The aim of the study was to analyze the characteristics of implant dentistry claims in Italy based on insurance company technical reports for malpractice claims.
One hundred twenty-one technical ...reports of cases of professional malpractice in implant dentistry between 2006 and 2010 were included in the study. Data included the sex and age of the patient and dentist, the kind of negligence claimed, and the damages awarded as a consequence of the alleged misconduct.
Of the cases examined in this study, 9.9% went to court. The patients were female in 73.6% of the cases. Most of the technical errors were committed during implant insertion (82.6%). In 50.4% of cases, the technical error involved the surrounding structures, such as damage to the inferior alveolar nerve (32.2%) or the lingual nerve (2.5%), invasion of the maxillary sinus (9.1%), or pulpal dental necrosis in adjacent teeth (6.6%). Incomplete clinical documentation was apparent in 54.5% of cases. In 9.9% of cases, a civil suit had already been filed before a visit, and medicolegal advice from the insurance expert had been procured.
The discrepancy between the total number of cases examined and those that went to court indicates that implant malpractice claims in Italy are most often settled out of court. The large number of intraoperative errors seen and the high proportion of injuries to surrounding structures suggest that implant dentists would benefit from further specific training. Also, clinical documentation vital to a defense against any claims relating to professional misconduct was incomplete or absent in more than half of the cases.
Cutaneous squamous cell carcinoma (cSCC), a non-melanoma skin cancer, is a keratinocyte carcinoma representing one of the most common cancers with an increasing incidence. cSCC could be in situ ...(e.g., Bowen's disease) or an invasive form. A significant cSCC risk factor is advanced age, together with cumulative sun exposure, fair skin, prolonged immunosuppression, and previous skin cancer diagnoses. Although most cSCCs can be treated by surgery, a fraction of them recur and metastasize, leading to death. cSCC could arise de novo or be the result of a progression of the actinic keratosis, an in situ carcinoma. The multistage process of cSCC development and progression is characterized by mutations in the genes involved in epidermal homeostasis and by several alterations, such as epigenetic modifications, viral infections, or microenvironmental changes. Thus, cSCC development is a gradual process with several histological- and pathological-defined stages. Dermoscopy and reflectance confocal microscopy enhanced the diagnostic accuracy of cSCC. Surgical excision is the first-line treatment for invasive cSCC. Moreover, radiotherapy may be considered as a primary treatment in patients not candidates for surgery. Extensive studies of cSCC pathogenic mechanisms identified several pharmaceutical targets and allowed the development of new systemic therapies, including immunotherapy with immune checkpoint inhibitors, such as Cemiplimab, and epidermal growth factor receptor inhibitors for metastatic and locally advanced cSCC. Furthermore, the implementation of prevention measures has been useful in patient management.
Paraneoplastic pemphigus is a rare autoimmune skin disease that is always associated with a neoplasm. Usually, oral, skin, and mucosal lesions are the earliest manifestations shown by paraneoplastic ...pemphigus patients. The pathogenesis of paraneoplastic pemphigus is not yet completely understood, although some immunological aspects have been recently clarified. Because of its rarity, several diagnostic criteria have been proposed. Besides, several diagnostic procedures have been used for the diagnosis, including indirect immunofluorescence, direct immunofluorescence, and ELISA. We reviewed the most recent literature, searching on PubMed "paraneoplastic pemphigus". We included also papers in French, German, and Spanish. We found 613 papers for "paraneoplastic pemphigus". Among them, 169 were review papers. Because of its varying clinical features, paraneoplastic pemphigus still represents a challenge for clinicians. Furthermore, diagnosis and management of paraneoplastic pemphigus requires close collaboration between physicians, including dermatologist, oncologist, and otorhinolaryngologist.
This study aims at comparing two Italian case studies in relation to school children's plate waste and its implications, in terms of nutritional loss, economic cost, and carbon footprint.
Plate waste ...was collected through an aggregate selective weighting method for 39 days.
Children from the first to the fifth grade from four primary schools, two in each case study (Parma and Lucca), were involved.
With respect to the served food, in Parma the plate waste percentage was lower than in Lucca (p<0.001). Fruit and side-dishes were highly wasted, mostly in Lucca (>50%). The energy loss of the lunch meals accounted for 26% (Parma) and 36% (Lucca). Among nutrients, dietary fibre, folate and vitamin C, calcium and potassium were lost at most (26-45%). Overall, after adjusting for plate waste data, most of the lunch menus fell below the national recommendations for energy (50%, Parma; 79%, Lucca) and nutrients, particularly for fat (85%, Parma; 89%, Lucca). Plate waste was responsible for 19% (Parma) and 28% (Lucca) of the carbon footprint associated to the food supplied by the catering service, with starchy food being the most important contributor (52%, Parma; 47%, Lucca). Overall, the average cost of plate waste was 1.8 €/kg (Parma) and 2.7 €/kg (Lucca), accounting respectively for 4% and 10% of the meal full price.
A re-planning of the school meals service organisation and priorities is needed to decrease the inefficiency of the current system and reduce food waste and its negative consequences.
