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Robotic assisted total knee arthroplasty (RTKA) has shown improved knee alignment and reduced radiographic outliers. However, there remains debate on functional outcomes and patient-reported outcomes (PROMs). This study compares the 1-year clinical outcomes of a new imageless robotically assisted technique (ROSA Knee System, Zimmer Biomet, Warsaw, IN) with an imageless navigated procedure (NTKA, iAssist Knee, Zimmer, Warsaw, IN).The study is a retrospective analysis of prospectively collected data that compared the functional outcomes and PROMs of 50 imageless RTKA with 47 imageless NTKA at 1-year follow-up. Baseline characteristics, intraoperative and postoperative information were collected including complications, revisions, Knee Society Score (KSS), Knee injury and Osteoarthritis Outcome Score (KOOS) score, and Forgotten Joint Score (FJS-12). Radiographic analysis of preoperative and postoperative images evaluating hip-knee-ankle (HKA) angle was performed.There was no difference regarding baseline characteristics between the groups. Mean operative time was significantly longer in the RTKA group (122 min vs. 97 min; p 0.0001). Significant differences were reported for the "Pain" (85 [RTKA] vs 79.1 [NTKA]; p = 0.0283) subsection of the KOOS score. In addition, RTKA was associated with higher maximum range of motion (119.4° vs. 107.1°; p 0.0001) and better mean improvement of the arc of motion by 11.67° (23.02° vs. 11.36°; p 0.0001). No significant differences were noted for other subsections of KOOS, KSS, FJS-12, complications, or limb alignment at 1-year follow-up.Imageless RTKA was associated with longer surgical time, better pain perception and improved ROM at 12-month follow-up compared with NTKA. No significant differences were reported on other PROMs, complication rates and radiographic outcomes.III.

Malnutrition affects up to 75% of cancer patients and results from a combination of anorexia and metabolic dysregulation. Metabolic and nutritional abnormalities in cancer patients can lead to cachexia, a multifactorial syndrome characterized by involuntary loss of skeletal muscle mass, systemic inflammation and increased protein catabolism. Cancer cachexia negatively affects patients’ outcomes, response to anticancer treatments, quality of life, and survival. However, risk of malnutrition, and cachexia are still under-recognized in cancer patients. The Prevalence of Malnutrition in Oncology (PreMiO) study revealed that 51% of patients already had nutritional deficiencies at their first medical oncology visit. Here, we report the results of the subsequent retrospective, observational NUTRItional status at first medical oncology visit ON Clinical Outcomes (NUTRIONCO) study, aimed at assessing the impact of baseline nutritional and non-nutritional variables collected in the PreMiO study on the clinical outcomes of the same patients followed up from August 2019 to October 2021. We have highlighted a statistically significant association between baseline variables and patient death, rehospitalization, and disease progression at follow-up. We found a higher overall survival probability in the well-nourished general study population vs. malnourished patients (p < 0.001). Of major interest is the fact that patient stratification revealed that malnutrition decreased survival probability in non-metastatic patients but not in metastatic patients (p < 0.001). Multivariate analysis confirmed that baseline malnutrition (p = 0.004) and VAS score for appetite loss (p = 0.0104), in addition to albumin < 35 g/L (p < 0.0001) and neutrophil/lymphocyte ratio > 3 (p = 0.0007), were independently associated with the death of non-metastatic patients at follow-up. These findings highlight the importance of proactive, early management of malnutrition and cachexia in cancer patients, and in particular, in non-metastatic patients, from the perspective of a substantial improvement of their clinical outcomes.

Introduction: Paleontological heritage rarely receives the same legislative attention as archeological heritage. Part of the problem seems to be, at least in some contexts (e.g., Italy), the difficulty of acknowledging fossils as distinct assets from other cultural heritage objects and the lack of expertise among the administrative functionaries. This study aims to describe and test an objective analytic operational procedure that could allow for the assessment of the relevance of any fossiliferous site and its potential vulnerability in its present state.Methods: The estimations were obtained using several quantitative and qualitative parameters that could describe the probability of fossil recovery for each site (Pr) and the scientific and cultural interest of the locality (In). Each parameter has subcategories for better defining. The product of probability and interest results in the scientific value (S), generally expressed as a percentage (S*). The vulnerability index (V) of productive and active sites considers the use of the land (U) and the natural erosion (E). The parameters were thought to apply to any type of fossil locality. We tested the indexes on 22 localities (7 of which were with paleoichnological records and 15 with direct body-fossil evidence), all different from one another.Results: The results show that the proposed indexes well describe and characterize each locality. Most of the sites are moderately vulnerable (V between 1 and 3) except for large quarry sites (e.g., Pirro Nord, Italy and Solnhofen, Germany) whose vulnerability indexes fell in the maximum degree of risk.Discussion: The operational procedure presented here is a simple, objective, and remotely applicable method allowing paleontologists and non-expert personnel to categorize localities and, therefore, act as a base to plan actions in paleontological heritage management relative to territorial development and land use.

