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In the context of the COVID-19 emergency, the closure of Italian schools from March 2020 has imposed the full use of distance learning, as well as a general rethinking of time, space and teaching/learning methodologies. In this study, we will introduce the outcomes of an analysis carried out on the planning of Service Learning (SL) activities that took place during the professional training course called 'All'Avanguardia per l'innovazione'. The course, which was designed before the pandemic, has been redesigned during the health emergency and required teachers to write a project work on didactic planning in SL. From the perspective of distance learning, didactic planning has integrated the 'virtual' component and become E-Service Learning or Virtual-Service Learning. This planning has been analysed in relation to the LifeComp framework because it fosters the development of the competences that are necessary to manage the complexity of the current scenario, it perfectly integrates with the identifying elements of SL and includes some indicators of the DigComp framework that aims at the development of student, teacher and school digital skills that are necessary to manage distance learning. The first outcomes of the analysis highlight how didactic planning covers the development of the different competences promoted by the LifeComp framework.

The intensification of the working life of academics in the corporate world of higher education shaped by new public management, is the backdrop for an exploration of the appropriation of opportunities for silence and quietude through the operation of internalised disciplines of self-imposed control. The paper includes a review of selected literature on the effects of neoliberal education policy reform on the working lives of academics in higher education. Specifically it considers the intensity and pressures and the possibilities for academics to find silence, quietude and respite from the 'hurley-burley', allowing them to 'stand back' from this for a time. The influence of dominant market rationalities in higher education on academic working life is explored, with a particular focus on three national contexts -- England, Sweden and Italy. Two vignettes illustrate some of the possibilities and limitations of silence and quietude in academic working life. In the paper, the authors have also examined how the value of such opportunities can be eroded when subjugated for the purposes of the neoliberal academy and the drive for efficiency and performativity.

This work discusses the professional outcomes of University of Padova graduates in academic year 2007/08. Its aim was to carry out an overall assessment of higher education professional outcomes, involving all the main actors of the learning process, students, teachers and tutors, in a perspective of participatory evaluation, to improve teaching and tutoring. The research design complements qualitative and quantitative approaches to data analysis. First, professional outcomes were analyzed according to longitudinal survey data, on a random sample of 210 graduates in Educational Sciences, interviewed within three years of obtaining their degree. The results of two parallel studies, sequential to the quantitative survey, are presented, involving 98 professors and 10 tutors in evaluation of professional outcomes. In particular, discourse analysis was applied to actors' free answers during semi-structured interviews, which focused on positive aspects and criticism of the courses analyzed, and potential improvements to them.

Previous findings suggest that religion has a specific impact on attentional processes. Here we show that religion also affects action control. Experiment 1 compared Dutch Calvinists and Dutch atheists, matched for age, sex, intelligence, education, and cultural and socio-economic background, and Experiment 2 compared Italian Catholics with matched Italian seculars. As expected, Calvinists showed a smaller and Catholics a larger Simon effect than nonbelievers, while performance of the groups was comparable in the Stop-Signal task. This pattern suggests that religions emphasizing individualism or collectivism affects action control in specific ways, presumably by inducing chronic biases towards a more "exclusive" or "inclusive" style of decision-making. Interestingly, there was no evidence that religious practice affects inhibitory skills. (Contains 1 figure and 1 table.)

The transition to college or university can lead to the challenge of adapting to a new setting. Homesickness has been frequently investigated as a potential negative consequence of relocation. This study analyzed the role of multiple place attachment in the development of homesickness among university students. The study used a multicausal framework. Situational, personality, and environmental psychological variables were considered. Different factors of a person's personality were associated with vulnerability to homesickness. In addition, multiple place attachment and vulnerability to homesickness impacted the homesickness felt by students. (Contains 4 tables.)

When a self-report instrument includes a balanced number of positively and negatively worded items, factor analysts often use method effect factors to aid model fitting. One of the most widely investigated sources of method effects stems from the respondent tendencies to agree with an item regardless of its content. The nature of these effects, often referred to as acquiescence, is still debated. This study provides a unique contribution to the understanding of the substantive nature of these factors. The revised Life Orientation Test was administered to 653 twins (40% males) to unravel the genetic and the environmental components of method effect associated with positively worded items. Biometric modeling revealed significant heritability for the method effect factor along with strong unique environmental influences. This provides a substantive interpretation of method effects as a stable individual tendency. Theoretical and practical implications of the findings are discussed. (Contains 2 tables and 2 figures.)

