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Luigi Cavanna, Chiara Citterio, Elena Orlandi Oncology and Hematology Department, Oncology Unit, Piacenza General Hospital, Piacenza 29121, ItalyCorrespondence: Luigi CavannaOncology and Hematology Department, Piacenza General Hospital, Via Taverna 49, Piacenza 29121, ItalyTel +39 0523302697Fax +39 0523302141Email l.cavanna@ausl.pc.itPurpose: To identify and to describe patient-reported outcomes (PROs) in lung cancer patients and to evaluate the feasibility and utility of PROs into surveillance strategies, a review was carried out.Patients and Methods: A systematic search in bibliographic databases evaluating the instruments used in PROs of non-small-Cell lung cancer (NSCLC) patients was done.Results: From August 2014 to August 2019, 33 studies were included in this review and 16,491 patients were evaluated. PROs were divided into 6 different categories: 1) PROs as a guide in therapeutic choice, 2) PROs as indicator of disease progression, 3) agreement between PROs and the evaluated parameters, 4) PROs to evaluate the effects of immunotherapy, 5)need to deepen the knowledge of PROs, and 6) use of new electronic PROs.Conclusion: The most frequently used instruments are EORTC QLQ-30 (16, 50%) and EORTC LC-13 (14, 43.75%) and in some studies (37.5%) they are used together. For different reasons (disease progression, adverse event, death, incomplete participation, etc.), the completion of these instruments decreased over time from baseline to subsequent measurements. This review demonstrates that PROs can play an important role as part of health care, and that routine use implementation could improve patient management in addition to the traditionally collected outcome.Keywords: quality of life, lung cancer, patient-reported outcomes, PROs

Fatigue is one of the most distressing symptoms of cancer patients. Its characteristics and impact on quality of life have not been fully explored and treatment of cancer-related fatigue in Italian oncological centers has not been codified. A cross-sectional study was carried out on all patients attending for any reason the 24 participating centers in two non-consecutive days. Patients with fatigue filled out the Brief Fatigue Inventory (BFI) questionnaire and reported any pharmacological or non-pharmacological treatment for fatigue. From October 2014 to May 2015, 1394 cancer patients agreed to participate in the study. Fatigue was referred by 866 (62.1%) of patients; its duration was > 4 months in 441 patients (50.9%). In the investigators’ opinion, the most important (probable or almost sure) determinants of fatigue were reduced physical activity (271 patients), anxiety (149), pain (131), insomnia (125), anemia (123), and depression (123). Fatigue of moderate/severe intensity was reported by 43%/29.2% of patients, while usual fatigue in the last 24 h by 45%/33.1%, and the worst fatigue in the last 24 h by 33%/54.8%, respectively. Concerning the impact on quality of life, fatigue interfered moderately/severely with general activity in 30.8%/38.6% of patients, with mood in 26.1%/32.8%, with the ability to work in 27.9%/35.6%, with normal work in 26.7%/38.9%, with relationships with others in 21%/23.4% and with the ability to amuse themselves in 22.2%/33.1%. Only 117/866 patients (13.5%) received a pharmacological treatment represented by a corticosteroid in 101 patients (86.3%) while 188 patients (21.7%) received a non-pharmacological treatment such as physical exercise (120 patients, 63.8%) and various alimentary supplements (52 patients, 27.6%). Cancer-related fatigue is frequently reported by oncological patients; its intensity and impact on quality of life is relevant.