Background Non-operative treatment with immobilization is the gold-standard for paediatric clavicular fractures. Purpose of this study is to evaluate functional outcomes and efficacy of non-operative treatment of clavicular fractures in a succession of 131 children. Methods Between 2006 and 2012, we treated non-surgically 131 children for a clavicular fracture. All fractures have been classified according to Robinson classification. Clavicle shortening, range of movements and muscular strength through the Medical Research Council (MRC) scale were evaluated. To assess the outcomes, QuickDASH questionnaire, dividing the sample in 3 age-related group, was administered. Results The average follow-up was 26 months (8-84 months). Clavicle shortening at the time of injury occurred in 18 cases. All fractures reached union. Average time to union was 34 days. Mean time return to activity was 12.6 weeks. No cases of nonunion or delayed union were reported. Complications occurred in 21 cases. A shortening persisted in 2 cases. Only one patient had a slight functional restriction. Average QuickDASH score was 6.2±1.1 (range 4.3-9.4). All patients recovered to a MRC score of 5, except for one patient with a score of 4. Best QuickDASH scores were observed in the group aged under 8 years and in non-comminuted and lateral third fractures of the clavicle. Conclusions Observing results, clavicle fractures have a satisfactory clinical healing as shown by the good scores at QuickDASH and MRC scale. Younger children under 8 years can achieve the best results with a conservative treatment in terms of bone healing and activity level.

Background: In recent years, ultrasound has represented a new field of application for nursing. Point of Care UltraSound (POCUS) has been defined as an essential skill in the pre-hospital setting. The primary objective of this scoping review is to describe what are the main ultrasound techniques applied by nurses in the pre-hospital emergency setting. The secondary objective is to identify the different training courses implemented in the various studies selected to learn the necessary ultrasound skills. Methods: We conducted a scoping review. The following databases were consulted: PubMed, Cochrane Library, CINAHL and Google Scholar. For the extraction of useful articles, after identifying the inclusion and exclusion criteria, the PRISMA methodology was used, two authors independently analyzed the identified records, in the event of a conflict a third author intervened. Results: The identified records were initially 815. After the duplicates removal, and screening made by the researcher for inclusion criteria, 6 articles were retrieved for qualitative analysis. The most discussed topic is the recognition of pneumothorax: two studies analyzed a specific educational program on ultrasound for flight nurses, three articles evaluated the us of US to verify the correct insertion of devices, and two explored the skills of nurses in performing ultrasound scans. The first study stated that nurses had 86.4% accuracy, 66.6% sensitivity and 100% specificity in ultrasound using; in the second one, nurses had a sensitivity and specificity of 100% in non-traumatized patients and a sensitivity of 60% and a specificity of 93% in trauma patients. Conclusions: Despite the methodological differences of the selected records, the main ultrasound techniques implemented by nurses in the Emergency Medical Service (EMS) are Focused Assessment with Sonography for Trauma (FAST), Extendend Focused Assessment with Sonography for Trauma (E-FAST), evaluation of pneumothorax and visualization of correct insertion of devices (Endotracheal Tube, Nasogastric Tube). At the level of training in the ultrasound field, on the other hand, a certain heterogeneity is highlighted in the structuring of training courses, both in terms of hours of theory and of controlled practice.

The synthesis and characterization of a small series of cyclic triimidazole derivatives functionalized with methylated pyridine or guanidine moieties is reported. These compounds were tested for their ability to bind to G-quadruplexes from both telomeric and oncogene promoter sequences. Some of them exhibited high affinity and effective G-quadruplex-stabilizing properties. Overall, these compounds may represent useful leads for developing more potent and selective analogues.

Altres ajuts: CERCA Programme/Generalitat de Catalunya Among the vertebrates found at Cava Monticino, carnivorans are by far the most abundant of all the large mammals. Five different taxa were recovered: one felid, two hyaenids, one canid and one mustelid. The small-sized felid remains can be attributed to Felis christoli and seems to represent one of the earliest records of a true member of the genus Felis in Western Europe. Hyaenids at Cava Monticino are represented by the large wolf-sized and cursorial Lycyaena cf. chaeretis, and by the peculiar small Plioviverrops faventinus, the most abundant taxon of all. The latter is one of the most derived species of the genus and the last to appear in the fossil record of these mongoose-like hyaenids. The medium-sized canid recorded at Cava Monticino, Eucyon monticinensis, represent one of the oldest, certain record in the Old World of the genus Eucyon. It was a mesocarnivorous species that preyed on small vertebrates (abundantly recorded in the area of Cava Monticino during the Late Miocene). Lastly, mustelids are represented by the large relative of the extant honey badger, Mellivora benfieldi, whose record at Cava Monticino represents the northernmost record of the species and, presently, the only record of the genus outside of Africa.

