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Endometrial polyps are one of the most common pathological conditions in gynecology. Hysteroscopy is the gold standard for the diagnosis and treatment of endometrial polyps. The purpose of this multicenter, retrospective study was to compare patients’ pain perception during an operative hysteroscopic endometrial polypectomy in an outpatient setting with two different hysteroscopes (rigid and semirigid) and to identify some clinical and intraoperative characteristics that are related to worsening pain during the procedure. We included women that underwent, at the same time as an diagnostic hysteroscopy, the complete removal of an endometrial polyp (using the see-and-treat strategy) without any kind of analgesia. A total of 166 patients were enrolled, of which 102 patients underwent a polypectomy with a semirigid hysteroscope and 64 patients underwent the procedure with a rigid hysteroscope. No differences were found during the diagnostic step; on the contrary, after the operative procedure, a statistically significant greater degree of pain was reported when the semirigid hysteroscope was used. Cervical stenosis and menopausal status were risk factors for pain both in the diagnostic step and in the operative one. Our results confirm that operative hysteroscopic endometrial polypectomy in an outpatient setting is an effective, safe, and well-tolerated procedure and indicate that it might be better tolerated if a rigid rather than semirigid instrument is used.

In September 2021, the La Fossa crater at Vulcano, in Italy, entered a new phase of unrest. We discuss a set of monitoring parameters included in the INGV surveillance network, which closely tracked the sequence of effects related to the crisis. The low-frequency local seismicity sharply increased, while the GPS and tiltmeter networks recorded the inflation of the cone, as an effect of fluid expansion in the hydrothermal system. Gravity variations were probably the effects of fast processes within shallow sources. The anomalies in soil CO2 flux, fumarole temperature, and in plume SO2 flux marked the strong increase in the vapor output from crater fumaroles. The signs of the impending crisis had been evident in the chemical and isotopic composition of fumarole gases since July 2021. These geochemical anomalies were clearly indicative of the enhanced input of gases from a magmatic source. In October, the massive degassing also influenced the areas at the base of the cone. In some areas, soil CO2 degassing and the thermal aquifer recorded strong anomalies. By early November, the crisis reached its acme. Afterward, the monitored parameters started a slow and discontinuous decreasing trend although remaining, some of them, sensibly above the background for several months. The multidisciplinary approach proved decisive for the interpretation of the underlying processes acting in the different phases of the unrest, thus allowing a consistent evaluation of the multiple hazards.

The impact of pregnancy and breastfeeding on the development and outcomes of Multiple sclerosis (MS) has been debated for decades. Since several factors can influence the evolution of the disease, the protective role of multiparity and breastfeeding remains uncertain, as well the role of hormone replacement therapy in the perimenopausal period. We report two cases of relatively late-onset MS in two parous women, who developed their first neurological symptoms after six and nine pregnancies, respectively. Both women breastfed each of their children for 3 to 12 months. One of them underwent surgical menopause and received hormone replacement therapy for 7 years before MS onset. We performed a systematic literature review to highlight the characteristics shared by women who develop the disease in similar conditions, after unique hormonal imbalances, and to collect promising evidence on this controversial issue. Several studies suggest that the beneficial effects of pregnancy and breastfeeding on MS onset and disability accumulation may only be realized when several pregnancies occur. However, these data on pregnancy and breastfeeding and their long-term benefits on MS outcomes suffer from the possibility of reverse causality, as women with milder impairment might choose to become pregnant more readily than those with a higher level of disability. Thus, the hypothesis that multiparity might have a protective role on MS outcomes needs to be tested in larger prospective cohort studies of neo-diagnosed women, evaluating both clinical and radiological features at presentation.