La trattazione cerca di delineare i confini teorici ed applicativi dell’istituto dell’interpretazione autentica, nella chiara consapevolezza che dietro tale tematica si celi il più complesso problema di una corretta delimitazione tra attività di legis-latio e attività di legis-executio. Il fenomeno delle leggi interpretative costituisce infatti nodo nevralgico e punto di intersezione di tre ambiti materiali distinti, ossia la teoria dell’interpretazione, la teoria delle fonti del diritto e la dottrina di matrice liberale della separazione dei poteri. All’interno del nostro ordinamento, nell’epoca più recente, si è assistito ad un aumento esponenziale di interventi legislativi interpretativi che, allo stato attuale, sono utilizzati per lo più come strumenti di legislazione ordinaria. Sotto questo profilo, il sempre più frequente ricorso alla fonte interpretativa può essere inquadrato nel più complesso fenomeno della “crisi della legge” i cui tradizionali requisiti di generalità, astrattezza ed irretroattività sono stati progressivamente abbandonati dal legislatore parallelamente con l’affermarsi dello Stato costituzionale. L’abuso dello strumento interpretativo da parte del legislatore, gravemente lesivo delle posizioni giuridiche soggettive, non è stato finora efficacemente contrastato all’interno dell’ordinamento nonostante l’elaborazione da parte della Corte costituzionale di una serie di limiti e requisiti di legittimità dell’esegesi legislativa. In tale prospettiva, diventano quindi di rilevanza fondamentale la ricerca e l’esame di strategie e rimedi, giurisdizionali ed istituzionali, tali da arginare l’“onnipotenza” del legislatore interprete. A seguito dell’analisi svolta, è maturata la consapevolezza delle potenzialità insite nella valorizzazione della giurisprudenza della Corte Edu, maggiormente incline a sanzionare l’abuso delle leggi interpretative., The treatment delineates the theoretical and applicative boundaries of the institute of authentic interpretation, in the clear awareness that this issue lurks behind the most complex problem of a proper delimitation between the activities of legis-latio and legis-executio. The phenomenon of the interpretative laws constitutes in fact a nerve centre and a point of intersection of three distinct areas of law, that are the theory of interpretation, the theory of sources of law and the liberal doctrine of the separation of powers. Within our system, in the most recent period, there has been an exponential increase of interpretative legislative interventions that, in the actual state, are used mainly as instruments of ordinary legislation. Under this aspect, the more and more frequent appeal to the interpretative source can be framed in the more complex phenomenon of the “crisis of the law” whose traditional requirements of generality, abstractness and non-retroactivity have been gradually abandoned by the legislator in parallel with the establishment of the constitutional State. The abuse of the interpretative tool by the lawmaker, seriously injurious of the subjective juridical positions, has not yet been effectively thwarted in spite of the elaboration from the constitutional Court of a series of limits and requirements of legitimacy of the legislative exegesis. In this perspective, the research and examination of strategies and jurisdictional and institutional remedies, such as to embank the “omnipotence” of the lawmaker interpreter, become extremely relevant. As a result of the analysis, the investigation has reached the awareness of the potentialities inherent in the development of the jurisprudence of the Court Edu more inclined to punish the abuse of interpretative laws.

La trattazione cerca di delineare i confini teorici ed applicativi dell’istituto dell’interpretazione autentica, nella chiara consapevolezza che dietro tale tematica si celi il più complesso problema di una corretta delimitazione tra attività di legis-latio e attività di legis-executio. Il fenomeno delle leggi interpretative costituisce infatti nodo nevralgico e punto di intersezione di tre ambiti materiali distinti, ossia la teoria dell’interpretazione, la teoria delle fonti del diritto e la dottrina di matrice liberale della separazione dei poteri. All’interno del nostro ordinamento, nell’epoca più recente, si è assistito ad un aumento esponenziale di interventi legislativi interpretativi che, allo stato attuale, sono utilizzati per lo più come strumenti di legislazione ordinaria. Sotto questo profilo, il sempre più frequente ricorso alla fonte interpretativa può essere inquadrato nel più complesso fenomeno della “crisi della legge” i cui tradizionali requisiti di generalità, astrattezza ed irretroattività sono stati progressivamente abbandonati dal legislatore parallelamente con l’affermarsi dello Stato costituzionale. L’abuso dello strumento interpretativo da parte del legislatore, gravemente lesivo delle posizioni giuridiche soggettive, non è stato finora efficacemente contrastato all’interno dell’ordinamento nonostante l’elaborazione da parte della Corte costituzionale di una serie di limiti e requisiti di legittimità dell’esegesi legislativa. In tale prospettiva, diventano quindi di rilevanza fondamentale la ricerca e l’esame di strategie e rimedi, giurisdizionali ed istituzionali, tali da arginare l’“onnipotenza” del legislatore interprete. A seguito dell’analisi svolta, è maturata la consapevolezza delle potenzialità insite nella valorizzazione della giurisprudenza della Corte Edu, maggiormente incline a sanzionare l’abuso delle leggi interpretative., The treatment delineates the theoretical and applicative boundaries of the institute of authentic interpretation, in the clear awareness that this issue lurks behind the most complex problem of a proper delimitation between the activities of legis-latio and legis-executio. The phenomenon of the interpretative laws constitutes in fact a nerve centre and a point of intersection of three distinct areas of law, that are the theory of interpretation, the theory of sources of law and the liberal doctrine of the separation of powers. Within our system, in the most recent period, there has been an exponential increase of interpretative legislative interventions that, in the actual state, are used mainly as instruments of ordinary legislation. Under this aspect, the more and more frequent appeal to the interpretative source can be framed in the more complex phenomenon of the “crisis of the law” whose traditional requirements of generality, abstractness and non-retroactivity have been gradually abandoned by the legislator in parallel with the establishment of the constitutional State. The abuse of the interpretative tool by the lawmaker, seriously injurious of the subjective juridical positions, has not yet been effectively thwarted in spite of the elaboration from the constitutional Court of a series of limits and requirements of legitimacy of the legislative exegesis. In this perspective, the research and examination of strategies and jurisdictional and institutional remedies, such as to embank the “omnipotence” of the lawmaker interpreter, become extremely relevant. As a result of the analysis, the investigation has reached the awareness of the potentialities inherent in the development of the jurisprudence of the Court Edu more inclined to punish the abuse of interpretative laws.

