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Alessio Giai Via,1 Antonio Frizziero,2 Paolo Finotti,2 Francesco Oliva,3 Filippo Randelli,1 Nicola Maffulli4,5 1Department of Orthopaedic Surgery and Traumatology, Hip Surgery Center, IRCCS Policlinico San Donato, Milano, Italy; 2Department of Physical and Rehabilitation Medicine, University of Padova, Padova, Italy; 3Department of Orthopaedics and Traumatology, Tor Vergata Hospital, University of Rome “Tor Vergata”, Rome, Italy; 4Department of Musculoskeletal Disorders, School of Medicine and Surgery, University of Salerno, Salerno, Italy; 5Centre for Sport and Exercise Medicine, Queen Mary University of London, Barts and the London School of Medicine and Dentistry, Centre for Sports and Exercise Medicine, Mile End Hospital, London, England Abstract: Osteitis pubis is a common cause of chronic groin pain, especially in athletes. Although a precise etiology is not defined, it seems to be related to muscular imbalance and pelvic instability. Diagnosis is based on detailed history, clinical evaluation, and imaging, which are crucial for a correct diagnosis and proper management. Many different therapeutic approaches have been proposed for osteitis pubis; conservative treatment represents the first-line approach and provides good results in most patients, especially if based on an individualized multimodal rehabilitative management. Different surgical options have been also described, but they should be reserved to recalcitrant cases. In this review, a critical analysis of the literature about athletic osteitis pubis is performed, especially focusing on its diagnostic and therapeutic management. Keywords: osteitis pubis, pubalgia, groin pain, rehabilitation, review

Total hip arthroplasty (THA) in congenital high grade hip dislocation often represents a problematic issue. Reviewing their selected cases and literature data, authors focus on some key points for this demanding surgery. Most important steps are acetabular positioning and surgical approach (exposure and release).We used two different cups, the Zweymuller and the Wagner cup, with good primary stability. A Conus stem (Wagner) or an Alloclassic stem (in less displastic femoral shape) were used.We always performed this surgery as a one step procedure.In the same cases a shortening femoral osteotomy was performed to allow refractory reduction.Possible complications are discussed.

COX-2 specific inhibitors (coxibs) have become a popular treatment for musculoskeletal disorders given that the incidence of gastrointestinal side effects is lower with these drugs than with traditional non-steroidal anti-inflammatory drugs. The aim of this review is to discuss the results of animal studies investigating the role of coxibs in the healing of soft tissues. MEDLINE was searched (years 2001-2009) for studies analyzing the effect of coxibs on the healing of soft tissues. There are relatively few data in the literature suggesting that coxibs can impair soft tissue healing and the data existing have the limitation of having been generated in animal studies. In fact, the method of administration and the doses used make it difficult to translate these results to the clinical setting. Short-term use of coxibs following lesions to ligaments or tendons remains a prudent choice. Traditional anti-inflammatory drugs are a safer treatment for patients with a high cardiovascular risk. These drugs should, however, be evaluated carefully with regards to gastrointestinal events and their still poorly defined effect on tissue healing.

The paper explores the use of open source geographic information system (GIS) applied to firms. Most data available in a company have a spatial dimension and even decisions in marketing and management often have a spatial dimension. The paper is focus on illustrating the variegated opportunities for an open source GIS based strategy for firms. We argue that open source GIS are today as good as its proprietary competitors, and under certain circumstances, they are a superior alternative to their proprietary counterparts. A GIS based strategy for firms, as any other new application of geographical knowledge, it is a prospect of a new area for geography studies. This paper can be considered an initial essay on the role that geographers can play in spatial analysis applied to business strategy. The application is an example of applied geography supporting firm strategies and it has the purpose to identify spatial customer potentials for a specific infrastructure, the inland terminal of Guasticce (Italy).

Partial-thickness rotator cuff tears are a challenge for shoulder surgeons. There is still no standard treatment protocol. The recent introduction of new arthroscopic techniques and a better grasp of pathogenic mechanisms along with a greater functional demand from patients, have led to the need for a thorough analysis of the problem. This paper analyses the literature in order to simplify the approach to treating partial-thickness rotator cuff tears.