Social distancing norms have been promoted after the COVID-19 pandemic. In this work, we tested interpersonal space (IPS) in 107 subjects through a reaching-comfort distance estimation task. In the main experiment, subjects had to estimate the comfort and reach space between an avatar wearing or not wearing a face mask. We found that IPS was greater between avatars not wearing a mask with respect to stimuli with the mask on, while reaching space was not modulated. IPS increment in the NoMask condition with respect to the Mask condition correlated with anxiety traits, as shown with the State-Trait Anxiety Inventory, rather than with transient aspects related to the pandemic situation. In the control experiment, the avatars with a mask were removed to further explore the conditioning effect provided by the presence of the facial protection in the main experiment. We found a significant difference comparing this condition with the same condition of the main experiment, namely, the distances kept between avatars not wearing a mask in the main experiment were greater than those between the same stimuli in the control experiment. This showed a contextual adaptation of IPS when elements related to the actual pandemic situation were relevant. Additionally, no significant differences were found between the control experiment and the Mask condition of the main experiment, suggesting that participants had internalized social distancing norms and wearing a mask has become the new normal. Our results highlight the tendency of people in underestimating the risk of contagion when in the presence of someone wearing a mask.

Offshore data in the western Ionian Sea indicate that the NW–SE-trending dextral shear zone of the Alfeo-Etna Fault System turns to the N–S direction near the Ionian coastline, where the extensional Timpe Fault System is located. Morpho-structural data show that NW–SE-trending right-lateral strike-slip faults connect the Timpe Fault System with the upper slope of the volcano, where the eruptive activity mainly occurs along the N–S to NE–SW-trending fissures. Fault systems are related to the ~E–W-trending extension and they are seismically active having given rise to shallow and low-moderate magnitude earthquakes in the last 150 years. As a whole, morpho-structural, geodetic and seismological data, seismic profiles and bathymetric maps suggest that similar geometric and kinematic features characterize the shear zone both on the eastern flank of the volcano and in the Ionian offshore. The Alfeo-Etna Fault System probably represents a major kinematic boundary in the western Ionian Sea associated with the Africa–Europe plate convergence since it accommodates, by right-lateral kinematics, the differential motion of adjacent western Ionian compartments. Along this major tectonic alignment, crustal structures such as releasing bends, pull-apart basins and extensional horsetails occur both offshore and on-land, where they probably represent the pathway for magma uprising from depth.

In July and August 2019, Stromboli volcano underwent two dangerous paroxysms previously considered “unexpected” because of the absence of significant changes in usually monitored parameters. We applied a multidisciplinary approach to search for signals able to indicate the possibility of larger explosive activity and to devise a model to explain the observed variations. We analysed geodetic data, satellite thermal data, images from remote cameras and seismic data in a timespan crossing the eruptive period of 2019 to identify precursors of the two paroxysms on a medium-term time span (months) and to perform an in-depth analysis of the signals recorded on a short time scale (hours, minutes) before the paroxysm. We developed a model that explains the observations. We call the model “push and go” where the uppermost feeding system of Stromboli is made up of a lower section occupied by a low viscosity, low density magma that is largely composed of gases and a shallower section occupied by the accumulated melt. We hypothesize that the paroxysms are triggered when an overpressure in the lower section is built up; the explosion will occur at the very moment such overpressure overcomes the confining pressure of the highly viscous magma above it.

After a period of mild eruptive activity, Stromboli showed between 2017 and 2018 a reawakening phase, with an increase in the eruptive activity starting in May 2017. The alert level of the volcano was raised from “green” (base) to “yellow” (attention) on 7 December 2017, and a small lava overflowed the crater rim on 15 December 2017. Between July 2017 and August 2018 the monitoring networks recorded nine major explosions, which are a serious hazard for Stromboli because they affect the summit area, crowded by tourists. We studied the 2017−2018 eruptive phase through the analysis of multidisciplinary data comprising thermal video-camera images, seismic, geodetic and geochemical data. We focused on the major explosion mechanism analyzing the well-recorded 1 December 2017 major explosion as a case study. We found that the 2017−2018 eruptive phase is consistent with a greater gas-rich magma supply in the shallow system. Furthermore, through the analysis of the case study major explosion, we identified precursory phases in the strainmeter and seismic data occurring 77 and 38 s before the explosive jet reached the eruptive vent, respectively. On the basis of these short-term precursors, we propose an automatic timely alarm system for major explosions at Stromboli volcano.