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Within the thriving area of research on informal access to English, the present paper focuses on the methodology and design of valid, reliable and effective instruments for data collection. Studies on informal language learning have addressed different target populations, with a preference for teenagers and young adults, and have mainly used questionnaires and users' reports to gather large amounts of information. Methodological reflections on questionnaire design, however, are not always in the foreground - while sharing methodology choices is crucial for the comparability and replicability of findings. Moving from these premises, the current study describes a new instrument to investigate the experiencing and learning of English outside the classroom through multiple media. It includes a newly-developed questionnaire (the Informal English Contact and Learning questionnaire, IECoL; see Appendix) and a receptive vocabulary test adapted from Nation (1990). The tool was designed as part of an ongoing large-scale national (PRIN) project on the informalisation of English language learning among university students in Italy. Both components are described in detail, focusing on the rationale, the innovative aspects, the development and piloting phases, and the final structure and layout. Cronbach's Alpha coefficient was calculated on the 4,000 valid questionnaires, showing the reliability and internal consistency of the instrument as a whole. We conclude by outlining the innovativeness of the instrument and by underlining the paramount importance of data collection methods and tools in a field where users' reports and recall are the main sources of information about respondents' behaviour and private worlds. [ABSTRACT FROM AUTHOR]

Simple Summary: Breast cancer is the most common cancer in women worldwide, with a high prevalence and incidence, configuring an important issue in cancer epidemiology. Over the years, the combination of primary and secondary prevention programs and multidisciplinary treatment approaches has improved the overall survival (OS) and quality of life (QoL) of patients. However, although treatment pathways should be standardized in evidence-based medicine, clinical practice (real-world evidence) may differ from expected. To improve OS and QoL, having a clear picture of the Patterns of Care actually applied is essential. To this aim, Breast IRRADIATA (Italian Repository of RADIotherapy dATA), a collaborative nationwide project, was developed as a simple tool to probe the current pattern of radiotherapy care in Italy and tested in a feasibility study. This pilot feasibility of IRRADIATA encourages a larger application of this tool nationwide and opens the way to the assessment of pattern of care radiotherapy directed to other cancers. Aim. Breast IRRADIATA (Italian Repository of RADIotherapy dATA) is a collaborative nationwide project supported by the Italian Society of Radiotherapy and Clinical Oncology (AIRO) and the Italian League Against Cancer (LILT). It focuses on breast cancer (BC) patients treated with radiotherapy (RT) and was developed to create a national registry and define the patterns of care in Italy. A dedicated tool for data collection was created and pilot tested. The results of this feasibility study are reported here. Methods. To validate the applicability of a user-friendly data collection tool, a feasibility study involving 17 Italian Radiation Oncology Centers was conducted from July to October 2021, generating a data repository of 335 BC patients treated between January and March 2020, with a minimum follow-up time of 6 months. A snapshot of the clinical presentation, treatment modalities and radiotherapy toxicity in these patients was obtained. A Data Entry Survey and a Satisfaction Questionnaire were also sent to all participants. Results. All institutions completed the pilot study. Regarding the Data Entry survey, all questions achieved 100% of responses and no participant reported spending more than 10 min time for either the first data entry or for the updating of follow-up. Results from the Satisfaction Questionnaire revealed that the project was described as excellent by 14 centers (82.3%) and good by 3 (17.7%). Conclusion. Current knowledge for the treatment of high-prevalence diseases, such as BC, has evolved toward patient-centered medicine, evidence-based care and real-world evidence (RWE), which means evidence obtained from real-world data (RWD). To this aim, Breast IRRADIATA was developed as a simple tool to probe the current pattern of RT care in Italy. The pilot feasibility of IRRADIATA encourages a larger application of this tool nationwide and opens the way to the assessment of the pattern of care radiotherapy directed to other cancers. [ABSTRACT FROM AUTHOR]