This paper describes the project "Biotech a Scuola" ("Biotech at School"), financed by the Italian Ministry of Education within the SeT program (Special Project for Scientific-Technological Education). The project involved the University of Siena, five senior and junior secondary schools in the Siena area, and a private company. Twenty-three teachers from diverse fields and 318 students from 15 classes were involved. The aim of the project was to improve scientific-technological teaching by providing schools with the support and materials necessary to understand some fundamental aspects of biotechnology. With this project we propose a model of close cooperation among various educational sectors with the goal of teaching junior and senior high school students some of the theory and practice of modern biotechnology.

The production of tomato products is massive in Italy resulting in a huge amount of tomato waste as seeds, peels and stems. The aim of our work is to re-utilize these matrices through the extraction of carotenoids, especially lycopene to obtain enriched extra virgin olive oil (EVOO). The extraction has been obtained by ultrasound-assisted extraction (UAE) technique using directly extra virgin olive oil as extraction solvent, due to its lipophilic nature. The quantification of lycopene has been done through HPLC-DAD, resulting in a good concentration of lycopene per gram of oil (0.9 mg/g oil). Then the lycopene enriched EVOO was evaluated in vitro to determine its antioxidant and enzyme inhibitory activity in comparison with the EVOO itself. These data were associated to the cytotoxicity assays and in vivo histological bioassays, aiming to highlight its safe and healthy profile on human normal cells. [Display omitted] [ABSTRACT FROM AUTHOR]

Endocrine therapy (ET) plus cyclin-dependent-kinases 4/6 inhibitors (CDK4/6i) represents the standard treatment for luminal-metastatic breast cancer (MBC). However, prospective head-to-head comparisons are still lacking for 1st line (L) options, and it is still crucial to define the best strategy between 1st and 2nd L. 717 consecutive luminal-MBC pts treated between 2008 and 2020 were analyzed at the Oncology Department of Aviano and Udine, Italy. Differences about survival outcomes (OS, PFS and PPS) were tested by log-rank test. The attrition rate (AR) between 1st and 2ndL was calculated. At 1stL, pts were treated with ET (49%), chemotherapy (CT) (31%) and ET-CDKi (20%) while, at 2ndL, 33% received ET, 33% CT and 8% ET-CDKi. Overall AR was 10%, 7% for CT, 8% for ET and 17% for ET-CDKi. By multivariate analysis, 1stL ET-CDK4/6i showed a better mPFS1 and OS. Moreover, 2ndL ET-CDK4/6i demonstrated better mPFS2 compared to ET and CT. Notably, 1stL ET-CDKi resulted in higher mPFS than 2ndL ET-CDKi. Intriguingly, 1stL ET-CDK4/6i was associated with worse mPPS compared to CT and ET. Secondarily, 1stL ET-CDK4/6i followed by CT had worse OS compared to 1stL ET-CDK4/6i followed by ET. Notably, none of baseline characteristics at 2ndL influenced 2ndL treatment choice (ET vs. CT) after ET-CDKi. Our real-world data demonstrated that ET-CDKi represents the best option for 1stL luminal-MBC compared to ET and CT. Also, the present study pointed out that 2ndL ET, potentially combined with other molecules, could be a feasible option after CDK4/6i failure, postponing CT on later lines. • To define the best treatment strategy for 1st and 2nd L is crucial for luminal mBC. • 1st L CDK4/6i-based therapies represent the standard treatment in luminal mBC. • This study confirmed the key role of 1st L CDK4/6i on a real-world cohort. • This study suggested a preeminent role for ET after first-line CDK4/6i. • The 2nd line ET with other molecules could allow to further postpone CT. [ABSTRACT FROM AUTHOR]