The aim of this study was to document the incidence of postoperative shoulder stiffness (SS) after arthroscopic rotator cuff repair and evaluate the role of risk factors for its development. Seventy-five consecutive patients that underwent arthroscopic rotator cuff repair were included. The incidence of postoperative SS was prospectively investigated and the presence of 20 potential risk factors was documented retrospectively. The incidence of post-operative SS was 10.4%. All patients were women, and sex was significantly associated to pathology development (p=0.0067). The presence of gastroesophageal diseases was found to be significantly associated with post-operative SS development (p=0.0046). A significant association between the occurrence of post-operative SS and the presence of gastroesophageal diseases was identified. This finding, not yet reported in literature, deserves further investigation. The incidence of postoperative SS fell among previously reported ranges, with females significantly more affected than men.

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International audience; Alors que la France est la première destination mondiale en matière de tourisme, l’Aquitaine la cinquième région du pays, l’œnotourisme s’est peu et tardivement développé. Un constat s’impose : Bordeaux tient un rôle majeur dans le monde du vin en termes de goût, d'œnologie, de puissance... mais guère dans l'œnotourisme ! En revanche, l'Italie est le seul pays au monde à avoir, dès 1985, promulgué une loi spéciale sur l'agritourisme. Elle définit le tourisme à la ferme comme une sous-activité de l'agriculture. C’est pourquoi elle a un triple but : favoriser les produits régionaux typiques, réutiliser les vieux bâtiments ruraux qui ne sont plus utilisables par l'agriculture moderne, enfin augmenter le revenu des agriculteurs.

Since it is not beneficial to everyone, the sustainability transition is a complex process and many mechanisms hinder its evolution. Some agents involved in this transition shoulder significant costs and burdens: even if some agents can shoulder part of them, it is unlikely that all agents will spontaneously comply with the responsibi-lity that the sustainability transition imposes on them. This paper intends to investigate how, in the context of the sustainability transition, the relevant agents must/can comply with the duties demanded by this responsibility (which can be defined as “first order” responsibility). Indeed, some agents do not comply with their own (first order) responsibility and with the consequent obligations. To induce such (first order) agents to act in accordance with their (first order) responsibility, the notion of “second order” responsibility – that is, the responsibility that other agents ensure that the first order agents act on the basis of their (first order) responsibility – should be employed. In this normative perspective, the work proposes a theoretical-analytical framework within which second order agents – which in a pragmatic perspective can be defined as “agents of destabilization” (divided into primary and operational) – take action to win the resistance of first order agents in order to favor the sustainability transition.

Motorcycle Hill Climbing. Sport and social media in a global perspective. The contribution aims to reconstruct the history, rules and diffusion of the Motorcycle hill climbing (MHC) sport; inserted among the categories of Enduro competitions, the MHC represents an extreme discipline divided into championships organized all over the world. The article, starting from a descriptive approach, will try to give a picture of the spatial diffusion of the main MHC events and the public flows generated, focusing in particular on the main European competitions. The article will then explore the relational and community dynamics that develop in some of the social networking platforms dedicated to the discipline which, being particularly spectacular, record millions of interactions and represent an interesting aspect of global dynamics connected to a rather marginal sport.

Increasing the success rate of rotator cuff healing remains tremendous challenge. Among many approaches, the possibility of activating resident stem cells in situ, without the need to isolate them from biopsies, could represent valuable therapeutic strategy. Along this line, it has been recently demonstrated that lipoaspirate product, Lipogems, contains and produces growth-factors that may activate resident stem cells. In this study, human tendon stem cells (hTSCs) from the rotator cuff were cocultured in a transwell system with the Lipogems lipoaspirate product and compared to control untreated cells in terms of cell proliferation, morphology, stem cell marker and VEGF expression, and differentiation and migration capabilities. Results showed that the Lipogems product significantly increases the proliferation rate of hTSCs without altering their stemness and differentiation capability. Moreover, treated cells increase the expression of VEGF, which is crucial for the neovascularization of the tissue during the healing process. Overall, this study supports that directly activating hTSCs with the Lipogems lipoaspirate could represent a new practical therapeutic approach. In fact, obtaining a lipoaspirate is easier, safer, and more cost-effective than harvesting cells from tendon or bone marrow biopsies, expanding them in GMP facility and then reinjecting them in the patient.

