D (<10 ng/ml) compatible with the condition of vitamin deficiency. The association among 25(OH)D levels, MMSE score, CDT score and CIRS scores were analyzed using Pearson correlation. All the elderly patients received an adequate vitamin D supplementation and were reassessed after 6 months.
At baseline, mean MMSE and CIRS scores were: 21.8+5.56 and 2.96 +1.63 respectively. Mean CDT score was 3,66+-2.05. No associations were found between 25(OH)D levels and global cognitive function. A significant relationship was observed between the total CIRS score and 25(OH)D levels (r=0.305; p=0.000) as well as between total CIRS score and MMSE (r=-0.375; p=0.000). After 6 months, 83.9 % had 25(OH)D levels >20 ng/ml. Mean MMSE and CDT scores were 22.20+-5.76 and 3.90+-2.06 respectively. There was no significant correlation among 25(OH)D, MMSE and CDT scores while a significant correlation was found between 25(OH)D and CIRS- severity score (r=0.275; p=0.001) and between MMSE and total CIRS scores (r=-0.247; p=0.005 for CIRS-comorbidities; r=-0.184; p=0.04 for CIRS-severity). A post hoc evaluation on two subgroups of elderly patients (the first with vitamin D deficiency without cognitive impairment, the second with vitamin D deficiency and dementia) showed a statistically significant difference (p=0.00001) regarding the CIRS-comorbidities scores.
In our cohort of elderly patients with a high burden of comorbidities, 25(OH)D low levels (<10 ng/ml) are not associated with MMSE and CDT scores. There is no statistically difference among the levels of 25(OH)D and MMSE and CDT scores after 6 months. The strong correlation we found regarding CIRS-comorbidities in the two sub-groups suggests that vitamin D deficiency may play a role in promoting cognitive impairment only with comorbidities.
Non-invasive Doppler ultrasonographic study of cerebral arteries transcranial Doppler(TCD) has been extensively applied on both outpatient and inpatient settings. It is performed placing a ...low-frequency(≤ 2 MHz) transducer on the scalp of the patient over specific acoustic windows, in order to visualize the intracranial arterial vessels and to evaluate the cerebral blood flow velocity and its alteration in many different conditions. Nowadays the most widespread indication for TCD in outpatient setting is the research of right to left shunting, responsable of so called "paradoxical embolism", most often due to patency of foramen ovale which is responsable of the majority of cryptogenic strokes occuring in patients younger than 55 years old. TCD also allows to classify the grade of severity of such shunts using the so called "microembolic signal grading score". In addition TCD has found many useful applications in neurocritical care practice. It is useful on both adults and children for day-to-day bedside assessment of critical conditions including vasospasm in subarachnoidal haemorrhage(caused by aneurysm rupture or traumatic injury), traumatic brain injury, brain stem death. It is used also to evaluate cerebral hemodynamic changes after stroke. It also allows to investigate cerebral pressure autoregulation and for the clinical evaluation of cerebral autoregulatory reserve.
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