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The Istituto Nazionale di Geofisica e Vulcanologia (INGV) has the primary responsibility for the seismic surveillance service of the Italian territory and the tsunami alert in the Mediterranean Sea.The activities in the monitoring room at the INGV National Earthquake Observatory headquarters in Rome (hereafter INGV-Rome), are carried on by two seismologists, one tsunami specialist and one technician/engineer who work in three shifts a day to provide monitoring service on a 24/7 basis. They calculate, as rapidly and accurately as possible, the location and size of all Italian earthquakes with M2.5+ and swiftly disseminate such information to emergency authorities, to government agencies, to the public and the media by different platforms (email, text message, and via Facebook and Twitter). Starting with hypocentral and magnitude parameters, the moment tensors, the historical seismicity map and the shakemaps are also published in (near) real time.In addition, the INGV-Rome monitoring room hosts the Italian Tsunami Alert Center (CAT-INGV). CAT-INGV is one of the Tsunami Service Providers acting in the North-eastern Atlantic, the Mediterranean and connected sea (NEAM) region of the Intergovernmental Oceanographic Commission (IOC)/UNESCO and is responsible for monitoring the seismicity of the Mediterranean Sea and disseminating tsunami alert messages to member States and EU agencies subscribing its services. The operation and the performance of the INGV monitoring system is ensured by a dedicated research and IT staff who facilitate real-time waveform acquisition and distribution, develop real-time seismic processing systems and new processing algorithms., The 28th IUGG General Assembly (IUGG2023) (Berlin 2023)

Summary: In this paper, we highlight the close link between fertility decline and the emergence of the female survival advantage in post reproductive age (50 years and over). We performed an ecological analysis on the evolution of gender differentials in mortality in 16 Italian administrative regions and in 16 European countries. In both cases, we kept under control the possible confounding effects due to the spreading of smoking, the general decline of mortality, the presence of migration, the outbreak of wars and the diffusion of the obesity pandemics. Two main results emerge. First, the rise of a significant mortality differential between sexes is a relatively recent phenomenon, whose onset dates back to the birth cohorts of the last decades of the 19th century. Second, this phenomenon is associated, at the aggregate level, to the process of fertility decline.

Summary: Tongue cancer is the most common malignant neoplasm of the oral cavity. Occurrence in the tip of the tongue (TOT) is rare. We describe a case report of a TOT tumor excision and reconstruction with a prelaminated fasciomucosal radial forearm free flap. A 41-year-old white man was referred to our department for a squamous cell carcinoma of the tip of the tongue. The patient worked as an air traffic control official; therefore, conservation of speech intelligibility, both in Italian and English language, was of paramount importance. A transoral excision of TOT, bilateral selective neck dissection, and reconstruction with prelaminated fasciomucosal radial forearm free flap were performed. Adjuvant radiotherapy was necessary. The patient was completely re-established as an air traffic control officer. Successful tongue reconstruction of smaller defects depends on thinness, pliability of flap, and conservation of tongue mobility. Surgical options for TOT reconstruction are facial artery muscolomucosa flap, Zhao flap, radial forearm free flap, or primary suture. In the authors' opinion, a fasciomucosal prelaminated RFFF offers a series of advantages for TOT reconstruction. The absence of subcutaneous tissue makes the PFRFFF much thinner than fascio-cutaneous flaps. Compared with mucosal loco-regional flaps, prelaminated flaps allow the preservation of oral mucosa lining while providing adequate bulk and reduced scar formation for optimal func- tional recovery. In our case report, the fasciomucosal flap allowed an adequate reconstruction of TOT volume with good functional and aesthetic outcomes. The flap's added bulk and its minimal scar retraction granted free tongue movement and optimal speech intelligibility.

Since the introduction of fibula flap as a reconstructive technique, an evolution of indications has been observed. Our first report of a traumatic mandibular reconstruction using fibula flap was in 1992. The vast majority of indications for surgery, are: malignant tumors, benign neoplasms, osteoradionecrosis and traumas. Nevertheless, extended indications have been described such as the treatment of dentoalveolar defect without bone discontinuity or reconstruction of maxilla defect up to type III (A and B), according to Cordeiro's classification. Unusual indications include cleft palate malformations with bone discontinuity less than 6 cm. Moreover, a particular attention should be focus on fibula flap harvest with more innovative technologies than traditional use of monopolar or bipolar and their advantages in pre and postoperative management., Highlights • The widely used indications for mandibular or maxillary reconstruction are malignant tumors, benign neoplasm, osteoradionecrosis and traumas. • Extended indications are represented by other conditions such as dentoalveolar defect without bone discontinuity. • Fibula flap can be used for the near-anatomic reconstruction of the orbit and for the obliteration of dead space. • Fibula flap can be performed to reconstruct bone discontinuity less than 6 cm.