In this manuscript, we present a preliminary report on the use of virtual palaeontology methodologies in two natural history museums in central Italy, the Geology and Paleontology Museum of Florence and the Civic Museum of Natural Sciences of Faenza. Despite the differences between the museums (in terms of history, type and size of the collections, etc.), the use of surface and computed tomography (CT) scans has allowed the acquisition of a consistent amount of data to create digital copies of selected specimens and to plan several future projects sparked from the use of these methodologies. Our first step focused on the selection of the scanning sample: type and historically relevant specimen in the case of the Florence museum, and fragile and relevant specimens for the Faenza museum from a local yet internationally known site, Cava Monticino, dated to the Late Miocene. The scanning techniques included the use of three high-resolution scanners, with different specifications, to acquire surface data and a medical scanner to obtain CT scans. The outputs of the surface scans were excellent digital copies of the specimens, whereas tomography allowed the first investigations and visualisations of the presence of embedded bones in the fossiliferous blocks of Cava Monticino. The resulting 3D and raw data represent invaluable resources that the two museums are currently planning to implement in their exhibitions using digital visualisation devices and techniques (e.g. AR web apps, touchscreens) or 3D-printed touchable specimens.

The molecular and phenotypic effects of a brown seaweed extract (BSE) were assessed in sugar beet (Beta vulgaris L.). Transcript levels of BSE-treated and untreated plants were studied by RNA-seq and validated by quantitative real-time PCR analysis (RT-qPCR). Root morphology, sugar yield, and processing quality traits were also analyzed to better elucidate the treatment effects. RNA-seq revealed 1019 differentially expressed genes (DEGs) between the BSE-treated and untreated plants. An adjusted p-value < 0.1 and an absolute value of log2 (fold change) greater than one was used as criteria to select the DEGs. Gene ontology (GO) identified hormone pathways as an enriched biological process. Six DEGs involved in auxin and ABA pathways were validated using RT-qPCR. The phenotypic characterization indicated that BSE treatment led to a significant increase (p < 0.05) in total root length and the length of fine roots of plants grown under hydroponics conditions. The sugar yield of plants grown under field conditions was higher (p < 0.05) in the treated field plots compared with the control treatment, without impacting the processing quality. Our study unveiled the relevant effects of BSE application in regulating auxin- and ABA-related gene expression and critical traits related to sugar beet development and yield.

IntroductionThe phylogenetic and ecological importance of paranasal sinuses in carnivorans was highlighted by several previous authors, mostly in extant species. Nevertheless, no specific study on this feature on extant canids, and no one on fossil representatives of the family, has been published up to now. Here, we analyze for the first time the paranasal sinus of extant and fossil canids through computed tomographic techniques to characterize them morphologically and morphometrically, making ecological inferences.MethodsTo do so, we applied for the first time an innovative deformation-based morphometric approach.ResultsThe results obtained for extant species highlight a remarkable correlation between morphology and ecomorphotypes previously defined by some scholars (namely hypercarnivorous group-hunters; small-prey hypercarnivores, mesocarnivores, hypocarnivores). Our results thus support the direct relationship between diet preferences and the development of frontal sinus in canids. Regarding fossil specimens, we reconstructed for the first time the frontal sinus of three Eucyon species and compared it to those of living forms.DiscussionThe best-preserved specimen, the only known cranium of Eucyon adoxus dated to the Late Pliocene of Saint-Estève (France), displayed similarities with hypercarnivorous group-hunter canids by the large sinus prominences. Given that the overall craniodental morphology of E. adoxus suggests that it acted as a small prey hypercarnivore—similar to extant Canis simensis—the aforementioned affinities might have evolved independently, in relation to high stresses during feeding. Overall, our study demonstrates that morphological inspection and deformation-based geometric morphometrics complement each other and allow a thorough investigation of sinus shape variability, thus enabling the study of sinus morphology in other fossil carnivorans with the ultimate goal of inferring their ecological preferences.

The coordination ability of the pyridine derivative of cyclic triimidazole, namely 3-(pyridin-2-yl)triimidazotriazine (TT-Py) towards Cu(I) was explored. TT-Py is an appealing nitrogen-rich ligand characterized by the presence of three imidazole nitrogen atoms with trigonal symmetry and a pyridine moiety, available for coordination to metal ions. The multidentate nature of TT-Py allows to isolate, by reaction with CuI at room temperature, the one-dimensional coordination network [Cu2I2(TT-Py)]n (1). 1 is characterized by a rare structural network built-up by the combination in a 1:2 ratio of two common motifs for Cu(I) halides coordination polymers, which are the double-stranded stair and the zig-zag chain. 1 displays one broad long-lived emission in the solid state, which has been associated, by the support of DFT and TDDFT calculation, with low-energy transitions of MLCT or XMLCT character.