Data from recently published trials have provided practice-changing recommendations for the surgical approach to the axilla in breast cancer. Patients with T1-2 lesions, treated with breast conservation, who have not received neoadjuvant chemotherapy and have 1–2 positive sentinel nodes (Z0011-criteria) may avoid axillary lymph node dissection (ALND). We aim to describe the dissemination of this practice in Europe over an extended period of time. Our source of data was the eusomaDB, a central data warehouse of prospectively collected information of the European Society of Breast Cancer Specialists (EUSOMA). We identified cases fulfilling Z0011-criteria from 2005 to 2016 from 34 European breast centers and report trends in ALND. Data derived from Germany, Italy, Belgium, Switzerland, Austria, and Netherlands. 6671 patients fulfilled Z0011-criteria. Rates of ALND showed a statistically significant decrease from 2010 (89%) to 2011 (73%), reaching 46% in 2016 (p < 0.001). After multivariable analysis, factors associated with higher probability of ALND were earlier year of surgery, younger age, increasing tumor size and grade, and being operated in Italy (p < 0.001). The minimum and maximal rates of ALND in the most recent two-year period (2015–2016) were 0% and 83% in two centers located in different countries (p < 0.001). Our study demonstrates, a decrease in rates of ALND that started after year 2010 through the end of the study period. Wide differences were observed among centers and countries indicating the need to spread unified clinical guidelines in Europe to allow for homogeneous evidence-based practice patterns. • Indications for axillary dissection in breast cancer have changed based on trials. • Little evidence has been reported about change in practice in Europe. • Axillary dissection rates decreased from 89% to 46% in a European dataset. • Higher probability of axillary dissection was associated with: • Earlier year of surgery. • Younger age. • Increasing tumor size and grade. • Being operated in Italy. • Minimum and maximal rates of dissection recently reported: 0% and 83% in two centers. [ABSTRACT FROM AUTHOR]

Aim: Explain the multidisciplinary methodological approach used for the treatment of a post -- surgical peristomal wound Method: Female patient, 17 years old, polytrauma, intubated and underwent tracheostomy. In the post -- operative, presence of a peristomal wound (3 x 3,3 cm), stage III of European Pressure Ulcer Advisory Panel (EPUAP). Treatment: - Debridement: Surgical, autolytic and chemical - Cleansing: Polyhexamethylene Biguanide - Antimicrobial action and exudate management: Azatiractica Indica + Iphyercum Perforatum + Hidrofibra with silver + Silicone foam with silicone border and border support with polyurethane film - Scar care: Elasticizing cream with massage therapy, silicone gel and lymphatic drainage with functional tape (kinesiology taping) - Nutrition: 30 Kcal/Kg; Proteins 1,8 g/Kg; Water 30 ml/Kg - Pain treatment: Lidocaine cream 5%. Results / Discussion: - Wound healing: 6 weeks - Average dressing change: 72 hours - Average pain: VAS = 2 - Scar healing: 6 weeks. Conclusion: Using a multidisciplinary approach to wound healing has proven to be an effective choice. The use of interactive dressings to prepare the bottom of the wound, accelerate neo angiogenesis, granulation, epithelization and reduced healing times. Appropriate nutritional intake allowed the patient not lose weight and supply the wound with the nutrients necessary for healing. The focused use of counseling for motivational support permit to manage the fragile emotional condition of the patient due to an altered perception of his own image which, unavoidably, the wound had generated. Finally, the treatment of the scar with kinesiological tape and silicone gel made it possible to healing the wound with a good aesthetic result. [ABSTRACT FROM AUTHOR]

