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The 15th century cross-vaults of the medieval Modena Cathedral (UNESCO site) consist of intricate patches of different masonry portions bound by three types of lime mortars and at least two types of gypsum mortars. Such anomalous structure suggests multiple repair works over time after damaging earthquakes. The absolute dating of lime mortars (14C) and bricks (TL) integrated with the pollen record of mortars allowed to clarify the construction and restoration history of the vaults and to link the repairs to the earthquake chronology for the area. The results reveal that the original construction of the vaults (1404–1454) was carried out using lime mortar binding reused Roman and medieval older bricks. Lime mortar was used also for later repairs caused by earthquakes in the 16th and 17th centuries. Gypsum mortars were then used to entirely rebuild some vaults and to repair others in the 18th and 19th centuries. The study indicates that unexpected damage could be revealed by the detailed chronology of masonry binders. These data represent fundamental steps to implement earthquake risk assessments and strengthening projects of ancient buildings.

After the last damaging earthquake in 2012, an anti-seismic reinforcement project of the cathedral of Modena was designed giving us the opportunity to investigate and date the building materials. Radiocarbon (14C), optically stimulated luminescence (OSL), and thermoluminescence (TL) dating techniques were performed on the vaults with the aim to (1) clarify the construction timing, (2) define the history of the restorations, and (3) explore the possible correlation of the main restoration works to the earthquake chronology deduced from the historic catalog. Preliminary results show that medieval older bricks were reused for most of the original construction. Only lime and non-gypsum mortar was used for the original construction in the 15th century and for later repair of damage caused by earthquakes in the 16th and 17th centuries. Gypsum mortar was used for later repair in the 18th century. The results show much stronger damage due to earthquakes than previously thought.

The treatment of advanced-stage oropharyngeal squamous cell carcinoma may utilize various modes, including combining surgery with chemoradiotherapy (CTRT), or primary CTRT followed by rescue surgery. In previous literature it has been revealed how patients treated with combined modes report a low quality of life (QoL) and severe consequences following surgery, radiotherapy and chemotherapy, in the short and in the long-term. The decrease in the QoL of patients treated with high-intensity multi-modal strategies highlights the necessity of modifying treatments, particularly for young HPV-positive patients, where an increased survival rate has already been reported. The modified treatment for HPV-positive tumors in the tonsils and at the base of the tongue is based on the deintensification of therapies aiming to reduce toxicity and thereby improve QoL in the long term, whilst still maintaining therapeutic effectiveness. The aim of the present study was to evaluate the QoL in patients with a long-term survival, who were treated with combined therapy for squamous cell tumors in the tonsils and at the base of the tongue, and to compare the results observed in HPV-positive and HPV-negative patients. According to statistical analysis, differences in the general QoL and in the single scales of the European Organization for the Research and Treatment of Cancer questionnaires were not correlated with the type of therapy selected for the particular patient. QoL considered the presence of HPV, the type of treatment, the subregion of the tonsils vs. the base of the tongue and the disease stage at the time of diagnosis, and was determined to be non-influential with regard to these specific variables.

The treatment of advanced-stage oropharyngeal squamous cell carcinoma may utilize various modes, including combining surgery with chemoradiotherapy (CTRT), or primary CTRT followed by rescue surgery. In previous literature it has been revealed how patients treated with combined modes report a low quality of life (QoL) and severe consequences following surgery, radiotherapy and chemotherapy, in the short and in the long-term. The decrease in the QoL of patients treated with high-intensity multi-modal strategies highlights the necessity of modifying treatments, particularly for young HPV-positive patients, where an increased survival rate has already been reported. The modified treatment for HPV-positive tumors in the tonsils and at the base of the tongue is based on the deintensification of therapies aiming to reduce toxicity and thereby improve QoL in the long term, whilst still maintaining therapeutic effectiveness. The aim of the present study was to evaluate the QoL in patients with a long-term survival, who were treated with combined therapy for squamous cell tumors in the tonsils and at the base of the tongue, and to compare the results observed in HPV-positive and HPV-negative patients. According to statistical analysis, differences in the general QoL and in the single scales of the European Organization for the Research and Treatment of Cancer questionnaires were not correlated with the type of therapy selected for the particular patient. QoL considered the presence of HPV, the type of treatment, the subregion of the tonsils vs. the base of the tongue and the disease stage at the time of diagnosis, and was determined to be non-influential with regard to these specific variables.

The medieval Modena cathedral (Northern Italy) was modified in the 15th century with the construction of 23 new vaults, which were progressively added throughout. A detailed survey of the vaults binder revealed the scars of multiple repair works after several earthquakes, resulting in a complex patchwork of lime mortar repairs over original gypsum vaults and gypsum repairs over original lime vaults. No apparent systematic construction criteria were followed to dictate the use of lime or gypsum binders. We used an integrated approach based on different absolute dating techniques in order to clarify the original vaults construction timing and to define the chronology of the restorations. The aim was to correlate the main restoration works to the earthquake chronology deduced from the catalogue of historic earthquakes. Radiocarbon dating using sequential dissolution (Lindroos et al., 2018) and Optically Stimulated Luminescence of the sand aggregate (Panzeri et al., 2018) were carried out to date the lime mortars and Thermoluminescence to date bricks. The preliminary results suggest that lime mortar was used both as original building material and for later major repairs. Some vaults were entirely rebuilt using a gypsum binder, and some others originally built using lime mortars were modified at least two times using two different gypsum mortars. These results are particularly significant because we were able to demonstrate that the vaults suffered much larger damage induced by earthquakes than previously assessed just by mapping fracture and crack networks.