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Abstract We present a multi-proxy investigation of a lower Carnian basinal succession from Polzberg in the Northern Calcareous Alps (Lower Austria). A section comprising a unique Konservat-Lagerstätte was studied based on bio- and chemostratigraphy along with geophysical methods, yielding a detailed and robust stratigraphic calibration of the Polzberg succession. The Polzberg section revealed the paleoceanographic history and helped to identify a global climatic reversal, the Carnian Pluvial Episode. The age of the Upper Triassic Reingraben formation in the Northern Calcareous Alps is refined as the Austrotrachyceras austriacum Zone within the lower Carnian (Julian 2). Ammonoids and conodonts provide a detailed biostratigraphic subdivision that serves as a basis for analyses of the faunal distribution and the paleoenvironmental evolution of the Upper Triassic Reifling Basin. The succession includes lithological and facies changes similar to those of coeval units in the Tethys. The Carnian was characterized by a weak (~ 1‰) positive δ13C trend, punctuated by a negative shift during the lower Carnian corresponding to the initiation of the Carnian Pluvial Episode, a period representing the onset of early/late Carnian transitional global greenhouse conditions. Organic maturity parameters and the conodont alteration index (CAI) show that the thermal overprint of the Polzberg section is low. Biomarker proxies suggest that the organic matter of the uppermost Göstling formation is a mixture of marine and terrestrial material deposited in a dysoxic environment. Within the overlaying Reingraben formation, the amount of marine biomass decreased gradually upwards. Oxygen-depleted conditions, probably due to water-column stratification, continued during deposition of the Reingraben formation. Bacterial sulfate reduction played a major role in organic matter degradation.

Abstract The clinical presentation of pheochromocytoma is variable and many biochemical and imaging methods have been suggested to improve the diagnostic accuracy of what has been termed "the great masquerader". This case-report is of a middle-aged woman with a non-specific clinical presentation suggesting acute coronary syndrome or subacute myocarditis. Cardiovascular magnetic resonance (CMR) at presentation showed myocardial edema and intramyocardial late gadolinium enhancement (LGE). An adrenal mass was seen, which was confirmed as pheochromocytoma and surgically removed. Our case shows evidence for acute adrenergic myocarditis, with resolution of both the edema and the LGE after surgical excision.

Our aim was to determine the impact of antimicrobial stewardship tools (ASTs) and the COVID-19 pandemic on antibiotic consumption (AC). We used the national software Consores® to determine AC in DDD/1000 days of hospitalization from 2017 to 2022 in voluntary private hospitals in France. The ASTs considered were: 1. internal guidelines; 2. the list of antibiotics with restricted access; 3. the presence of an antibiotic referent or 4. an ID specialist; and 5. proof of an annual meeting on antimicrobial resistance. Institutions with dedicated units for COVID-19 patients were specified. In 30 institutions, the total AC varied from (means) 390 to 405 DDD/1000 DH from 2017 to 2022. Fluoroquinolones and amoxicillin/clavulanate consumption decreased from 50 to 36 (p = 0.003) and from 112 to 77 (p = 0.025), respectively, but consumption of piperacillin/tazobactam increased from 9 to 21 (p < 0.001). Over the study period, 10 institutions with ≤2 AST had lower AC compared to 20 institutions with ≥3 AST (p < 0.01). COVID-19 units opened in 10 institutions were associated with a trend toward higher macrolide consumption from 15 to 25 from 2017 to 2020 (p = 0.065) and with an acceleration of piperacillin/tazobactam consumption from 2020 to 2022 (p ≤ 0.003). Antibiotic consumption in 30 private hospitals in France was inversely related to the number of AST. The COVID-19 pandemic was associated with limited impact on AC, but special attention should be paid to piperacillin/tazobactam consumption.

Malnutrition is a common condition in cancer patients which is usually associated with functional limitations, as well as increased morbidity and mortality. Based on the support of the young sections of Italian Association of Medical Oncology (AIOM), Italian Association of Radiotherapy and Clinical Oncology (AIRO) and Italian Society of Surgical Oncology (SICO) merged into the NutriOnc Research Group, we performed a multidisciplinary national survey with the aim to define the awareness of nutritional issues among healthcare professionals delivering anticancer care. The questionnaire was organized in four sections, as follows: Knowledge and practices regarding Nutritional Management of cancer patients; Timing of screening and assessment of Nutritional Status; Nutritional Treatment and prescription criteria; Immunonutrition and educational topics. The modules focused on esophagogastric, hepato-bilio-pancreatic and colorectal malignancies. Overall, 215 physicians completed the survey. As regards the management of Nutritional Status of cancer patients, many responders adopted the ERAS program (49.3%), while a consistent number of professionals did not follow a specific validated nutritional care protocol (41.8%), mainly due to lack of educational courses (14.5%) and financial support (15.3%). Nearly all the included institutions had a multidisciplinary team (92%) to finalize the treatment decision-making. Cancer patients routinely underwent nutritional screening according to 57.2% of interviewed physicians. The timing of nutritional assessment was at diagnosis (37.8%), before surgery (25.9%), after surgery (16.7%), before radiochemotherapy (13.5%) and after radiochemotherapy (7%). Most of the responders reported that nutritional status was assessed throughout the duration of cancer treatments (55.6%). An important gap between current delivery and need of nutritional assessment persists. The development of specific and defined care protocols and the adherence to these tools may be the key to improving nutritional support management in clinical practice.

