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This study examines the quality of non-financial disclosure in Strategic Reports, focusing on non-financial key performance indicators (NFKPIs). A vital issue for NFKPI disclosure quality deals with overtime comparability. As NFKPI disclosure is mainly based on managers’ discretional choices regarding which indicators to disclose and how, we argue that corporate governance could play a key role in affecting disclosure practices. The analysis of a sample of UK listed companies from different industries reveals that most companies consistently report NFKPIs and that disclosure practices are influenced by the quality of the board of directors. Additional analyses indicate that among board characteristics, experience in financial key roles is the most effective. Further, intangible intensity is found to be positively associated with NFKPI consistency. Finally, more leveraged and less profitable firms seem to pay more attention to disclosure consistency, supporting the argument that they are subject to more severe scrutiny. This study is the first to examine the relationship between governance quality and NFKPI consistency. It enlarges previous evidence on the relation between corporate governance and disclosure by supporting the role of the board of directors in monitoring non-financial reporting.

Thanks to their low fertilization requirements and high consumer demand, ancient wheats and old durum wheat cultivars represent an attractive option for the marginal areas of Mediterranean environments no longer cultivated due to the low grain yields attainable using modern wheat cultivars. Dual-purpose utilization may increase their value in these cropping systems, but no information is available on the suitability of ancient wheat species to this type of utilization. To fill this gap, Khorasan, einkorn, and emmer wheats, clipped at the terminal spikelet stage or left unclipped, were compared in a two-year field trial. The grains were sown in the month of October, in Sardinia (41°N, 80 m asl), Italy, on low-fertility soils and with low-medium fertilization rates. Einkorn cultivars produced the highest biomass yield (2–3 t ha−1), reflecting the longer time to the onset of the terminal spikelet stage (119–138 days). After clipping, all species recovered their ability to intercept radiation to the levels of the unclipped crops, but clipping lowered their radiation use-efficiency. Grain yield was not penalized by clipping: the increase in the harvest index compensated for the decrease in biomass. Here we show for the first time that ancient wheat species are suitable for dual-purpose utilization (herbage plus grain in the same season) rendering them valuable for marginal areas; this was because the early sowing adopted for dual-purpose utilization allowed them to take full advantage of their lateness in terms of herbage yield, and to bring flowering forward (i.e. make it earlier) so that a satisfactory grain yield was obtained, even under severe water stress. Dual-purpose utilization of ancient wheats increases the sustainability of mixed cropping systems, by making herbage available to animals in a critical period, without decreasing the grain yield attainable after grazing in the same season.

Background Targeting the epidermal growth factor receptor (EGFR) either alone or in combination with chemotherapy is an effective treatment for patients with RAS wild-type metastatic colorectal cancer (mCRC). However, only a small percentage of mCRC patients receive clinical benefits from anti-EGFR therapies, due to the development of resistance mechanisms. In this regard, HER2 has emerged as an actionable target in the treatment of mCRC patients with resistance to anti-EGFR therapy. Methods We have used SW48 and LIM1215 human colon cancer cell lines, quadruple wild-type for KRAS, NRAS, BRAF and PI3KCA genes, and their HER2–amplified (LIM1215-HER2 and SW48-HER2) derived cells to perform in vitro and in vivo studies in order to identify novel therapeutic strategies in HER2 gene amplified human colorectal cancer. Results LIM1215-HER2 and SW48-HER2 cells showed over-expression and activation of the HER family receptors and concomitant intracellular downstream signaling including the pro-survival PI3KCA/AKT and the mitogenic RAS/RAF/MEK/MAPK pathways. HER2-amplified cells were treated with several agents including anti-EGFR antibodies (cetuximab, SYM004 and MM151); anti-HER2 (trastuzumab, pertuzumab and lapatinib) inhibitors; anti-HER3 (duligotuzumab) inhibitors; and MEK and PI3KCA inhibitors, such as refametinib and pictilisib, as single agents and in combination. Subsequently, different in vivo experiments have been performed. MEK plus PI3KCA inhibitors treatment determined the best antitumor activity. These results were validated in vivo in HER2-amplified patient derived tumor xenografts from three metastatic colorectal cancer patients. Conclusions These results suggest that combined therapy with MEK and PI3KCA inhibitors could represent a novel and effective treatment option for HER2-amplified colorectal cancer. Electronic supplementary material The online version of this article (10.1186/s13046-019-1230-z) contains supplementary material, which is available to authorized users.

Purpose The transversus abdominal plane (TAP) block has been described as an effective pain control technique after abdominal surgery. We performed a systematic review and meta-analysis of randomized-controlled trials (RCTs) to account for the increasing number of TAP block studies appearing in the literature. The primary outcome we examined was the effect of TAP block on the postoperative pain score at six, 12, and 24 hr. The secondary outcome was 24-hr morphine consumption.