Aim: To test if mechanical keratolysis (MK) is able to restore skin elasticity in high-risk DF patients. Method: A cohort of consecutive DFP attending the preventative outpatient clinic of the diabetic foot (DF) section of our hospital was prospectively evaluated for the presence of localised hyperkeratosis (HK), deformities (D) and skin temperature (ST), and underwent keratolysis mechanically removing keratosis with a #10 scalpel in the hand of expert podologists (LAN, EL, NR). Skin hardness was blindly measured before and after the procedures by means of a durometer by another podologist (LA) at I and V metatarsal-phalangeal Joints (I-MTP, V-MTP) and at the heel. Rsults: 102 DFP [age 74.1±10.5 yrs; DM duration 19.4±8.7 yrs; HbA1c 7.8±1.9%: 52% males; 61 with (Group1) and 41 without (Group2) HK] were studied. Group1 showed a higher prevalence of D (95.1% vs 78.6%, p=0.014) and higher ST (33.4±1.9°C vs 32.6±1.8°C, p=0.03) compared to Group2. SH at I-MPJ (39.2±20.4 UI vs 27.2±15.9 UI p=0.002) V-MPJ (37.2±19.3 UI vs 28.8±17.5 UI p=0.027), were significantly greater in Group1 compared to Group2, while no differences were found at heel. MK reduced significantly SH both at I-MPJ (ΔSH 5.0±7.0 UI, p=0.0024), V-MPJ (ΔSH 3.4±5.6 UI, p=0.0008) and at heel (ΔSH 1.3±3.2UI, p=0.03), annulling the differences in SH with Group2. Conclusion: HK is a frequent feature in high-risk DFP and is associated with D and increased ST; MK performed by expert podologists is able to restore skin elasticity in DFP at high ulcerative risk. [ABSTRACT FROM AUTHOR]

Aim: Lean Thinking is a certified technique for the quality implementation in complex systems like factories, distribution chain supply etc. Aim of our study was to check if the application of the lean management approach to our DF clinic would produce positive effects in the quality of the work of the podologists. Method: A thorough analyisis of working processes was carried out in our DF clinic for six consecutive months and three critical aspects were identified: 1. The supplying of materials and the organization of storage, 2. The pathways for the patients accessing the clinic for being visited or leaving it after the visit and 3. The distant location of the waiting room. The interventions consisted in 1. the implementation of a web-based operative program for the supply of materials and the re-organization of the storage, 2. the creation of separate pathways for patients in and out the clinic and 3. The relocation of the waiting room. we measured before and after the changes for one month respectively: 1. rates of missing materials (RMM), 2. time for patients' changing in the visit rooms (TPC) and 3. rate of occupation of the waiting room (ROW). Results / Discussion: RMM significantly decreased after the intervention (3.2±1.1% vs 12.4±3.7%, p<0.01); TPC reduced as well (5.2±2.3 min vs 10.8±4.1 min p<0.05), while ROW did not show significant modifications although it improved (72.4±16.8% vs 60.1±22.3% ns). Conclusion: Lean management is effective in improving the quality of podological work in a DF clinic. [ABSTRACT FROM AUTHOR]

Aim: To compare diabetic foot patients (DFP) at high ulcerative risk in primary and secondary prevention from a podological point of view. Method: A cohort of consecutive DFP attending the preventative outpatient clinic of the diabetic foot (DF) section of our hospital in primary (Group1) or secondary (Group2) prevention were prospectively blindly evaluated for the following parameters: condition of autonomy (A), hygiene (H), compliance (C), shoes (S) and nails (N); presence of new lesions )=(NL), hyperkeratosis (HK), fissurations (F), deformities (D); ABPI, skin hardness (SH) measured with a durometer at metatarsal-phalangeal joint (I-MPJ and V-MPJ) and heel, skin temperature (T) at the dorsum of the foot. Results / Discussion: 102 DFP (64 Group1/38 Group2; age 74.1±10.5 yrs; DM duration 19.4±8.7 yrs; HbA1c 7.8±1.9%: 52% males) were studied. No significant difference emerged between the two groups for levels of A, H and C; S and N were superimposable as the number of NL (3 Group 1 vs 7 in Group 2), HK (57.8% vs 63.2%), F (3.1% vs 2,6%) and D (85.9% vs 84.2%). ABPI (1.22±0.28 in Group 1 vs 1.33±0.51 in Group 2) showed no differences as well as T (33.3±1.7 °C vs 32.7 ±1.9°C), while SH at I-MPJ (30.1±17.2 UI vs 41.5 ±21.3 UI p=0.003) V-MPJ (29.2±18.4 UI vs 38.2±20.9 UI p=0.025), and at heel (30.1±15.5 UI vs 37.4±14.3 p=0.018) were all significantly greater in Group 2 compared to Group 1. Conclusion: SH is able discriminated between new and recurrent DFP at high ulcerative risk. [ABSTRACT FROM AUTHOR]

