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Ports are complex environments due to their complicated geometry (quays, channels, and piers), the presence of human activities (vessel traffic, shipyards, industries, and discharges), and natural factors (stream and torrent inputs, sea action, and currents). Taking these factors into consideration, we have examined the marine environment of a port from the point of view of the circulation of the water masses, hydrological characteristics, distribution of the sediment grain-size, mineralogical characteristics, and metal concentrations of the bottom sediments. Our results show that, in the case of the Port of Genoa (north-western Italy), the impact of human activities (such as a coal power-plant, oil depots, shipyards, dredging of the bottom sediments, etc.), natural processes (such as currents, fresh water and sediment inputs from the torrents), and the morphology of the basin, are important factors in the sediment, water, and metal distributions that have given rise to a complex environment. [ABSTRACT FROM AUTHOR]

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The stakeholders involved in a dredging operation are many and varied, some specifically involved in the technical aspects (client and dredging operators, organisations involved in legislative matters and/or environmental monitoring), and others less so (general public).These different kinds of stakeholders need different information and consequently different kind of data need to be produced (description of dredging objectives and scope, technical dredges characteristics, related legislation, environmental monitoring data, work progress, etc.) that need to be managed to share dredging information and knowledge. Here, we illustrate two examples of communication strategy adopted in the case of the dredging of the Port of Genoa (Italy) to ensure the correct data dissemination among the project partners and to the public. The first realized with a WebGIS (MArine Coastal Information SysTEm-Port Section, MACISTE-PS), a technology composed of data handling tools for storage, recovery, management and analysis of spatial data, and the second with a set of different communication products (posters, article publications, congress participations, website, etc.). The adoption of these two strategies assures us the dissemination of dredging information to a broad spectrum of people. [ABSTRACT FROM AUTHOR]

Dravet syndrome, a developmental and epileptic encephalopathy, manifests with varying degrees of cognitive and communication impairment, postural and movement disorders (such as ataxia, coordination issues, and crouch gait) and behavioural challenges (including attention deficit/hyperactivity, oppositional/defiant behaviour, and autistic traits). Rehabilitation is a valuable tool for most patients, typically prescribed to address the most pressing issues. However, current practices often fall short in proactively preventing and treating known challenges associated with the syndrome, as indicated by the latest literature, at different life stages. Furthermore, there is a notable lack of evidence regarding treatment types and efficacy specific to people with Dravet Syndrome. Conducted in collaboration with one of the Italian Patient associations, this national survey provides a comprehensive view of the rehabilitation landscape in Dravet Syndrome, as perceived by caregivers. It outlines the types of treatments for 51 patients, based on age and relevant clinical features. The findings reveal a heterogenous rehabilitation approach, only partly tailored to the presence of specific comorbidities, and underline numerous unmet needs. Compared to the past there is indirect evidence that more patients are offered early rehabilitation. Nonetheless, while nowadays speech therapy and neuropsychomotor therapy are nearly universal for children up to the age of 10, some begin physiotherapy and psychotherapy thereafter, with a majority discontinuing treatments. Therefore, families of adolescent and adult patients often face a lack of comprehensive support, predominantly offered when epilepsy is more challenging to control affecting rehabilitation adherence and effectiveness. Finally, a negligible minority is offered treatments such as neurovisual training, augmentative and alternative communication, and occupational therapy. Many of these considerations could apply to other developmental and epileptic encephalopathy with lifelong disability. This survey calls for more data collection on this important topic for more efficient allocation of rehabilitation resources., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: The aim of this study was to evaluate efficacy and safety of the ATOMS system for the treatment of postoperative stress urinary incontinence (SUI)., Methods: We included all consecutive male patients referring for postoperative SUI and treated with ATOMS system from June 2013 to July 2017. Patients received anamnesis, 24 h Pad Test, Pad count, physical examination, urodynamic evaluation, ICIQ-UI SF questionnaire. We excluded patients with low bladder capacity and compliance, uncontrolled detrusor overactivity., Results: We treated 98 patients with median age of 70.21±10.02 years. The most common cause of SUI was open radical prostatectomy in 79 patients. Ten patients had undergone urethrotomy, 7 bladder neck incision, 14 adjuvant radiotherapy. Thirty-nine patients suffered of mild incontinence (24 h Pad Test <200 g), 49 moderate incontinence (200-400 g), 10 severe incontinence (≥400 g). Thirty-one patients underwent previous incontinence surgery: 29 ProACT, 3 artificial urinary sphincters (in 2 cases both devices), 1 bulking agents and subsequent male sling. Median follow-up was 21.5 months. We had a significant reduction of mean 24 h Pads Test, pad count and ICIQ-UI SF questionnaire (P<0.01). At last follow-up 47.96% of patients were dry and 79.59% reached social continence. A high incontinence grade, adjuvant radiotherapy, previous urethral surgery and incontinence surgery have been associated with lower continence results. We had complications in 33 patients (33.7%). The device was removed in 4 cases due to scrotal port erosion and in one case due to persistent pain., Conclusions: The ATOMS system seems to be an effective and safe surgical treatment for postoperative male SUI.