In 2017, a hemimandible (MW5-B208), corresponding to the Ethiopian wolf (Canis simensis), was found in a stratigraphically-controlled and radio-isotopically-dated sequence of the Melka Wakena paleoanthropological site-complex, on the Southeastern Ethiopian Highlands, ~ 2300 m above sea level. The specimen is the first and unique Pleistocene fossil of this species. Our data provide an unambiguous minimum age of 1.6–1.4 Ma for the species’ presence in Africa and constitutes the first empirical evidence that supports molecular interpretations. Currently, C. simensis is one of the most endangered carnivore species of Africa. Bioclimate niche modeling applied to the time frame indicated by the fossil suggests that the lineage of the Ethiopian wolf faced severe survival challenges in the past, with consecutive drastic geographic range contractions during warmer periods. These models help to describe future scenarios for the survival of the species. Projections ranging from most pessimistic to most optimistic future climatic scenarios indicate significant reduction of the already-deteriorating territories suitable for the Ethiopian Wolf, increasing the threat to the specie’s future survival. Additionally, the recovery of the Melka Wakena fossil underscores the importance of work outside the East African Rift System in research of early human origins and associated biodiversity on the African continent.

Altres ajuts: CERCA Programme/Generalitat de Catalunya The late Villafranchian is one of the pivotal timespans in the succession of Pleistocene European faunal assemblages, setting the bases for the major faunal renewal that characterized the continent during the Epivillafranchian. Bison is one of the most important and successful large mammals to spread in Europe at the latest stages of the Early Pleistocene. Here we describe the remains of a large bovid from the late Villafranchian site of Pietrafitta (ca. 1.5 Ma), previously attributed to Leptobos. Our analyses allow to refer this sample to the genus Bison. The primitive characters featured by this sample suggest the attribution to the subgenus Eobison, a long-debated taxon which includes all the earliest forms of Bison. At Pietrafitta, thus, one of the largest and most complete record of primitive Bison is recorded. The vague diagnosis and confused taxonomic history of Eobison called for a reappraisal of its status. We present a re-definition of the diagnostic characters and a review of the Eurasian record of Eobison with a focus on the late Villafranchian samples from the Mediterranean area. We recognize at least three valid species of Eobison remarking, however, the extreme morphological variability of this group. The comparative analysis of Eobison and its closest relatives (i.e., Leptobos and Bison s.s.), confirms that both the leptobovine and bisontine clades underwent to an increase of stoutness of the appendicular skeleton in response to the shrinking of forested habitats and the onset of colder, arid climate during the Pleistocene.

The search of new organic emitters is receiving a strong motivation by the development of ORTP materials. In the present study we report on the preparation, optical and photophysical characterization, by both steady state and time resolved techniques, of two pyrene-functionalized cyclic triimidazole derivatives. Together with the already reported mono-substituted derivative, the di- and tri-substituted members of the family have revealed as intriguing emitters characterized by impressive quantum yields in solution and RTP properties in the solid state. In particular, phosphorescence lifetimes increase from 5.19 to 20.54 and 40.62 ms for mono-, di- and trisubstituted compounds, respectively. Based on spectroscopical results and theoretical DFT/TDDFT calculations on the di-pyrene molecule, differences in photophysical performances of the three compounds have been assigned to intermolecular interactions increasing with the number of pyrene moieties appended to the cyclic triimidazole scaffold.

I pazienti ricoverati sono a rischio di eventi avversi gravi, ma il riconoscimento precoce dell'instabilità clinica può essere difficile. Gli infermieri sono tra i professionisti con le competenze più adatte a rilevare precocemente i segni di instabilità clinica e il Modified Early Warning Score (MEWS) è uno strumento utile a supportare i professionisti in questa fase. Attualmente non esiste una versione in italiano del MEWS. Lo scopo dello studio è di tradurre ed adattare per il contesto italiano il MEWS attraverso il processo di traduzione forward and backward, la verifica della validità di facciata e contenuto e attraverso lo sviluppo di uno studio monocentrico.

The different nature of the emissive states of AgI and CuI one- and three-dimensional coordination polymers is here explained by a higher covalent character of the Cu—N bond with respect to the Ag—N one., A QTAIM and IQA investigation on model compounds of two isostructural AgI and CuI coordination polymers (CPs) based on cyclic tri­imidazole (L), i.e. the [MIL] n 1D double-stranded stair chain and the [MClL] n 3D network (M = Cu, Ag), has allowed light to be shed on the different emissive behaviour associated with the two metal ions. According to a previously reported investigation [Malpicci et al. (2021). Inorg. Chem. Front. 8, 1312–1323 ▸], AgI CPs showed both fluorescence and multiple ligand-centred room-temperature phospho­rescences, whereas CuI CPs displayed non-thermally equilibrated halogen and metal-to-ligand charge transfer and two ligand-centred phospho­rescences, the latter observed only by their selective activation. Analysis of both local and integral QTAIM descriptors, including delocalization indices and source function, of the Ag—N and Cu—N bonds reveals a higher covalent and local character for the latter, explaining the greater metal–ligand electronic communication observed for the Cu compounds. Moreover, IQA investigation shows that the Cu—N bond is characterized by higher interaction energy, due to both higher electrostatic and exchange-correlation contributions. Analysis on the M—X (M = Ag, Cu; X = I, Cl) bonds, also present in these structures, highlights a much higher covalent and local character with respect to the M—N bonds.