A rational evaluation of the seismic risk of urban areas cannot neglect the variability of the ground motion due to site amplification and the induced effects, such as soil liquefaction and slope stability. In this framework, the microzonation maps certainly represent the most adequate tool to account for this element in the seismic risk and for planning mitigation strategies. This study shows the preliminary results of a multidisciplinary research, which deals with the seismic microzonation of the Western area of Napoli. The selected case study is a challenging choice, as the seismic hazard is affected by both tectonic and volcanic seismicity, which in historical time differently affected the urban setting. The latter, in turn, results highly heterogeneous, as consisting of a mixing of both masonry and concrete structures. The adopted approach followed the recommendations of both the National and International Guidelines, with reference to the multi-levels methods. The collection, homogenization and synthesis of a significant number of existing data permitted the development of reliable geological and geotechnical subsoil models, leading to Grade I and II seismic microzonation maps, characterized by different expected amplification of ground motion and instability due to the liquefaction. Such maps represent a key for a quantitative assessment of seismic performance of buildings and infrastructures, in view of the expected urban requalification of the area. [ABSTRACT FROM AUTHOR]

Objective: Olfactory function, a cognitive impairment biomarker, was evaluated in mountain ultramarathon (MUM) runners during the Tor des Géants race (332.5 km with an overall altitude gain of 24,000 m; altitude range 330-3296 m above the sea).Methods: An Odor Identification Test was administered before (T0; n = 53), at 148.7 kms (T1; n = 32) and after the race (T2; n = 28). The effect of dehydration and sleep deprivation on olfactory function was assessed. Olfactory function was also assessed in non-MUM athletes and sedentary controls (C) at rest.Results: A majority of the athletes completed the olfactory test at all time intervals. Olfactory function decreased throughout the race (T0: 13.8 ± 1.9, T1: 13.7 ± 1.6, T2: 13.1 ± 1.8; T0 vs T2 P = .01). There was no relationship with race time or sleep deprivation on the sense of smell throughout the competition. However, there was a combined effect with decreased olfaction during the second half of the race, while a poor relationship was seen between olfaction and total body water at midterm (T1: rs = -0.427; P = .019), but not at baseline or after the race. MUM athletes had similar olfactory scores to C (13.8 ± 1.9 vs 13.7 ± 1.4) and non-MUM (13.8 ± 1.9 vs 13.9 ± 1.6) athletes.Conclusions: This pilot study showed the feasibility of olfactory evaluation as a minimally invasive cognitive impairment assessment. The test can be used in logistically difficult environments, adding scientific value to this promising method. Although olfaction decreased after prolonged physical activity, further studies are warranted to make the relationship between cognition and external factors (eg, sleep deprivation, dehydration) more clear. [ABSTRACT FROM AUTHOR]

Polybrominated diphenyl ethers (PBDEs) were determined in sewage sludge samples collected from eight Italian wastewater treatment plants (WWTPs) between June 2009 and March 2010. Total PBDE concentrations ranged from 158.3 to 9427 ng g−1 dw, while deca-BDE (BDE-209) (concentrations ranging from 130.6 to 9411 ng g−1 dw) dominated the congener profile in all the samples, contributing between 77% and 99.8% of total PBDE. The suitability of using a magnetic particle enzyme-linked immunoassay (ELISA) to analyse PBDEs in sewage sludge was also tested. The ELISA results, expressed as BDE-47 equivalents, were well correlated with those obtained by GC–NCI–MS, with correlation coefficients (r 2) of 0.899 and 0.959, depending on the extraction procedure adopted. The risk assessment of PBDEs in sewage sludge addressed to land application was calculated. PECsoil values compared to the relative PNECsoil for penta and deca-BDE suggests that there is a low risk to the soil environment. [Copyright &y& Elsevier]