The European regulatory framework requires prior authorization for the use of plants and activities that may impact the environment, to ensure an adequate level of environmental and human health protection. Data on industrial wastewater, urban sewage, atmospheric emissions and waste management of installations subject to licenses generate interest among stakeholders (Environmental Protection Agencies, Police Forces, regions, provinces, municipalities, Local Health Authorities, operators, research bodies, citizens), but unfortunately, they are not properly digitized and processed, as they are often unavailable. Therefore, the main goal of this project is to provide a flexible, interactive and easy-to-use tool for stakeholders to allow them to consult these kinds of environmental data. For this purpose, a database integrated with a web-based Geographical Information System (GIS) platform to collect, manage and share pollutant emissions data, is currently being designed and developed. The web platform offers to users interconnected informative modules on required authorizations, license processes and analytical controls. Moreover, stored data from industries and on emissions are georeferenced and displayed in a web GIS map. Stakeholders have free but limited access to specific sections of the web platform, depending on their tasks. They can consult environmental data and GIS representations, download reports or documents and enter new data. This web application seeks to: (1) promote collaboration among stakeholders, (2) simplify the monitoring of an installation's authorization status and industrial emissions trends, (3) optimize the environmental licensing procedures, (4) enhance the management of environmental control by the relevant authorities, (5) support health and environmental research, and (6) provide industries with innovative services for data transmission. To evaluate the performance and benefits of the newly-developed tool, a real-life pilot case has been applied using data from industries located in the Province of Ascoli Piceno (Marche region, Italy). [ABSTRACT FROM AUTHOR]

Purpose: We herein present the results of the first Italian Association of Radiotherapy and Clinical Oncology (AIRO) survey regarding salvage external beam re-irradiation of local prostate cancer relapse named PROLAPSE. Methods: A questionnaire with 12 items was administered to the 775 Italian radiation oncologist members of the AIRO. Results: One hundred of the members completed the survey. The survey highlighted that 59% of the participants are currently performing prostate re-EBRT, while nearly two-thirds (65%) affirmed that they are taking into consideration the procedure in case of intraprostatic relapse. Regarding the clinical target volume (CTV), only a minority (16%) declared to always prefer the partial prostate re-irradiation, while a consistent portion (nearly two-thirds) relied on clinical considerations of the choice towards partial or whole gland irradiation. The main techniques used for re-irradiation resulted to be intensity-modulated RT (IMRT)/volumetric modulated arc therapy (VMAT) and SBRT, having received approximately 40% of responses each. Regarding the criteria for patients' selection, more than 75% of responders agreed on the use of positron emission tomography (PET)/computed tomography (CT)-choline to exclude distant metastases and of multiparametric magnetic resonance imaging (mp-MRI) to detect intraprostatic recurrence. A sufficient timeframe (> 3 years) between primary RT and reirradiation was indicated by more than half of participants as an important driver in decision-making, while histological confirmation of the relapse was considered not essential by more than two-thirds. For the use of concomitant androgen deprivation therapy (ADT), most AIRO members (79%) agreed that the prescription should be based on a case-by-case analysis. Extreme hypofractionation (> 5 Gy/fraction) was preferred by the majority (52%) of the AIRO members. In most centers (more than 74%), the planning dose–volume constraints were generally extrapolated from the published data. In half of the cases, the interviewed responders affirmed that no major gastrointestinal (GI) and genitourinary (GU) toxicities were registered in the follow-up of their re-EBRT patients. Bladder complications represented the most commonly observed form of toxicity, with an incidence of 67%. Conclusion: This first AIRO survey about salvage prostate re-EBRT provides an interesting snapshot and suggests increasing interest in re-EBRT patients in Italy. Consensus about some aspects of patients' selection, the necessity of biopsy, fractionation, and highly selective techniques seems feasible, but other key points such as irradiated volume, dosimetry parameters, and hormonal treatment association need to be clarified. [ABSTRACT FROM AUTHOR]

In recent years, Italy has seen a rapid growth in the PV (photovoltaic) sector, following the introduction of the FIT (feed in tariff) scheme known as Conto Energia. In July 2013 the Italian government definitively cut FITs, leaving only tax benefits and a revised net metering scheme (known as “Scambio sul Posto”) for new PV installations. In this scenario, the design of a new PV plant ensuring savings on electricity bills is strongly related to household electricity consumption patterns. This paper presents a high-resolution model of domestic electricity use. The model is based on Fuzzy Logic Inference System. Using as inputs patterns of active occupancy and typical domestic habits, the fuzzy model give as output the likelihood to start each appliance within the next minute. The model has been validated with electricity demand data recorded over the period of one year within 12 dwellings in the central east coast of Italy. The tool has been used to evaluate the self consumption percentage to correctly size a residential photovoltaic plant in a case study. A cost benefits analysis is presented to show the effectiveness of PV-generation in the new Italian scenario. [ABSTRACT FROM AUTHOR]