Environmental variables can regulate behavior in healthy subjects. Recently, some authors investigated the role of meteorological variables in bipolar patients with an impact on both the onset and course of bipolar disorder (BD). The aim of this study was to investigate the impact of meteorological variables and other indexes in bipolar hospitalized patients. We examined all patients admitted to the Psychiatric Inpatient Unit of San Luigi Gonzaga Hospital, Orbassano (Turin, Italy) from September 2013 to August 2015, collecting several socio-demographic and clinical characteristics. Seven hundred and thirty patients were included. Compared to the day of admission of control individuals, patients with BD were admitted on a day that presented higher minimum, medium, and maximum temperature, higher maximum humidity, higher solar radiation, and higher hours of sunshine. After logistic regression analysis, admissions to the emergency psychiatric ward due to a primary diagnosis of BD were associated with maximum temperature and solar radiation. The current study provides a novel perspective on the question surrounding seasonal mood patterns in patients with BD. A greater awareness of all possible precipitating factors is needed to inform self-management and psycho-educational programs as well as to improve resilience regarding affective recurrences in the clinical practice.

Sediment dredging can cause damage to the marine environment due to mobilization of sediments and contaminants. The effects of dredging and boundary environmental conditions on the concentration of Polycyclic Aromatic Hydrocarbons (PAHs) in water were evaluated during dredging of the Oil Port of Genoa-Multedo (Italy). Results showed that turbidity and PAH concentrations increased in the water during dredging. However, the scenario was complex due to the high number of interacting physical-chemical factors influencing PAH concentrations and transport. Due to these, PAH distribution is different in water, where low-molecular-weight PAHs were predominant (maximum concentration 0.105 μg L -1 ), and in bottom sediments, where high-molecular-weight PAHs had the highest concentrations (from 299.3 to 1256.5 ng g -1 ). Moreover, mainly during dredging the PAH concentrations in water were significantly higher inside than outside the port as a consequence of the lower dynamics within the port basin. Turbidity was the main parameter related to PAH concentrations., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Background: The aim of this prospective, multicentre, observational study was to evaluate the initial diagnostic procedures for lower urinary tract symptoms (LUTS) carried out by Italian general practitioners (GPs)., Methods: Data were collected from 445 GPs in Italy regarding the initial clinical decisions and diagnostic procedures adopted for the management of 1399 male patients with LUTS aged >or= 50 years., Results: 50.3% of patients were managed by the GP,4.9% were referred to the urologist immediately and 44.8% after carrying out some diagnostic procedures. A digital rectal examination was performed in only one-third of the patients, many of whom were not subsequently referred to the urologist (26.4%). Laboratory tests that are usually recommended (i.e. PSA, urinalysis and serum creatinine) were undertaken in 98.3% of patients, while tests that are generally considered optional (such as flowmetry) were undertaken in up to 64%. Other generally not recommended investigations, such as ultrasonography, were carried out in 77.2%. The mean time to diagnosis was significantly shorter when the urologist was not involved (36.0 days for GP only management vs 51.4 days for immediate referral and vs 43.4 days for delayed referral (p = 0.0003)., Conclusions: Our findings show a propensity for the majority of Italian GPs to deal with LUTS patients in a primary setting without immediate referral to the urologist. In principle, this trend could be beneficial for the patient (i.e. by reducing time to diagnosis) and cost saving for the national health system. However, the diagnostic procedures selected by the GPs were not in line with best evidence practice recommendations. Shared-care protocols involving both GPs and urologists may contribute to better implementation of the guidelines on the management of LUTS and benign prostatic hyperplasia in Italy.