This paper offers a contribution to the call for research on the effectiveness of regulatory interventions governing management commentary disclosure. Specifically, we focus on the mandatory requirement concerning performance indicator disclosure introduced by the Modernisation Directive (2003/51/EC). In keeping with other regulators, the European legislator opted to implement a regulatory approach based on a rule with loose specifications. To understand the effects of this Directive, we have investigated the Italian context, in which neither the national legislator nor the standard setter have supported companies with detailed specifications or guidelines aimed at integrating the European provision. We have compared companies’ disclosure practices before and after the adoption of the Directive, investigating the number of disclosed indicators and also their modalities of presentation, as they are considered essential to guaranteeing the quality of this disclosure. Our results document that a mandatory intervention, even if based on loose specifications, is associated with an increase in disclosure practices. Nevertheless, such regulation does not seem able to guarantee high quality disclosure practices. In fact, before and after the regulation, companies primarily disclose common financial measures. Moreover, the usefulness of such disclosure is undermined by a limited compliance with the international guidelines concerning the modalities of presentation. These results reveal some weaknesses in the European approach to performance indicator regulation. In general, the EU legislator fails to explain the purpose and the objective of performance indicator disclosure and does not take into account the differences between financial and non-financial indicators. Furthermore, it does not provide firms with clear guidelines concerning the presentation modalities.

Anesthesia is able to modulate the balance between proinflammatory and anti-inflammatory cytokine production during surgery. The aim of this study is to assess the effect of three anesthesia approaches, total intravenous anesthesia (TIVA), inhalation anesthesia, and xenon anesthesia, on sieric levels of nitric oxide (NO), IL6, IL10, and TNFα in obese patients undergoing Roux-en-Y laparoscopic gastric bypass. Thirty adult morbidly obese patients (BMI > 35) scheduled for Roux-en-Y laparoscopic gastric bypass were randomly recruited and allocated to TIVA (N = 10), inhalation anesthesia (SEV, N = 10), and xenon anesthesia (XE, N = 10). Exclusion criteria were ASA IV, age 60 years, and Mallampati IV. Opioid dosage and ventilation parameters were standardized. Sieric levels of NO, IL6, IL10, and TNFα were assessed at T0 (before induction of anesthesia), T1 (end of surgery), and T2 (12 h after the end of surgery). We compared the relative cytokine level variations (delta) at T1 and T2 and the cytokine exposure levels calculated as the area under the curve (AUC) between T0 and T2 in the XE and non-XE (SEV + TIVA) groups. At T1, we found a significant ΔIL10 (reduction) and ΔTNFα (reduction) between XE and SEV (p

High protein content and a ‘strong’ gluten are required in durum wheat (Triticumturgidum L. var. durum) to process semolina into a suitable final pasta product. The variation in grain protein content and quality realized through breeding and the concomitant variation in biomass production and partitioning have been analyzed by comparing in a 2-year field trial, four groups of cultivars released in different eras and areas of breeding. Three groups of cultivars represented the evolution of the Italian germplasm from the first landraces and genealogical selections (Group 1) to the cultivars constituted by crossing Mediterranean types with Syriacum types (Group 2), and the modern dwarf and semi-dwarf cultivars (Group 3). Group 4 was an ICARDA collection of breeding lines bred for adaptation to high altitudes. The measured traits included both biomass production and its partitioning to the grain, and total nitrogen uptake and its partitioning to the grain. Grain protein percentage, gluten content and gluten index were utilized as quality traits. Breeding resulted in an increased earliness, reduced height without significant decreases in total biomass, and improved partitioning. The concomitant total nitrogen uptake did not change, whereas the changed biomass partitioning caused a parallel change in nitrogen partitioning, with an increase in nitrogen harvest index from 0.41 to 0.59. The lower protein percentage in the grains of modern cultivars was therefore not due to a reduced nitrogen uptake, nor to a lower NHI or to less milligram of nitrogen per grain, but to the dilution effect caused by the heavier grains of modern cultivars. A notable increase in gluten index was observed in the modern cultivars, reflecting an improvement in the pasta-making quality of grain proteins.

SPAD readings may represent a useful screening criterion in breeding programs aimed at increasing the rate and duration of leaf photosynthesis. A two-year trial was conducted on 17 cultivars of durum wheat, 8 of triticale and 18 of barley at two experiment stations in Sardinia, Italy, to evaluate the existence of genetic variation for SPAD readings, and to quantify the genetic associations between SPAD readings, area per leaf blade (LA), specific leaf area (SLA), leaf nitrogen concentration (LNC) and leaf nitrogen per unit of leaf surface (LN) in the period between beginning of tillering and flag leaf appearance. Plants were grown at sufficient nitrogen fertilization. The average SPAD reading of barley was 9–10 units lower than that of durum wheat and triticale. The combined ANOVA indicated that, in all the three species, the genotype by environment interaction variance associated with SPAD readings was lower than the genetic variance. In durum wheat and barley, SPAD readings exhibited a greater genetic variance in comparison with LNC, LN and SLA. In durum wheat and triticale, SPAD readings were genetically correlated with LN and SLA. Durum wheat differed from triticale because its genetic variation in SLA was not associated with LA. A screening based on both SPAD readings and LA values should identify lines with good photosynthetic machinery that is not associated with low area per leaf blade.