Dilute water solutions of sodium alginate are used in molecular cooking and the dairy industry as thickening and gelling agents and also as edible films. Typically, they are obtained from brown algae or seaweeds and form stable gels in the presence of calcium ions. Calcium alginate gels can be easily prepared in the form of small solid spheres by dropping, with a syringe or a pipette, the sodium alginate solution into a water bath of calcium ions (“direct method”). After rinsing the calcium alginate spheres, fully or just partially jellified, their external pH can be easily regulated using ordinary acid and/or basic solutions. The chapter describes in detail the various steps of the procedure adopted for the preparation of calcium alginate spheres and for detecting the diffusion of protonated water inside them by observing the colour change of a suitable pH indicator contained in the spheres.

Andrea Casadei Gardini,1,* Emanuela Scarpi,2,* Elena Orlandi,3 Davide Tassinari,4 Silvana Leo,5 Ilaria Bernardini,6 Fabio Gelsomino,7 Stefano Tamberi,8 Silvia Ruscelli,1 Roberto Vespignani,9 Sonia Ronconi,10 Giovanni Luca Frassineti,1 Dino Amadori,1 Alessandro Passardi1 1Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy; 2Unit of Biostatistics and Clinical Trials, IRST IRCCS, Meldola, Italy; 3Medical Oncology Department, Piacenza Hospital, Piacenza, Italy; 4Department of Oncology, City Hospital, Rimini, Italy; 5Medical Oncology Unit, Vito Fazzi Hospital, Lecce, Italy; 6Medical Oncology Unit, Ramazzini Hospital, Carpi, Italy; 7Department of Oncology and Hematology, Division of Oncology, University Hospital Modena, Italy; 8Oncolgy Unit, Degli Infermi Hospital, Faenza, Italy; 9IT Service, IRST IRCCS, Meldola, Italy; 10Hematology Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy *These authors contributed equally to this work Background: The aim of this study was to investigate the role of pre-treatment aspartate aminotransferase-lynphocyte ratio (ALRI) as a predictor of prognosis and treatment efficacy in patients with metastatic colorectal cancer (mCRC) enrolled in the prospective multicenter randomized ITACa (Italian Trial in Advanced Colorectal Cancer) trial to receive first-line chemotherapy (CT) + bevacizumab (B) or CT alone. Patients and methods: Patients randomly received CT+B or CT alone as first-line therapy. CT consisted of either FOLFOX4 or FOLFIRI at the clinician’s discretion. Results: Out of the 284 patients enrolled, increased ALRI levels were associated with shorter PFS and OS (p