Background A connection between amyotrophic lateral sclerosis (ALS) and altered gut microbiota composition has previously been reported in animal models. This work is the first prospective longitudinal study addressing the microbiota composition in ALS patients and the impact of a probiotic supplementation on the gut microbiota and disease progression. Methods Fifty patients and 50 matched controls were enrolled. The microbial profile of stool samples from patients and controls was analyzed via PCR-Denaturing Gradient Gel Electrophoresis, and the main microbial groups quantified via qPCR. The whole microbiota was then analyzed via next generation sequencing after amplification of the V3–V4 region of 16S rDNA. Patients were then randomized to receive probiotic treatment or placebo and followed up for 6 months with ALSFRS-R, BMI, and FVC%. Results The results demonstrate that the gut microbiota of ALS patients is characterized by some differences with respect to controls, regardless of the disability degree. Moreover, the gut microbiota composition changes during the course of the disease as demonstrated by the significant decrease in the number of observed operational taxonomic unit during the follow-up. Interestingly, an unbalance between potentially protective microbial groups, such as Bacteroidetes, and other with potential neurotoxic or pro-inflammatory activity, such as Cyanobacteria, has been shown. The 6-month probiotic treatment influenced the gut microbial composition; however, it did not bring the biodiversity of intestinal microbiota of patients closer to that of control subjects and no influence on the progression of the disease measured by ALSFRS-R was demonstrated. Conclusions Our study poses the bases for larger clinical studies to characterize the microbiota changes as a novel ALS biomarker and to test new microbial strategy to ameliorate the health status of the gut. Trial registration CE 107/14, approved by the Ethics Committee of the “Maggiore della Carità” University Hospital, Italy.

The People’s Liberation Army (PLA), officially the army of the Communist Party of China (CPC) – hereinafter the “CPC” or the “Party” –, has always been a crucial player in the Chinese political system. It is not a national army, although it is the only army China has and its members have been active participants in the life of the State since its founding. The close relationship between the armed forces and the Party has, over time, encouraged Chinese policy analysts to explore the influence of the PLA on national decision-making processes, and consider this interaction as “intrinsic to the Party leadership itself ”. The involvement of the PLA in this regard has been compared to that of an “interest group” capable of exerting pressure on political decisions about aspects of national stability and, more recently, security, defence, and foreign policy. Assessing the weight of the PLA as an interest group, mostly in foreign policy, is also the aim of this analysis, which proceeds as follows. First, it briefly reviews the major reforms that have targeted the PLA, emphasising how such restructurings have stimulated the creation of an identity for the military as an interest group. Second, it investigates the current role of PLA officers in Party institutions, mainly focusing on the functioning of the Central Military Commission (CMC), which is one of the key bodies used by the military to lobby politicians and influence foreign policy decision-making. Third, the article introduces readers to the ongoing shrinkage of civil society that is taking place under the leadership of General Secretary, and President, Xi Jinping and which is having consequences for the performance of interest groups in Chinese policy-making, and more generally for its political system. In this respect, the reform measures that the PLA is currently undergoing also embody Xi Jinping’s desire to reduce the rise of interests, due to the presence of groups not entirely under the authority and control of the Party, which may clash with his policy agenda. The impact of Xi's recent power centralisation efforts on the military's capacity may have contributed to a decrease in the extent to which the PLA continues to have a say in foreign policy.

Despite the US longstanding opposition, the Trump administration’s contestation of the International Criminal Court (‘ICC’ or ‘Court’) has been unprecedentedly severe. Not only did it turn against the wholesale legitimacy of the Court, but it ultimately led to sanctions against the ICC Prosecutor and senior prosecution official, while hindering the enforcement of the principle of non-impunity at the international level. Investigating the US stance towards the ICC during the Trump presidency exemplifies one of the most representative moments of what we term a ‘contestation from within’, hence, a contestation of the Liberal International Order originating from one of its founders, in this case, the US. Drawing on the constructivist literature on norm contestation and a narrative inquiry, this article seeks to explore how the US contestation over the Court and the norm of non-impunity intensified, shifting from applicatory to justificatory, and from discursive to behavioural contestation, specifically, in the Trump era.

Obiettivo dell’articolo è proporre un’analisi inerente ai cambiamenti ed allo sviluppo della produzione agricola in Russia a seguito della transizione dall’economia pianificata all’economia di mercato. Nello specifico, il contributo indaga gli approcci adottati dall’amministrazione Gorbachev, ma soprattutto quella di Eltsin e Putin. Lo scopo è quello di rintracciare tanto le cause del drastico calo della produzione di cibo all’indomani della nascita della Federazione Russia, quanto i fattori che hanno determi-nato la ripresa negli anni duemila. Pertanto, gli autori mettono in evidenza il differente sostegno fornito dallo Stato alle imprese agro-alimentari dalla fine degli anni Ottanta ai giorni nostri, ed il tipo di sistema produttivo di volta in volta promosso a seconda delle esigenze interne e di geopolitica internazionale. L’articolo discute, infine, come il raggiungimento dell’autosufficienza, in termini di produzione di cibo, sia diventato uno dei fattori chiave dell’odierna strategia della Russia per preservare la propria sicurezza nazionale.

