The subject of this paper are the Central European 'foreigners' in Istria between the middle of the nineteenth and the first part of the twentieth century. The article investigates the notion and ...identity of foreigners and their role in the social, intellectual and political development of the north-Adriatic peninsula in the concluding period of the Austrian sovereignty, until and immediately after the annexation by Italy. The people who settled in Istria during the period of Austrian sovereignty in the nineteenth century came from different areas of Central Europe, from Italy and the Balkan Peninsula. Some of them were foreigners and some were Austrian citizens, although citizenship was not the only attribute that measured the level of integration in the local society, especially in the multinational Habsburg Empire. Looking at the cultural and political developments in Istria, and analyzing the voluntary associations, the schools and the clergy, this article examines the presence of foreigners and the national composition and identifications in the little Adriatic peninsula. It explores the phenomena of negotiation and the capacity of the 'outsiders' from Central Europe (mainly Slovenes, Germans and Czechs) to deal with the local dynamics and patterns of nationalization, and verifies how Central Europeans identified with and integrated into Italian or Croatian national groups or produced separate channels of social and cultural interaction.
Background:
The fat-augmented latissimus dorsi (FALD) flap combines this pedicled flap with immediate intraoperative fat transfer. Very little is described concerning its inset at the mammary site. ...Our efforts have concentrated on seeking the best flap orientation and skin-adipose paddle shaping, to improve the aesthetic outcome and to obtain a complete breast reconstruction (BR) in one stage.
Methods:
A prospective clinical study was performed in patients who underwent BR with FALD flaps, between December 2020 and March 2022. Patients were randomly enrolled into two groups: ergonomic inset of the FALD flap with vertical orientation of the skin-adipose paddle (group A) and FALD flap with traditional horizontal paddle orientation (group B). The study’s endpoints were the evaluation of the aesthetic outcomes (from patients’ and surgeon’s perspectives) and complications.
Results:
Thirty-two FALD flaps (23 patients) were performed for group A, and 31 FALD flaps (25 patients) for group B. The two groups were homogeneous in terms of demographic and surgical data (
P
> 0.05). The overall complication rate was homogeneous among the groups, without statistically significant differences (
P
= 1.00). The surgeon’s assessments showed a statistically significant superior aesthetic outcome in group A regarding volume, symmetry, and shape (
P
< 0.05). Higher satisfaction was observed in group A patients, in terms of breast size (
P
< 0.00001), shape (
P
= 0.0049), and overall satisfaction (
P
= 0.00061).
Conclusions:
The ergonomic vertical FALD flap technique enables surgeons to perform one-stage total BR, with excellent breast projection and upper pole fullness. These refinements in flap shaping and molding reduced the need for further autologous fat transfer, obtaining a brilliant totally autologous BR without the need for microsurgical experience.
Aims. This study explores the metal enrichment signatures attributed to the first generation of stars (Pop III) in the Universe, focusing on the E-XQR-30 sample – a collection of 42 high ...signal-to-noise ratio spectra of quasi-stellar objects (QSOs) with emission redshifts ranging from 5.8 to 6.6. We aim to identify traces of Pop III metal enrichment by analyzing neutral gas in the interstellar medium of primordial galaxies and their satellite clumps, detected in absorption. Methods. To chase the chemical signature of Pop III stars, we studied metal absorption systems in the E-XQR-30 sample, selected through the detection of the neutral oxygen absorption line at 1302 Å. The O I line is a reliable tracer of neutral hydrogen and allowed us to overcome the challenges posed by the Lyman- α forest’s increasing saturation at redshifts above ∼5 to identify damped Lyman- α systems (DLAs). We detected and analyzed 29 O I systems at z ≥ 5.4, differentiating between proximate DLAs (PDLAs) and intervening DLAs. Voigt function fits were applied to obtain ionic column densities, and relative chemical abundances were determined for 28 systems. These were then compared with the predictions of theoretical models. Results. Our findings expand the study of O I systems at z ≥ 5.4 fourfold. No systematic differences were observed in the average chemical abundances between PDLAs and intervening DLAs. The chemical abundances in our sample align with literature systems at z > 4.5, suggesting a similar enrichment pattern for this class of absorption systems. A comparison between these DLA-analogs at 4.5 < z < 6.5 with a sample of very metal-poor DLAs at 2 < z < 4.5 shows in general similar average values for the relative abundances, with the exception of C/O, Si/Fe and Si/O which are significantly larger for the high- z sample. Furthermore, the dispersion of the measurements significantly increases in the high-redshift bin. This increase is predicted by the theoretical models and indicates a potential retention of Pop III signatures in the probed gas. Conclusions. This work represents a significant advancement in the study of the chemical properties of highly neutral gas at z ≥ 5.4, shedding light on its potential association with the metal enrichment from Pop III stars. Future advancements in observational capabilities, specifically high-resolution spectrographs, are crucial for refining measurements and addressing current limitations in the study of these distant absorption systems.