The aim of this work is to assess the structural, production, environmental, and economic impact of an increasing tax on climate change gas emissions related to milk production under the current CAP ...payment system. The analysis is performed using an Agent-Based Model (ABM) based on Positive Mathematical Programming (PMP). The integration between ABM and PMP makes it possible to simulate farmers’ strategies considering the interaction between them, the territorial specificity, and the heterogeneity of farms in the presence of little information on production costs. It also makes it possible to add a social and cultural perspective to the economic factors. The model is calibrated using FADN data for the Emilia-Romagna region (Italy) from the year 2020. The results show that farmers belonging to different age groups make decisions based on economic profitability, but also on their social and cultural background. To maximise their utility functions, farmers can opt for more efficient agricultural management practices that may result in the exchange of production factors, especially land. The overall impact penalises less efficient farms and agricultural production with higher negative externalities.
The 2014-2020 Common Agricultural Policy (CAP) reform defines new rules for farmers including maintenance of the ecological focus area (EFA). Sustainability is also a requirement to meet consumer ...expectations and a competitive advantage for firms. This paper aims to evaluate the farmers' intention to implement sustainable practices related to the EFA measure and to the private sustainability schemes proposed by the food industry. The Theory of Planned Behaviour (TPB) was applied on a sample of durum wheat producers to analyse intentions 1) to maintain 7% of the arable land as an EFA, and 2) to implement the private sustainability scheme. Structural equation modelling was applied to test for the relative importance of intention determinants. The farmers' attitude and past behaviour positively affect intentions to implement the EFA, while perceived behavioural control and attitudes predict intentions to adopt the private sustainability scheme. These results suggest possible interventions that public authorities and supply chain leaders might implement to stimulate farmers' sustainable behaviours. Keywords. Common Agricultural Policy, durum wheat, theory of planned behaviour, sustainability, ecological focus area. JEL Codes. Q18, D22, Q01
Non-melanoma skin cancer (NMSC) is the most frequently diagnosed cancer in humans. Several different non-melanoma skin cancers have been reported in the literature, with several histologic variants ...that frequently cause important differential diagnoses with other cutaneous tumors basal cell carcinoma (BCC) is the most common malignant skin tumor, with different histologic variants that are associated with a greater or less aggressive behavior and that usually may be confused with other primitive skin tumors. Actinic keratosis, Bowen's disease, keratoacanthoma, and invasive squamous cell carcinoma (SCC) correspond to the other line of NMSC, that may have only local tumoral behavior, easy to treat and with local management (as in the case of actinic keratosis (AK), Bowen's disease, and keratoacanthoma) or a more aggressive behavior with a potential metastatic spread, as in case of invasive SCC. Therefore, histopathology serves as the gold standard during daily clinical practice, in order to improve the therapeutical approaches to patients with NMSC and to understand the distinct histopathological features of NMSC. Here, we reported the main pathological features of different non-melanoma skin cancers.
Improving the eco-efficiency of food systems is one of the major global challenges faced by the modern world. Short food supply chains (SFSCs) are commonly regarded to be less harmful to the ...environment, among various reasons, due to their organizational distribution and thus the shortened physical distance between primary producers and final consumers. In this paper, we empirically test this hypothesis, by assessing and comparing the environmental impacts of short and long food supply chains. Based on the Life Cycle Assessment (LCA) approach, we calculate eco-efficiency indicators for nine types of food distribution chains. The analysis is performed on a sample of 428 short and long food supply chains from six European countries. Our results indicate that, on average, long food supply chains may generate less negative environmental impacts than short chains (in terms of fossil fuel energy consumption, pollution, and GHG emissions) per kg of a given product. The values of eco-efficiency indicators display a large variability across analyzed chains, and especially across different types of SFSCs. The analysis shows that the environmental impacts of the food distribution process are not only determined by the geographical distance between producer and consumer, but depend on numerous factors, including the supply chain infrastructure.
Food production and therefore human diet are identified as important sources of environmental impact. Unhealthy and unsustainable diets with high intake of meat and low intake of plant‐based products ...are predominant worldwide. On the other hand, a balance between health and sustainability is necessary, since diets that are environmentally sustainable could lack essential macro‐ and micronutrients and result in nutrient deficiencies, non‐communicable diseases and malnutrition. The aim of this project was to investigate the nutritional adequacy and environmental impact of adults' diet by comparing current dietary habits and new alternative dietary scenarios. First, a systematic review was conducted following PRISMA guidelines to assess the environmental impact of current diets and sustainable dietary scenarios such as vegan, vegetarian, pescatarian, omnivorous and optimised dietary patterns worldwide. In the second part of the project, an optimisation study was conducted, based on a multi‐objective optimisation approach, with the purpose of creating the optimal diet based on nutritional and environmental constraints for the adult Italian population. The dietary scenarios of the optimised models were developed in accordance with the Italian food‐based dietary guidelines. Food consumption data was extracted from the INHES study and used as baseline diet. A clear evaluation of the current environmental impact because of diet and potential sustainable dietary scenarios globally is challenging. Finally, national food‐based guidelines should be adjusted by suggesting healthy and sustainable dietary recommendations in line with traditional eating habits and local food availability in order the desirable dietary shifts towards sustainability to be feasible.
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