A mandible fragment and four isolated teeth of the fossil foxes, Vulpes alopecoides (Del Campana, 1913), Vulpes cf. vulpes (Linnaeus, 1758) and Vulpes sp., are described from the Early Pleistocene locality of Taurida cave (Crimea, Late Villafranchian, 1.8–1.5 Ma). Based on the size and morphological features, a mandible fragment and two M1 are attributed to V. alopecoides. The structure of m1 of Vulpes cf. vulpes is similar to that of V. vulpes and V. alopecoides, but the size greatly exceeds the size limits for the latter species. Although m1 of Vulpes sp. fits the size of the lower carnassials of V. alopecoides, its morphology is definitely unique among the Early Pleistocene representatives of the genus Vulpes.

La didattica mediante la simulazione sta assumendo sempre più un ruolo centrale nei percorsi formativi in ambito sanitario e vede l'infermiere protagonista nell'erogazione della stessa. L'obiettivo di questo studio è quello di valutare la qualità della formazione erogata attraverso l'analisi del grado di soddisfazione del personale tecnico non sanitario che ha preso parte ad un percorso formativo basato sulla simulazione di casi avente come docente l'infermiere di Emergenza Territoriale dell'Azienda USL di Piacenza.

Pre-hospital emergency medical systems do not appear to work totally coordinated with Accident and Emergency (AE). Often, patient admission to AE is marked by scarce attention to the handover between the respective healthcare professionals. This phenomenon is potentially dangerous because it exposes patients to the risk of errors in a context where the patients' critical or progressing conditions must not be worsened by avoidable errors of communication between professionals.to describe the evidence concerning handover between local emergency medical services and AE.pre-hospital emergency medical and AE professionals, setting defined as within AE, articles on pre-hospital to AE handover.PubMed and CINAHL Complete databases. Grey literature.the results are displayed in tables according to 'Title', 'Design', 'Country', 'Population', 'Concept', 'Context' and 'Results'.10 studies were included. The following themes emerged: communication and interpersonal issues, secondary risks, need for staff training, the use of structured methods, information technology support.There is a gap in the literature. Issues regarding communication, differing ideas of what should be considered as priority, interpersonal relationships and trust between staff working for different services emerge. Connected with this there are structural problems such as shortage of suitable spaces and lack of staff training. The use of structured mnemonic methods, including computerized ones, seems to improve the quality of handovers, but to date it has not been possible to establish which method would be better than another. Further studies are recommended.

La ventilazione non invasiva risulta essere una procedura molto utilizzata in emergenza-urgenza territoriale; della corretta applicazione l'infermiere ne è responsabile. L'obiettivo di questo studio è indagare quali siano i dispositivi maggiormente utilizzati.

Il Sistema di Soccorso Sanitario italiano è disomogeneo: la costituzione dell'equipaggio d'ambulanza, i criteri di assun- zione e mantenimento del ruolo differiscono tra le organizzazioni. La legislazione favorisce autonomia e responsabilità professionale, ma nonostante ciò non è chiara l'identità dell'infermiere di emergenza territoriale, i requisiti per poter ottenere il ruolo differiscono nelle realtà. L'obiettivo dello studio è quindi l'esplorazione del concetto di Infermiere di emergenza territoriale individuandone formazione, conoscenze e competenze.

Purely organic luminophores that exhibit room temperature phosphorescence (RTP) are receiving an ever-growing attention. The design of efficient RTP materials and the understanding of their emissive behaviour, however, remain a challenging task. Herein, to gain further insights into metal-free RTP, we report the synthesis, characterization, and photophysical study of chloro-derivatives of [1,2-a:1',2'-c:1'',2''-e][1,3,5]triazine or cyclic triimidazole (TT). Mono-(1Cl), di-(2Cl) and tri-chloro-TT (3Cl) derivatives are prepared by mild chlorination with N-chlorosuc-cinimide (NCS). The three compounds are characterized by aggregation-induced emission (AIE) comprising dual fluorescence and multiple phosphorescences, whose origin is disclosed by crystal structure analysis together with accurate DFT/TDDFT calculations. Comparison with previously reported bromine and iodine TT derivatives reveals the new chlorinated compounds as the best performing halogenated AIE members of the family.

Bosworth lesions are fracture-dislocations of the ankle and are characterized by entrapment of the proximal segment of the fibula behind the posterior tubercle of the distal tibia. Treatment is challenging, mainly due to failure of a closed reduction. The aim of this study was to review the literature concerning this type of injury. A total of 103 patients with Bosworth fractures were included in the study. The analyzed studies yielded a total of 103 cases, of which 68% (n = 70) were male and 32% (n = 33) were female. Bosworth fractures are mainly due to accidental trauma (58.2%), sports-related injuries (18.4%), and traffic accidents (18.4%). More than 76% of the patients presented a Danis–Weber B fracture, 8.7% a type C fracture, and only 0.97% presented a type A fracture. In 92.2% of the patients, the attempted closed reduction was unsuccessful. A definitive treatment with open reduction and internal fixation (ORIF) was used in 96 patients (93.2%). The most frequent complication was post-traumatic arthritis (10.7%). Bosworth fractures are challenging. The available literature lacks adequate information about this fracture, and an approved standardized algorithm for treating such fractures is not available.