The conflict between hosts and guests in the touristic regions: a questionable solution of 1926. Tourists generally move in a place normally belonging to the autochthones, therefore the relationship between these two categories can give rise to a real conflict. Politics often put itself as an intermediary to regulate the coexistence between hosts and guests and prevent the degeneration of their intercourse. In 1926 a book has been published in Sanremo (Italy) with the aim to teach the schoolboys of a health resort the more correct behaviour to prevent conflicts with the tourists. This book is here examined with the critical approach typical of the most up-to-date tendencies of the geography of tourism and of the didactics of geography.

La vitalità del settore culturale quale vettore di crescita, innovazione e sviluppo, l???efficacia attrattiva dei territori creativi e la forte interrelazione esistente tra cultura e sviluppo economico, possono ritenersi certamente acquisite sia nella letteratura scientifica quanto nel lessico programmatico europeo e nazionale. Alcune tra le più dinamiche aree europee stanno agendo proprio sul settore culturale e creativo in prospettiva anticiclica, superando la tradizionale percezione del valore della cultura relegato ad una posizione ancillare e strumentale rispetto al settore turistico, per sperimentarne tutte le opportunità non solo in termini di sviluppo economico e sociale, ma anche quale leva di innovazione, apprendimento e coesione. La cultura diviene così un???infrastruttura immateriale capace di valorizzare l???immagine territoriale e di attivare molteplici filiere. Tuttavia gli asimmetrici effetti territoriali indotti dalle politiche culturali già operative e l???imponente fase di cambiamento imposta ai consolidati modelli strategici dalla shock finanziario e culturale conseguente al 2008, induce alcuni temi di riflessione in merito ad una concreta misurazione del contributo delle politiche culturali allo sviluppo territoriale e alla reale natura ed estensione di esso. Il lavoro di ricerca qui proposto, attraverso l???analisi di un programma di investimenti pubblici in ambito culturale che ha coinvolto molte amministrazioni del Sud Italia, sia regionali che locali, si propone di verificare la reale efficacia di tali modelli di sviluppo in ordine all???implementazione di processi di rigenerazione urbana, alla redistribuzione di opportunità di crescita e alla riduzione delle disparità territoriali.

L’evidenza scientifica suggerisce che per avere una probabilità del 75% di limitare il riscaldamento globale nel 2100 a 2°C al di sopra del livello pre-industriale, soglia oltre la quale gli impatti climatici sul nostro pianeta sarebbero rovinosi e irreversibili, le emissioni cumulate di Co2 nel periodo 2012-50 non devono superare le 584,5 Gt. Obiettivo dell’articolo è l’analisi della distribuzione di tale budget delle emissioni secondo diverse prospettive etiche. In particolare, l’articolo introduce i più importanti principi e criteri per la distribuzione budget delle emissioni. Quindi, ne discute le porzioni attribuite agli Stati a seguito dell’applicazione dei criteri di distribuzione considerati. Infine, l’articolo evidenzia le implicazioni dell’esercizio condotto e avanza alcune lezioni per le politiche internazionali contro i cambiamenti climatici e sulle relative dinamiche economiche e politiche.

nuove traiettorie dei flussi commerciali dei paesi del Mediterraneo

Territories of wine, collective ownership, and the terroirs are subject to multiple pressures internationally. A whole school of thought considers the terroir as an annuity abuse and an obstacle to the liberalization of world trade. As deregulation of global markets grows it put forward alternative approaches (based on private brands and varieties) while marginalizing the rules established by the International Organisation of Vine and Wine., Les territoires du vin, d'appropriation collective, et les terroirs sont sujets à de multiples pressions à l'échelle internationale. Tout un courant de pensée considère le terroir comme une rente abusive, une entrave à la libéralisation du commerce mondial, voire même une arnaque intellectuelle. Aussi la dérégulation des marchés mondiaux pousse-t-elle à mettre en avant d'autres approches (fondées sur les marques privées et les cépages) tout en marginalisant les règles mises en place par l'Organisation Internationale de la Vigne et du Vin.