Severe complicated intra-abdominal sepsis (SCIAS) has an increasing incidence with mortality rates over 80% in some settings. Mortality typically results from disruption of the gastrointestinal ...tract, progressive and self-perpetuating bio-mediator generation, systemic inflammation, and multiple organ failure. A further therapeutic option may be open abdomen (OA) management with negative peritoneal pressure therapy (NPPT) to remove inflammatory ascites and attenuate the systemic damage from SCIAS, although there are definite risks of leaving the abdomen open whenever it might possibly be closed. This potential therapeutic paradigm is the rationale being assessed in the Closed Or Open after Laparotomy (COOL trial) ( https://clinicaltrials.gov/ct2/show/NCT03163095 ). Initially, the COOL trial received Industry sponsorship; however, this funding mandated the use of a specific trademarked and expensive NPPT device in half of the patients allocated to the intervention (open) arm. In August 2022, the 3 M/Acelity Corporation without consultation but within the terms of the contract canceled the financial support of the trial. Although creating financial difficulty, there is now no restriction on specific NPPT devices and removing a cost-prohibitive intervention creates an opportunity to expand the COOL trial to a truly global basis. This document describes the evolution of the COOL trial, with a focus on future opportunities for global growth of the study.
The COOL trial is the largest prospective randomized controlled trial examining the random allocation of SCIAS patients intra-operatively to either formal closure of the fascia or the use of the OA with an application of an NPPT dressing. Patients are eligible if they have free uncontained intraperitoneal contamination and physiologic derangements exemplified by septic shock OR severely adverse predicted clinical outcomes. The primary outcome is intended to definitively inform global practice by conclusively evaluating 90-day survival. Initial recruitment has been lower than hoped but satisfactory, and the COOL steering committee and trial investigators intend with increased global support to continue enrollment until recruitment ensures a definitive answer.
OA is mandated in many cases of SCIAS such as the risk of abdominal compartment syndrome associated with closure, or a planned second look as for example part of "damage control"; however, improved source control (locally and systemically) is the most uncertain indication for an OA. The COOL trial seeks to expand potential sites and proceed with the evaluation of NPPT agnostic to device, to properly examine the hypothesis that this treatment attenuates systemic damage and improves survival. This approach will not affect internal validity and should improve the external validity of any observed results of the intervention.
National Institutes of Health ( https://clinicaltrials.gov/ct2/show/NCT03163095 ).
To compare autologous fat transfer (AFT), injections of reabsorbable polylactic acid (PLA) and non-reabsorbable polyacrylamide hydrogel (PAAG) filler materials for the treatment of HIV-related facial ...lipoatrophy.
Eligible individuals with enough residual subcutaneous fat in the abdomen or in the dorso-cervical region were offered AFT surgery. Other individuals were blindly assigned to two different surgical teams, who administered a set of PLA or PAAG injections every 4 weeks. The primary endpoint was the measurement of Bichat's fat pad region, determined by the result of dermal plus subcutaneous thickness. Secondary endpoints included body image evaluation (determined by ABCD questionnaire), facial aesthetic satisfaction (determined by Visual Analogue Scale), and aesthetic pre- and post-picture comparisons by independent reviewers. All variables were measured at baseline and at 24 weeks after the last treatment session.
Twenty-four individuals received AFT and 35 were selectively randomized to PLA (20) or PAAG (15) infiltrations. PLA and PAAG groups received a mean of 5 and 6 injections respectively (P = NS). The mean change in dermal and subcutaneous thickness was 3.3 +/- 4.1 mm, 3.5 +/- 4.0 mm; 2.1 +/- 3.0 mm (P = 0.687), respectively. The mean change in ABCD score result was poorer in the AFT arm, but there were no other differences in other measured factors. Four serious adverse events were documented in the AFT arm only.
All three interventional techniques were highly effective in improving the aesthetic satisfaction of the patients. Longer follow-up is necessary to determine the most durable and suitable treatment.
This study explores the metal enrichment signatures attributed to the first generation of stars (PopIII) in the Universe, focusing on the E-XQR-30 sample. We aim to identify traces of Pop III metal ...enrichment by analyzing neutral gas in the interstellar medium of primordial galaxies and their satellite clumps, detected in absorption. To chase the chemical signature of PopIII stars, we studied metal absorption systems in the E-XQR-30 sample, selected through the detection of the OI absorption line at 1302A. The OI line is a reliable tracer of HI and allowed us to overcome the challenges posed by the Lyman-\(\alpha\) forest's increasing saturation at redshifts above \(\sim5\) to identify Damped Lyman-\(\alpha\) systems (DLA). We detected and analyzed 29 OI systems at \(z\geq5.4\), differentiating between proximate DLAs (PDLA) and intervening DLAs. Voigt function fits were applied to obtain ionic column densities, and relative chemical abundances were determined for 28 systems. These were then compared with the predictions of theoretical models. Our findings expand the study of OI systems at \(z\geq5.4\) fourfold. No systematic differences were observed in the average chemical abundances between PDLAs and intervening DLAs. The chemical abundances in our sample align with literature systems at \(z>4.5\), suggesting a similar enrichment pattern for this class of absorption systems. A comparison between these DLA-analogues at \(4.5<z<6.5\) with a sample of very metal-poor DLAs at \(2<z<4.5\) shows in general similar average values for the relative abundances, with the exception of C/O, Si/Fe and Si/O which are significantly larger for the high-\(z\) sample. Furthermore, the dispersion of the measurements significantly increases in the high-redshift bin. This increase is predicted by the theoretical models and indicates a potential retention of PopIII signatures in the probed gas. (Abridged)