Screening programs for congenital hypothyroidism (CH) dramatically improved the neuropsychological prognosis in affected children. However, mild impairments in cognitive performances, poorer motor skills, defective language abilities, and learning problems have been reported in some studies of early-treated CH children. The occurrence of these defects makes neuropsychological follow-up mandatory. The aim of the present study was to identify those neuropsychological functions that are more frequently affected in early-treated CH children and that might require prompt rehabilitation treatment to prevent permanent defects. The study group involved 24 CH children. Levothyroxine (LT4) treatment (initial dose 8-10 microg/kg per day) was started at mean age of 28 days (range 15-45) and was then adjusted with the goal to keep thyrotropin (TSH) and free thyroid hormone levels in the normal range. Cognitive evaluation was performed at 3, 5, and 7 years of age and did not significantly differ from that of controls. Mean neurological scores were lower in children 5 years of age than in controls. Children with severe neonatal hypothyroidism (serum thyroxine [T4] < 2 microg/dL) had significantly lower neurological scores compared to less affected CH children and normal controls. The most affected functions were balance, extremity coordination, fine motricity, quality of movements, associated movements, and head movements. Language disorders were observed in half of CH children at 3 and 5 years of age, but moderately severe defects were restricted to those with severe neonatal hypothyroidism. In conclusion, a problem-oriented, simplified neuropsychological follow-up of early-treated children with CH should not systematically include the frequent repetition of time-consuming and expensive psychometric tests because individual IQ scores are in the normal range of tests in almost all CH children and can be differentiated from those of normal controls only on a population-statistic basis. Selected tests of motor proficiency are indicated at 3 and 5 years of age to detect those defects in motor skills that appear to be more specifically affected in CH children. Language performances are at particular risk in CH children, and should be always checked at 3 and 5 years of age. Children with even mild language disorders or delayed language achievements should be regularly reevaluated at 6-month intervals and, if no spontaneous improvement is observed, they should receive specific rehabilitation treatment. No further motor and language evaluation is warranted in CH children with normal tests at age 5 years.

The objective of this study was to compare the clinical and bacteriologic efficacy and safety of cefodizime 1 g intramuscularly (IM) once daily (group A) versus cefodizime 1 g IM twice daily (group B) and versus ceftriaxone 1 g IM once daily (group C) in patients with community-acquired pneumonia. A total of 298 patients, affected by bronchopneumonia or pneumonia with known or suspected bacterial cause, new focal signs on examination of chest, and radiographic evidence of a recent infiltrate, were randomized in three comparable groups. The infection was rated as mild, moderate, or severe. A total of 283 patients were assessable for efficacy: 95 in group A, 94 in group B, and 94 in group C. Mean (+/- SD) duration of treatment was 5.96 +/- 1.39 days in group A, 6.24 +/- 1.57 days in group B, and 6.66 +/- 1.95 days in group C. Symptoms such as purulent sputum, cough, and dyspnea improved significantly after treatment in all groups; temperature normalized by about day 3. Clinical efficacy was rated good in 94.74% of patients in group A, in 92.55% in group B, and in 87.23% in group C. Positive bacteriologic cultures were obtained before treatment from 144 patients: bacteriologic responses were rated good in 98.11%, 98.08%, and 92.80% in groups A, B, and C, respectively. No significant differences were found between the three treatment groups for any measures of clinical efficacy. No serious adverse event occurred in any of the groups. We conclude that cefodizime 1 g IM once daily is an effective dosing regimen in the treatment of patients with community-acquired pneumonia.

The authors analyze some medico-legal aspects concerning the surgical therapy of transsexualism, as it is regulated by the Law N. 442/1982. At first they examine the problems related to the verification of the indications for the surgical treatment, with particular reference to nosography, differential diagnosis and clinical criterions suitable to evaluate the usefulness of this intervention. Afterward they analyze the problem of the validity of the consent, considering the particular kind of treatment and the psychological connotations of these patients.

The Authors, after synthetic outline of the new regulations concerning "the release on trust in social service", an alternative measure to that of imprisonment according to law no. 354 of 26 July 1975, take into consideration some of the problems and difficulties which have emerged in the first months of application of this law. This examination is followed by a review of the results of criminological research on the period of probation and of the present aims emerging with regard to this measure, in the countries where it has been tested for some time. The Authors conclude with a critical evaluation of the present regulations and a series of proposals aimed at improving the application of the probation system in social service.