The identification of the genotypic and environmental factors responsible for the genotype by environment interaction is essential in any breeding program. A Multi Environmental Trial (MET) including 3 years, 3 locations and 14 lines of spring triticale (× TriticosecaleWittmack) was carried out in a Mediterranean environment (Sardinia, Italy). Water available to the crops was calculated through a model run with the environmental variables and the phenological data recorded in each environment. Yield, yield components and heading date were used to perform an Additive Main effects and Multiplicative Interaction (AMMI) analysis. Interaction for yield was relevant only in 2 environments out of 8, one characterised by a late sowing, the other by the warmest pre-anthesis period. Correlations between Interaction Principal Component Axis (IPCA) scores and environmental and genotypic variables showed that genotype by environment interaction for yield and kernels per m2 is related to interaction for phenology but not to the yield level. Yield level was significantly correlated with the water availability. Genotype by environment interaction for yield is mainly determined by thermal conditions in the pre-anthesis period, genotypic photoperiodic sensitivity and sowing time.

Objective: To calculate cardiac output from dual oximetry with carbon dioxide production (VCO2) and oxygen consumption (VO2) measured by a new metabolic monitor, and to compare these values with measurements made simultaneously using the thermodilution method during the steady state condition. Design: Prospective, comparative clinical study. Setting: The adult postsurgical intensive care unit (ICU) of a University Hospital. Patients: Twenty mechanically ventilated postsurgical patients (70.7 ± 7.8 years of age; range 50–84). Measurements and results: A new metabolic monitor (Puritan-Bennett 7250, Carlsbard, USA) connected to a ventilator (Puritan-Bennett 7200) was used to measure VCO2 and VO2. Measurements of arterial (SaO2) and mixed venous (SvO2) oxygen saturations were made using pulse and venous fiberoptic oximeters. Cardiac output starting from VCO2 (COVCO2) was obtained according to Mahutte's formula: COVCO2 = VCO2/[k (SaO2− SvO2)], where k represents a constant. The value for each patient was determined from the initial measurements of thermodilution cardiac output (COtd), VCO2, SaO2 and SvO2. COVCO2 calculated from the previous equation was compared to the COtd. Cardiac output calculated from the traditional O2 Fick equation (COVO2) was compared to the COtd. All patients were studied over a period of 120 min at 15-min intervals in reasonably stable conditions. COVCO2 was closely related to COtd (r = 0.94; SEE = 0.79; p = 0.0001; n = 180) with a bias of − 0.10 and a precision of 0.45 l/min. The mean percent difference between the two methods was − 2.2 ± 8.3 %. COVO2 was related to COtd (r = 0.77; SEE = 0.79; p = 0.0001; n = 180) with a bias of − 0.57 and precision of 0.86 l/min. The mean percent difference between the two methods was − 10.8 ± 16.0 %. Conclusions: In stable patients, cardiac output measurements obtained from dual oximetry with VO2 and VCO2 measured by this new metabolic monitor, show good correlation with measurements made using the thermodilution method. The values of cardiac output calculated from VCO2 are more accurate and precise than values from VO2. The validity of these measurements in hemodynamically unstable patients and during various modes of mechanical ventilation seems warranted.

The sexual hormone pattern of the chronic critically ill patient has been recently considered as one of determinants of the catabolic state that delays recovery and conditions the outcome of the disease. It is characterized by a reduction of the pituitary production of luteinizing hormone-follicle-stimulating hormone (LH-FSH) and consequently of the peripheral androgens; on the contrary, the levels of estrogens are increased due to the enhanced activity of aromatase [1]. The objective of our study was to evaluate the pattern of sexual hormone production to identify a correct replacement therapy.

Teicoplanin is a glycopeptide antibiotic. The principle pharmacodynamic parameter is time dependency.

The aim of this study was to elucidate the impact of ICU-acquired infection on ICU and hospital mortality. The main determinants of hospital infection onset were investigated and the role of the most used antibiotics in the ICU was considered a risk factor for selection of peculiar bacterial species responsible for ICU pneumonia.

Acute renal failure (ARF) is one of the most common problems of the critical patient, often resulting in acute tubular necrosis following an impairment in renal hemodynamics. Fenoldopam is a selective dopaminergic agonist specific for dopaminergic receptor DA-1 that, provoking an increase in renal blood flow, diuresis and natriuresis, seems to prevent ARF – exerting a nephro-protective effect.

In this retrospective study, we evaluated two different modes of weaning: assisted spontaneous breathing (ASB) plus CPAP with automatic tube compensation (Evita 4, Draeger Medical, Germany) versus assisted spontaneous ventilation (ASV) (Galileo Gold, Hamilton Medical, Switzerland) in 80 patients who had undergone abdominal surgery. Our target was to assess differences in weaning times using different modes of assistance.

Remifentanil is a short-acting μ-opioid with a half-life of less than 9–10 min, metabolized by plasmatic esterasis. In this retrospective study, we evaluated the safety of remifentanil sedation (RS) versus midazolam–morphine sedation (MM) in 80 patients undergoing abdominal surgery. Our target was to assess whether RS is able to reduce times of weaning from mechanical ventilation with respect to MM sedation.

The aim of the study is to evaluate three different methods in order to carry out a magnetic resonance brain scan in children.