The remarkable emissive properties of cyclic triimidazole (TT), showing crystallization-induced emissive behavior and, in particular, room temperature phosphorescence (RTP), are here combined with its versatility in assembling coordination compounds. A series of Ag(I) coordination polymers (CPs), comprising a 1D chain ([Ag(TT)I]n, 1-Ag) and 3D networks ([Ag(TT)Cl]n, 2-Ag, and [Ag3(TT)4]n(NO3)3n·6nH2O, 3-Ag), have been synthesized and their photophysical behavior thoroughly investigated. They show both fluorescence and multiple RTPs, all simultaneously activated but varied in intensity by changing the excitation energy. Based on DFT/TDDFT calculations and analysis of the X-ray crystal structures, the origin of the different phosphorescences has been ascribed to H-aggregation of the ligand (in 1-Ag and 2-Ag), intermolecular electronic coupling by an extrinsic heavy-atom effect (in 1-Ag) and ligand-centered emissive states (in all three compounds). Comparison with isostructural 1-Cu and 2-Cu CPs reveals that, different from the Ag(I) analogues, non-thermally equilibrated XMLCT and ligand-centered emissive states are active. The isostructural Ag(I) and Cu(I) compounds show comparable emission efficiency, while the phosphorescence lifetimes are longer for the former (ms regime) than the latter (micro-s regime). A Quantum Theory of Atoms In Molecules (QTAIM) topological analysis of electron density allows the interpretation of the different nature of the emissive states of Ag(I) and Cu(I) compounds on the basis of larger shell-shared character of the Cu-N bond with respect to the Ag-N one.

O presente trabalho apresenta dois instrumentos interdisciplinares - a discussão de casos e as rodas de conversas - utilizados para o atendimento de pessoas com transtorno ou deficiência, envolvendo saúde mental, na Regional Central da Defensoria Pública do Estado de São Paulo, em 2017. Além disso, discorre brevemente sobre os espaços institucionais em que há atuação interdisciplinar na Defensoria Pública. Porém, o principal objetivo será registrar as atividades, como parte do processo interdisciplinar. E, para além dos benefícios resultantes do registro, é refletir sobre dificuldades e benefícios para as/os profissionais que participaram e redigiram este trabalho, à instituição e aos atendimentos. &nbsp

Based on the data of a research conducted by researchers at Universities of Bologna and Genoa on history textbooks in Italian secondary school and in particular on the representation of Islàm in school texts, the essay focuses its attention on the strengths and weaknesses of one of the most important tools that the teacher uses to make history. The survey confirms the need and urgency to prevent and counter the easy tendencies to erect irremediable fences and contrasts, largely, starting from the manuals themselves, due to the repetition of inaccuracies, stereotypes and prejudices. The conclusions are aimed at a general reflection on the structure and use of manuals, on the approach to historical narration through the outcomes of global history and intercultural pedagogy from the point of view of both the skills of the teachers necessary for the conscious choice of the instrument and of the active participation and involvement of students in learning the discipline.

The analysis of female icons, as a deconstruction factor of the imaginary related to gender, just like it has been built and declined by different cultures, represents the subjet of this article. Through a journey in the imaginary between East and West, an attempt will be made to identify female educational models in cultures, which can be deduced from the study of some significant icons.Barbie, Sharazade, Alyssa are not only characters of stories, myths, legends or playful objects, but convey, through their own “specificity”, a model to follow, pointing to young girls and adolescents– but also to their male counterpart– their belonging not only of gender, but also of culture. What is the specificity of this belonging? What emerges from the comparison between such icons and models? The imaginary inherent in feminine icons reveals an “issue of identity” which allows us to grasp the deep meaning of gender belonging, as a product of one’s own culture, meaning that we can fully understand only through comparison with otherness.

TT-Py exhibits anti-Kasha and multiple emissive behaviour due to the copresence of rigid TT and partially conformationally free Py., The development of purely organic materials showing multicolor fluorescent and phosphorescent behaviour represents a formidable challenge in view of practical applications. Herein the rich photophysical behaviour of 3-(pyridin-2-yl)triimidazotriazine (TT-Py) organic molecule, comprising excitation-dependent fluorescence and phosphorescence under ambient conditions in both blended films and the crystalline phase, is investigated by means of steady state, time resolved and ultrafast spectroscopies and interpreted on the basis of X-ray diffraction studies and DFT/TDDFT calculations. In particular, by proper excitation wavelength, dual fluorescence and dual phosphorescence of molecular origin can be observed together with low energy phosphorescences resulting from aggregate species. It is demonstrated that the multiple emission properties originate from the copresence, in the investigated system, of an extended polycyclic nitrogen-rich moiety (TT), strongly rigidified by π–π stacking interactions and short C–H···N hydrogen bonds, and a fragment (Py) having partial conformational freedom.