The National Palliative Care and Interventional Radiotherapy Study Groups of the Italian Association of Radiotherapy and Clinical Oncology (AIRO) carried out a survey whose aim was to obtain a "snapshot" of the real-world practice of nonmelanoma skin cancer (NMSC) treatments in Italy. The survey was conducted on SurveyMonkey's online interface and was sent via e-mail to our society Radiation Oncologists. Fifty-eight Italian radiation oncologists (ROs), representing 54 centers, answered the survey. Thirteen percent of the ROs declared they treat fewer than 10 NMSC lesions annually, 36% treat between 11 and 20, and 51% treat more than 20 lesions annually. Interventional radiotherapy (IRT) was offered by 25% of the ROs, and every case was reportedly discussed by a multidisciplinary team (71%). Electrons (74%), volumetric modulated arc therapy (V-MAT) (57%), three-dimensional conformal radiotherapy (3D-CRT) (43%), and IRT (26%) were the main treatment options. With external beam radiotherapy (EBRT), 46 and 53 different RT schedules were treated for curative and palliative intent, respectively; whereas for IRT, there were 21 and 7 for curative and palliative intent, respectively. The most popular EBRT curative options were 50–70.95/22–35 fractions (fx) and 50–70 Gy/16-20fx and for EBRT palliative settings, 30Gy/10fx, and 20–35Gy/5fx. For IRT, the most popular curative options were 32–50Gy/8-10fx and 30–54Gy/3-5fx, whereas 30Gy/6fz was the palliative option. Less than 10 re-RT cases were reported in one year in 42.5%, 11–20 cases in 42.5%, and >20 cases annually in 15%. Electrons (61%), VMAT (49%), and BRT (25%) were the most widely used approaches: 20–40Gy in 10fx and 20–25Gy in 5fx were the recommended fractionations. The survey shows a variegated reality. A national registry with more detailed data could help in undercover its causes. • The Italian Association of Radiotherapy and Clinical Oncology (AIRO) proposed a survey to verify the national radiotherapy practices for nonmelanoma skin cancer (NMSC). • The preferred treatment techniques were: electrons (74%) and volumetric modulated arc therapy (V-MAT) (57%). • Interventional radiotherapy (IRT) can only be offered as a therapeutic option in only 25% of Italian RT centers. • Differing RT schedules but mainly adhering to international recommendations. • Data show that the single center experience was likely to play a prevalent role. [ABSTRACT FROM AUTHOR]

• Medium-term energy planning in an academic end-user is performed. • 20 solutions are studied to get the environmental goal of 50% emissions reduction. • At least, 3.3 MW of Photovoltaic panels and 7 MWh of battery capacity are required. • Hydrogen integration implies a lower size of most of the energy systems. • Battery capacity is connected to both heat pump and thermal energy storage sizes. The European Union defined the ambitious carbon-neutrality goal for 2050. Such a transition must be done gradually to avoid huge investments; therefore, medium-term energy planning of energy supply systems must be performed properly considering both economic and environmental aspects. Sector coupling measures aid to achieve this ambitious target, although they require a remarkable financial investment. This paper presents an innovative methodology for the medium-term energy planning of the university campus "Marche Polytechnic University" located in Italy towards the carbon neutrality, i.e., 50 % of carbon emissions reduction by considering financial investment aspects. The university campus is a multi-carrier local energy community with multiple technologies such as photovoltaic, combined heat and power, gas-fired boilers, absorption, and electric chillers that satisfy the end-users' energy demand. A different mix of installed and new technologies (e.g., energy storage or hydrogen) are investigated through the Calliope framework. The case studies present the economic-based optimal scenario of a typical year planning, guaranteeing the same 50 % carbon emissions reduction. Results underline the importance of exploiting synergies among multiple carriers and the essential role of i) renewables (e.g., additional 3.3 MW of photovoltaic to be installed), ii) batteries with a capacity of 7 MWh, and (iii) sector coupling technologies. [ABSTRACT FROM AUTHOR]