PurposeBiochemical recurrence (BR) occurs in up to 40% of patients with prostate cancer (PCa) treated with primary radical prostatectomy (RP). Choline PET/CT may show, in a single-step examination, the site of tumor recurrence earlier than traditional imaging methods, particularly at low prostate-specific antigen (PSA) levels, thus influencing subsequent treatment. Methods/patientsPatients with recurrent and non-metastatic prostate cancer (nmPCa), who were assessed with choline PET/CT, were included in the analysis. Based on imaging results, the following therapeutic strategies were chosen: radiotherapy to the prostatic bed, androgen deprivation therapy (ADT), and chemotherapy or stereotactic body radiotherapy (SBRT) to either the pelvic lymph nodes or distant metastases. We assessed the impact of age, PSA levels, Gleason score (GS), and adjuvant therapy on oncological outcomes.ResultsData from 410 consecutive nmPCa patients with BR who underwent RP as primary treatment were analyzed. One hundred seventy-six (42.9%) patients had a negative choline PET/CT, and 234 (57.1%) patients resulted positive. In the multivariate analysis, only chemotherapy and PSA at recurrence were significant independent prognostic factors on overall survival (OS). In the PET-positive subgroup, the number of relapses, PSA post-prostatectomy, and chemotherapy impacted on OS. PSA (post-surgery and at recurrence) affected progression-free survival (PFS) in the univariate analysis. In the multivariate analysis, GS, the number of relapse sites, and PSA (post-surgery and at recurrence) were significant prognostic factors for disease-free survival (DFS).ConclusionCholine PET/CT provides better accuracy than conventional imaging for the assessment of nmPCa with BR after prostatectomy, thereby enabling salvage strategies and improving quality of life.

During the Permian, climate experienced a change from icehouse to greenhouse conditions. Few multidisciplinary studies have investigated Kungurian (late Cisuralian) tropical terrestrial ecosystem and climate changes. Here, we apply an interdisciplinary approach to two alluvial-lacustrine successions of the Athesian Volcanic Group (Southern Alps, northern Italy) deposited in a Kungurian megacaldera during periods of volcanic quiescence. Sedimentological analysis combined with palynofacies studies allowed the reconstruction of the depositional environments. The study of sporomorph assemblages and stable organic carbon isotopes provided information on plant communities and the climate context. Two different depositional environments were present in the megacaldera: one proximal and one more distal with respect to the source, distinguished by a slightly different composition of the sediments, palynofacies and organic carbon isotopes. The plant community in the area was dominated by xeromorphic-hygromorphic taxa. The δ13Corgvalues are comparable to those of other Cisuralian continental organic matter and plants. The stable carbon isotope values show a small variability, which correlates weakly, but significantly, with the abundance of xeromorphic elements. All observations support deposition during semiarid to arid climate conditions, typical of the mid-late Cisuralian in the area.

Intracranial hemangiopericytomas are rare tumors, accounting for 1% of all central nervous system malignancies. This tumor is considered at high risk of local and also distant metastases. Surgical excision is the gold standard for treatment, but it is seldom curative by itself. Adjuvant radiotherapy is often recommended. We report an overview and update of the available literature on one such rare but aggressive mesenchymal tumor, using the case of a 46-year-old woman affected by hemangiopericytoma of the cavernous sinus surgically removed and treated with adjuvant radiotherapy at our institution. After seven years, the patient underwent a local recurrence and was treated with exeresis and Gamma Knife radiotherapy. Sixteen years after the initial diagnosis, she is still well with stable disease.