Background: The aim of the present study was to show that the Infection Risk Index (IRI), based on only 3 factors (wound classification, American Society of Anesthesiologists score, and duration of surgery), can be used to standardize selection of infection high-risk patients undergoing different surgical procedures in Plastic Surgery. Methods: In our Division of Plastic Surgery at Modena University Hospital, we studied 3 groups of patients: Group A (122 post-bariatric abdominoplasties), Group B (223 bilateral reduction mammoplasties), and Group C (201 tissue losses with first intention healing). For each group, we compared surgical site infection (SSI) rate and ratio between patients with 0 or 1 risk factors (IRI score 0 or 1) and patients with 2 or 3 risk factors (IRI score 2 or 3). Results: In group A, patients with IRI score 0–1 showed an SSI Ratio of 2.97%, whereas patients with IRI score 2–3 developed an SSI ratio of 27.27%. In group B, patients with IRI score 0–1 showed an SSI ratio of 2.99%, whereas patients with IRI score 2–3 developed an SSI ratio of 18.18%. In group C, patients with IRI score 0–1 showed an SSI ratio of 7.62%, whereas patients with IRI score 2–3 developed an SSI ratio of 30.77%. Conclusions: Existing infection risk calculators are procedure-specific and time-consuming. IRI score is simple, fast, and unspecific but is able to identify patients at high or low risk of postoperative infections. Our results suggest the utility of IRI score in refining the infection risk stratification profile in Plastic Surgery.

Summary: Giant lipomas affecting the retroperitoneum and pelvis are quite rare. The surgical management of these lesions may be technically demanding and controversies exist with respect to diagnosis, competences being involved, type of surgical approach, radicality, and timing. A unique case presentation of a giant lipoma occupying the whole pelvis and the gluteal region is presented. Due to its size, many anatomical areas are involved, requiring the expertise of multiple specialists to treat. After multidisciplinary counseling, the lesion is radically resected in one stage by using a new videolaparoscopically assisted transperineal access to the pelvis. This type of surgical approach may be of interest for resecting pelvic tumors in women and men.

Background Up to 10% of individuals with breast cancer (BC) belong to families with hereditary syndromes. The aim of this study was to develop an instrument to identify individuals/families at high‐hereditary risk for BC and offer dedicated surveillance programs according to different risks. Methods The instrument consisted of a primary questionnaire collecting history of BC and ovarian cancer (OC). This questionnaire was applied to women enrolled in the Emilia‐Romagna Breast Cancer Screening Program. General practitioners (GPs) and specialists could propose the same questionnaire too. Women with a score of ≥ 2, were invited to complete an oncogenetic counseling. According to the Tyrer‐Cuzick evaluation, women considered at high risk were invited to involve the most representative alive individual of the family affected with BC/OC for BRCA1/2 genetic testing. Results Since January 2012 and December 2016, 660 040 women were evaluated by the regional screening program, of which 22 289 (3.5%) were invited to the Spoke evaluation, but only 5615 accepted (25.2%). Totally, also considering women sent by GPs and specialists, 11 667 were assessed and 5554 were sent to the Hub evaluation. Finally, 2342 (42.8%) women fulfilled the criteria for genetic testing, and 544 (23.2%) resulted BRCA1/2 mutation carriers. Conclusions To our knowledge, this is the first regional population‐based multistep model that is aimed to identify individuals with BRCA1/2 mutations and to offer an intensive surveillance program for hereditary‐high risk women. This tool is feasible and effective, even if more efforts must be performed to increase the acceptance of multiple assessments by the study population., This is, to our knowledge, the first multistep approach, including regional breast cancer screening program, general practitioners and specialists, aimed to identify individuals with BRCA1/2 mutations and to offer an intensive surveillance program for hereditary, high and intermediate risk women. Our results show that a regional population‐based model is feasible, even if more efforts have to be yielded to increase the acceptance of subsequent assessments from women at risk.

Lipedema is a disorder of adipose tissue characterized by abnormal subcutaneous fat deposition, leading to swelling and enlargement of the lower limbs and trunk. The aim of this study was to evaluate the lipedema phenotype by investigating the role of polymorphisms related to IL-6 (rs1800795) gene in people with diagnosis of lipedema. The second aim was to identify indicators of body composition, useful for a differential analysis between subjects with lipedema and the control group.Two groups are involved in the study, 45 women with lipedema (LIPPY) and 50 women randomly chosen from the population as Control (CTRL). Clinical and demographical variables recorded include weight, height, body mass index (BMI) and circumference measurements. Body composition (Fat mass, FM; lean mass, LM) was assessed by Dual-energy X-ray Absorptiometry (DXA). The genetic tests for IL-6 (rs18oo795) gene were performed for both groups, using a saliva sample.The study of the relationship between the IL-6 (rs1800795) gene polymorphism, the anthropometric values and the body composition indices has provided the following significant results: subjects with diagnosis of lipedema present statistically significant increased values with regard to weight, BMI, waist, abdomen and hip circumferences, arms, legs and whole FM (% and kg), gynoid FM (kg), legs LM (kg) and ASMMI. Moreover, the value of the waist hip ratio was found to be decreased.For the first time, we suggested that IL-6 gene polymorphism could characterize subjects with lipedema respect to Normal Weight Obese and obese subjects. The intra-group comparisons (LIPPY carriers vs. LIPPY non-carriers and CTRL carriers vs. CTRL non-carriers) showed no statistically significant values. In contrast, the inter-group comparisons (LIPPY non-carriers vs. CTRL non-carriers and LIPPY carriers vs. CTRL carriers) resulted statistically significant. We have identified other indices, such as leg index, trunk index, abdominal index, total index, that could be promising clinical tools for diagnosis of the lipedema phenotype and for predicting the evolution of the disease.