Purpose: Intraoperative radiation therapy with electrons (IOERT) may represent a viable choice for partial breast reirradiation after repeat quadrantectomy for local recurrence (LR) for primary breast cancer (BC) in lieu of mastectomy., Methods and Materials: A database collecting data on partial breast reirradiation with IOERT from 8 Italian centers was set up in 2016 to 2018, providing data on cumulative incidence (CumI) of second LR and survival with a long follow-up., Results: From 2002 to 2015, 109 patients underwent the conservative retreatment. The median primary BC first LR interval was 11.1 years (range, 2.4-27.7). The median first LR size was 0.9 cm (range, 0.3-3.0), and 43.6% cases were luminal A. Median IOERT dose was 18 Gy (range, 12-21), and median collimator diameter was 4 cm (range, 3-6). Median follow-up duration was 11.7 years (IQR, 7.7-14.6). The second LR CumI was 12.2% (95% CI, 6.8%-19.2%) at 5 years and 32.3% at 10 years (95% CI, 22.8%-42.2%), occurring in the same site as the first LR in about half of the cases. Human epidermal growth factor receptor 2 status and collimator size were independent LR predictors. The 5- and 10-year overall survival rates were 95.2% and 88.3%, respectively, whereas 5- and 10-year BC-specific survival rates were 98% and 94.5%, respectively. The development of a second LR significantly reduced BC-specific survival (hazard ratio, 9.40; P < .001). Grade ≥3 fibrosis rate was 18.9%. Patient-reported cosmesis was good/excellent in 59.7% of the cases., Conclusions: Second LR CumI was within the range of the literature but higher than expected, opening questions on radiation field extension and fractionation schedule. Because a second LR worsened the outcome, salvage modality must be carefully planned., Competing Interests: Disclosures The Division of Radiation Oncology of the European Institute of Oncology (IEO) received research funding from the Italian Association for Cancer Research (AIRC), Fondazione Istituto Europeo di Oncologia-Centro Cardiologico Monzino (IEO-CCM), Accuray, and Ion Beam Applications (IBA), all outside the current project. Barbara Alicja Jereczek-Fossa received speaker fees from Bayer, Accuray, Astellas, IBA, Ipsen, Astra Zeneca, Tecnologie Avanzate, Recordati, and Novartis; participated in the Advisory Board of Accuray, Bayer, and Seagen, all outside the current project. Maria Cristina Leonardi received a speakers fee from Accuray, and Samantha Dicuonzo received a speakers fee from Accuray Asia (all outside the current project). The remaining authors declare no conflicts of interest that are relevant to the content of this article., (Copyright © 2024 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.)

Aim: This survey derived from the collaboration between the Palliative Care and Reirradiation Study Groups of the Italian Association of Radiotherapy and Clinical Oncology (AIRO). Its aim was to obtain a real "snapshot" on the treatments of spinal metastases, focusing on reirradiation, among radiation oncologists in Italy., Methods: The survey was elaborated on SurveyMonkey's online interface and was sent via e-mail to all Radiation Oncologists of AIRO that were invited to anonymously fill in the electronic form within 60 days. The questionnaire was prepared by the AIRO "Palliative care" and "Reirradiation" Study Groups and it consisted of 36 questions, 19 single-choice questions, 10 multiple-choice questions and 6 open questions. The data were analyzed and represented with tables and graphs., Results: The survey shows that palliative radiotherapy remains a field of interest for most ROs in the Italian centers. 3D Conventional Radiation Therapy (3DCRT) alone or in combination with other techniques is the primary choice for patients with a life expectancy of less than 6 months. For patients with a life expectancy of more than six months, there is an increased use of new technologies, such as Volumetric Modulated Arc Therapy (VMAT). Factors considered for retreatment are time between first and second treatment, dose delivered to spine metastasis and spinal cord in the first treatment, vertebral stability, symptoms, and/or performance status. The most feared complication are myelopathy followed by vertebral fracture and local recurrence. This explain an increasing focus on patient selection and the use of high technology in the treatment of metastatic patients., Conclusion: Stereotactic body radiotherapy (SBRT) and image-guided radiotherapy allow the administration of ablative RT doses while sparing the constraints of healthy tissue in spinal metastases. However, there is still an unclear and heterogeneous reality in the reirradiation of spinal metastases. A national registry with the aim of clarifying the most controversial aspects of vertebral metastasis retreatments will enable better management of these patients and design more targeted study designs., (© 2022. The Author(s), under exclusive licence to Federación de Sociedades Españolas de Oncología (FESEO).)