Substance abuse is a risk factor for recidivism that is commonly assessed by the Level of Service Inventory–Ontario Revision (LSI-OR) via the Substance Abuse subscale. Research has yet to examine the predictive validity of this subscale relative to types of substances abused. To explore this, substance abuse history, LSI-OR information, and recidivism were coded for a sample of 498 individuals convicted of a crime with a current substance abuse problem. These individuals were classified by the types and number of substances abused. Results of this study provide some evidence supporting the predictive validity of the LSI-OR Substance Abuse subscale. Furthermore, we found preliminary evidence supporting the predictive validity of the subscale for substance abusers relative to types of substances abused and for those who abuse a single substance versus multiple substances. These results have implications for research, policy, and correctional practice.

The late Miocene was a period of great radiation for the subfamily Caninae in North America. During this time, the early taxa of the two tribes of this subfamily, Vulpini and Canini, arose. Among them, Eucyon is one of the most important elements of the latest Miocene-Pliocene Canidae guild of both North America and Eurasia as they rapidly spread worldwide. The earliest member of the genus Canis, Canis ferox, was also reported from deposits related to this time frame. Recent research has pointed out the disputed nature of several Miocene-Pliocene Caninae, including some species of Eucyon and Eucyon-like taxa. Furthermore, dietary habits of fossil Caninae, such as Eucyon and Eucyon-like taxa, have never been tested before. This current revision of the type and paratype specimens of C. ferox shows numerous cranial and dentognathic features that do not fit with the diagnostic characteristics of the genus Canis and are more consistent with those of Eucyon. Although reopening the question of the origin of Canis, the reassessment of E. ferox points out a previously underestimated ecomorphological variability of Eucyon. The development of some dentognathic features in E. ferox seems to suggest a hypercarnivorous diet. Thanks to selected morphometric ratios, the present study show that Eucyon species apparently had mesocarnivorous diets, with the exception of the large-sized E. ferox. Although it remains difficult to assess if it preyed on small animals or on larger prey, the analyses clearly confirm a highly carnivorous diet for this species.

Introduction The use of the internet for health-related information continues to increase. Because of its decentralized structure, information contained within the World Wide Web is not regulated. The purpose of the present study is to evaluate the type and quality of information on the internet regarding Kienböck’s disease. We hypothesized that the information available on the World Wide Web would be of good informational value. Materials and Methods The search phrase “Kienböck’s disease” was entered into the five most commonly used internet search engines. The top 49 nonsponsored Web sites identified by each search engine were collected. Each unique Web site was evaluated for authorship and content, and an informational score ranging from 0 to 100 points was assigned. Each site was reviewed by two fellowship-trained hand surgeons. Results The informational mean score for the sites was 45.5 out of a maximum of 100 points. Thirty-one (63%) of the Web sites evaluated were authored by an academic institution or a physician. Twelve (24%) of the sites were commercial sites or sold commercial products. The remaining 6 Web sites (12%) were noninformational, provided unconventional information, or had lay authorship. The average informational score on the academic or physician authored Web sites was 54 out of 100 points, compared with 38 out of 100 for the remainder of the sites. This difference was statistically significant. Conclusion While the majority of the Web sites evaluated were authored by academic institutions or physicians, the informational value contained within is of limited completeness. More than one quarter of the Web sites were commercial in nature. There remains significant room for improvement in the completeness of information available for common hand conditions in the internet.

Purpose To determine the risk for infection in trigger finger release surgery after preoperative corticosteroid injection. Methods We retrospectively evaluated all patients undergoing trigger finger release by 16 surgeons over a 2-year period. Data collected included demographic information, medical comorbidities, trigger finger(s) operated on, presence of a prior corticosteroid injection, date of most recent corticosteroid injection, postoperative signs of infection, and need for surgery owing to deep infection. Superficial infection was defined per Centers for Disease Control criteria. Deep infection was defined as the need for surgery related to a surgical site infection. Results In this cohort of 2,480 fingers in 1,857 patients undergoing trigger release surgery, 53 (2.1%) developed an infection (41 superficial [1.7%] and 12 deep [0.5%]). Before surgery, 1,137 fingers had no corticosteroid injection. These patients developed 1 deep (0.1%) and 17 superficial (1.5%) infections. In contrast, 1,343 fingers had been given a corticosteroid injection before surgery. These patients developed 11 deep (0.8%) and 24 superficial (1.8%) infections. Median time from corticosteroid injection to trigger release surgery was shorter for fingers that developed a deep infection (63 days) compared with those that developed no infection (183 days). The risk for developing a deep infection in patients who were operated on within 90 days of an injection (8 infections in 395 fingers) was increased compared with patients who were operated on greater than 90 days after an injection (3 infections in 948 fingers). Conclusions Preoperative corticosteroid injections are associated with a small but statistically significantly increased rate of deep infection after trigger finger release surgery. The risk for postoperative deep infection seems to be time dependent and greater when injections are performed within 90 days of surgery, especially in the 31- to 90-day postinjection period. Type of study/level of evidence Therapeutic IV.