The Aghdarband Basin in the Kopeh-Dagh Range (NE Iran) is one of the most important areas for unraveling the evolution of the Turan plate (southern margin of Eurasia) during the last phase of the closure of the Paleotethys and to reconstruct the history of the Cimmerian blocks just before their collision with Eurasia during the early Late Triassic. The youngest sediments affected by the Early Cimmerian orogeny are those of the Upper Triassic Miankuhi Formation, which covers unconformably the Upper Triassic (lower Carnian) marine beds of the Sina Formation by an interval of continental facies including local conglomerates, cross-bedded sandstones, mudstone layers, silty shales, an up to one-meter thick coal layer with plant remains, and shales. The plant assemblages represent a relatively wide variety of different forms (sphenophytes, ginkgophytes, conifers, and incertis sedis), documenting wetlands with lush vegetation typical of warm and humid environments. In this study, we describe a plant fossil assemblage from the base of the Miankuhi Fm., dominated by roots and vegetative organs of Neocalamites iranensis n. sp., with few plant fossils of uncertain botanical affinity. Palynological investigations of the basal part of the Miankuhi Formation confirm a latest early Carnian to late Carnian age for this interval and reveal, for the first time, a clear link between this plant-bearing bed, and a time of global environmental changes, the Carnian Pluvial Episode. This is the first report of the Carnian Pluvial Episode in the Turan plate (southern margin of Eurasia) and Iran.

Cardiac Magnetic Resonance Imaging offers incremental value as diagnostic and prognostic tool in a wide range of cardiac diseases in front of the traditional non-invasive imaging techniques. Tissue characterization with and without non-nephrotoxic contrast-media offers the opportunity of precise assessment of myocardial fibrosis, edema and fatty infiltration. The quantitative assessment of myocardial mass, left and right ventricular volumes is considered a gold standard reference with important effects on clinical decision making and cost effectiveness ratio. The recent introduction of new sequences for mapping tissue resonance signal and myocardial strain will improve the diagnostic and prognostic accuracy for cardiovascular diseases.

Our aim was to determine the impact of antimicrobial stewardship tools (ASTs) and the COVID-19 pandemic on antibiotic consumption (AC). We used the national software Consores® to determine AC in DDD/1000 days of hospitalization from 2017 to 2022 in voluntary private hospitals in France. The ASTs considered were: 1. internal guidelines; 2. the list of antibiotics with restricted access; 3. the presence of an antibiotic referent or 4. an ID specialist; and 5. proof of an annual meeting on antimicrobial resistance. Institutions with dedicated units for COVID-19 patients were specified. In 30 institutions, the total AC varied from (means) 390 to 405 DDD/1000 DH from 2017 to 2022. Fluoroquinolones and amoxicillin/clavulanate consumption decreased from 50 to 36 (p = 0.003) and from 112 to 77 (p = 0.025), respectively, but consumption of piperacillin/tazobactam increased from 9 to 21 (p < 0.001). Over the study period, 10 institutions with ≤2 AST had lower AC compared to 20 institutions with ≥3 AST (p < 0.01). COVID-19 units opened in 10 institutions were associated with a trend toward higher macrolide consumption from 15 to 25 from 2017 to 2020 (p = 0.065) and with an acceleration of piperacillin/tazobactam consumption from 2020 to 2022 (p ≤ 0.003). Antibiotic consumption in 30 private hospitals in France was inversely related to the number of AST. The COVID-19 pandemic was associated with limited impact on AC, but special attention should be paid to piperacillin/tazobactam consumption. [ABSTRACT FROM AUTHOR]

The nobleman Achille De Zigno (1813–1892) was an Italian geologist and naturalist who studied the geological and paleontological features of the Veneto and Tirol regions. His field notes were accompanied by a great number of extremely detailed drawings. His eight notebooks were written between 1841 and 1890, starting when he was 28 until shortly before his death in 1892. He sketched mountain sections, maps, geological outcrops, and he made ink drawings of fossils together with archeological and landscape views. The most impressive features in De Zigno's notebooks are the illustrations of a great number of 'strati'. These testify to the great effort he made to understand the age and stratigraphic order of the main geological sections in the mountains which he visited. In the spring of 1846, De Zigno crossed the already renowned Dolomites and described in detail in his notebooks the geology of the area, providing a state-of-the-art account of the geological kowledge of the Dolomites during the mid-nineteenth century. Using a geological map prepared by Leopold von Buch, De Zigno travelled from Auer (Ora) to Bozen (Bolzano), walking through all the western Dolomites, including a site in the village of Predazzo. The former locality, described by Giuseppe Marzari Pencati in 1819, was renowned for its rock layer sequence which contradicted neptunism, a dominant stratigraphic theory of the early 19th century. De Zigno, in sketching the 'Stratified rocks' underlying the so-called 'Primitive rocks' that therefore were not placed at the base of the entire stratigraphic sequence, made a significant contribution to the history of geology of the Dolomites of that time. [ABSTRACT FROM AUTHOR]