This review is aimed at evaluating whether radiation therapy (RT) can be omitted in older adult early-stage low-risk breast cancer (BC) patients. The published data are particularly relevant at present, during the COVID-19 pandemic emergency, to define a treatment strategy and to prioritize essential therapy. Cochrane Database of Systematic Reviews and PubMED were systematically researched from outset through April 2020 using Mesh terms. Only randomized controlled trials (RCT), with one arm without adjuvant whole-breast irradiation (WBI), were included in the analysis. Recent literature regarding the COVID pandemic and BC RT was assessed. The reported RCTs identified a group of BC patients (pT1-2N0M0 R0, grade 1-2, estrogen receptor (ER) positive, human epidermal growth factor receptor 2 (HER2) negative tumours) in which the absolute risk of local recurrence (LR) was considered low enough to omit RT. The most common risk factors were tumor diameter, nodal and receptor status. Adjuvant RT had a significant impact on LR but not on distant metastasis (DM) or death. During the COVID 19 pandemic, results from RTCs were re-considered to define treatment recommendations for BC patients. International scientific societies and radiation oncology experts suggested RT omission, whenever possible, in older adult early-stage BC patients. Adjuvant RT might be omitted in a highly selected group of older adult early-stage BC patients with favourable prognostic factors. Hypofractionated regimens should be the standard. RT omission, partial breast irradiation (PBI), and ultra- hypofractionated regimens could be considered in selected cases due to the pandemic., Competing Interests: Declaration of Competing Interest The authors declare no conflict of interest., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Objectives: To determine interobserver variability in axillary nodal contouring in breast cancer (BC) radiotherapy (RT) by comparing the clinical target volume of participating single centres (SC-CTV) with a gold-standard CTV (GS-CTV)., Methods: The GS-CTV of three patients (P1, P2, P3) with increasing complexity was created in DICOM format from the median contour of axillary CTVs drawn by BC experts, validated using the simultaneous truth and performance-level estimation and peer-reviewed. GS-CTVs were compared with the correspondent SC-CTVs drawn by radiation oncologists, using validated metrics and a total score (TS) integrating all of them., Results: Eighteen RT centres participated in the study. Comparative analyses revealed that, on average, the SC-CTVs were smaller than GS-CTV for P1 and P2 (by -29.25% and -27.83%, respectively) and larger for P3 (by +12.53%). The mean Jaccard index was greater for P1 and P2 compared to P3, but the overlap extent value was around 0.50 or less. Regarding nodal levels, L4 showed the highest concordance with the GS. In the intra-patient comparison, L2 and L3 achieved lower TS than L4. Nodal levels showed discrepancy with GS, which was not statistically significant for P1, and negligible for P2, while P3 had the worst agreement. DICE similarity coefficient did not exceed the minimum threshold for agreement of 0.70 in all the measurements., Conclusions: Substantial differences were observed between SC- and GS-CTV, especially for P3 with altered arm setup. L2 and L3 were the most critical levels. The study highlighted these key points to address., Advances in Knowledge: The present study compares, by means of validated geometric indexes, manual segmentations of axillary lymph nodes in breast cancer from different observers and different institutions made on radiotherapy planning CT images. Assessing such variability is of paramount importance, as geometric uncertainties might lead to incorrect dosimetry and compromise oncological outcome.

Background/aim: This study aimed to investigate the bolus practice among Italian radiation oncologists., Patients and Methods: In 2018, a survey on bolus application was sent to all members of the Italian Association of Radiotherapy and Clinical Oncology., Results: The survey was joined by 102 radiation oncologists. Not all respondents answered to every question. A 69.5% of 82 respondents used bolus in case of skin infiltration and 52 of 68 respondents (76.5%) applied it every day. Skin was included as part of chest wall Clinical Target Volume both in the absence or the presence of breast reconstruction. Five mm bolus was the most used. 3D Conformal radiotherapy was the most used technique, in 73.5% of cases. Acute RTOG G2-G3 skin toxicity was recorded by 93.9% physicians., Conclusion: There was heterogeneity in the use of bolus, though an agreement was found in some topics. The achievement of a National Consensus may represent an interesting future goal., (Copyright© 2020, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)

Aims: To investigate the present attitude of the Italian Radiation Oncologists in the management of breast cancer (BC) concerning hypofractionated radiotherapy (hRT), partial-breast irradiation (PBI), re-irradiation (rRT) and radiotherapy after neoadjuvant chemotherapy (post-NAC RT)., Methods: A nationwide, 21-point questionnaire was distributed online via SurveyMonkey., Results: Seventy-four Italian Radiotherapy Centers answered to the survey. In most cases, the responding centers treated more than 100 BC patients/year between January 2016 and December 2017. Almost half of responding centers (49%) treated patients with hRT, out of these, 95% as routine practice for early-stage BC. Dose prescriptions ranged between 39 and 45 Gy indicating a high use of moderate hRT. The chest wall and regional lymph nodes were irradiated with hRT by 13% and 15% of the responding centers, respectively. PBI was used by 60% of responders, with different techniques. Only 0.6% of participants perform rRT after BC recurrence. Finally, only 11% of the interviewed centers responded to their attitude toward post-NAC RT, which, however, was indicated in 97% of patients after breast-conserving surgery., Conclusions: This survey shows a fairly good use of hRT and a moderate practice of PBI in Italy. Some practices like hRT to the chest wall and regional lymph nodes as well as rRT need further verification. Likewise, the management of post-NAC RT is very heterogeneous. Future national clinical collaborative studies are advocated in order to investigate these controversial topics about breast cancer radiotherapy.