Copyright of Inchiesta is the property of Edizioni Dedalo SRL and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Inchiesta is the property of Edizioni Dedalo SRL and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Inchiesta is the property of Edizioni Dedalo SRL and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In this study we investigated the accuracy of diagnoses of oral mucosal diseases made by family physicians (without a dental degree), other categories of physicians, and general dental practitioners prior to referring patients to a university oral medicine unit. Over a three-year period, we compared the diagnoses proposed in referral letters with the definitive histological diagnoses made by the specialist unit. Only 305 of 678 (45 percent) of the referral letters included a clinical diagnosis. Eighty-six patients (86/305, 28 percent) were referred by general dental practitioners (GDPs) who had graduated in dentistry; seventy-six (76/305, 25 percent) were sent by GDPs who had graduated in medicine with a postgraduate degree in dentistry; and 143 (143/305, 47 percent) were referred by other categories of physicians. More than 50 percent of the referring professionals were not able to make a clinical diagnosis of oral mucosal diseases. Only 40 percent of the provisional diagnoses (122/305) coincided with the diagnosis made at the specialist unit. The proportion of correct diagnoses was 40 percent for GDPs who had graduated in dentistry, 33 percent for other categories of physicians, and 27 percent for GDPs who had graduated in medicine with a postgraduate degree in dentistry. These findings suggest that Italian dental and medical practitioners have limited knowledge in the field of oral medicine. Consequently, there is a need for better education in the diagnosis and treatment of oral diseases and for improvement in total oral health training. [ABSTRACT FROM AUTHOR]

• This research presents a simplified tool to analyse the energy performance of the building stock. • The method combines Wrapper Feature Selection, Random Forests, Hierarchical and k -medoids clustering. • Buildings are grouped according to their main features and reference buildings are identified. • Energy efficiency measures are prioritized for the different groups. • The proposed method is applied to a set of 41 Italian schools. In the recent years, existing public buildings have been put under the spotlight for the application of retrofit strategies prescribed by the European Energy Efficiency Directives. Among them, schools have a pivotal role since, besides energy performance, they have to cope also with high indoor environmental quality requirements. However, the definition of a refurbishment policy for the stock of school buildings presents some criticalities: limited data are often available, comprehensive energy audits are too onerous to apply to each school building, and the findings of many case-studies discussed in the literature can be too specific for a robust generalization. In this context, this work proposes a new integrated method for energy audit on large stocks of existing buildings, avoiding case-by-case analyses and focusing on identifying the most significant retrofit areas and priorities of intervention. This approach, based on the combination of different data mining techniques (i.e., Wrapper Feature Selection, Random Forests, Hierarchical and k -medoids Clustering), is meant to deliver a useful tool for the existing buildings' stock to professionals and Public Administrations. The method is described and discussed, and then applied for validation purpose on a case study of 41 educational buildings in the Province of Treviso, Italy. [ABSTRACT FROM AUTHOR]

An abstract of the article "Project of the Local Health Unit-ASL9 of Grosseto: Educating Caregivers in Tracheotomy Management," by Lorenza Bennati et al is presented.

Objective: Although several studies have been conducted on the relation between dietary habits and endometrial cancer risk, the evidence for specific food groups is still controversial. Study Design: We analyzed data from an Italian case-control study including 454 women with histologically confirmed endometrial cancer and 908 controls admitted to the same hospitals for acute, nonneoplastic conditions. Multivariate odds ratios (ORs) were obtained after allowance for major potential confounding factors. Results: A significant increase in risk was observed for red meat, with an OR of 2.07 for an increment of 1 serving per day. Inverse associations were observed for coffee (OR, 0.83), cereals (OR, 0.92), and vegetables (OR, 0.83). Conclusion: Our results support the existence of a relation between dietary habits and endometrial cancer risk and in particular suggest that a diet rich in red meat and poor in vegetables may have an unfavorable effect. [Copyright &y& Elsevier]

Abstract: Aim: This study examines the trends and outcomes of breast cancer patients who have undergone surgical procedures at the Department of Surgical Sciences, University of Insubria, Varese, Italy. It also identifies the factors that contributed to the reduction of the breast tumor size over a 13-year period at a tertiary referral center. Methods: All breast cancer operations performed at the Department of Surgical Sciences, University of Insubria, Varese, Italy, from January 1992 to June 2005 were examined and data from their surgical pathology reports were also analyzed, using a prospective database. A longitudinal study was performed to compare and analyze the pathological data during three consecutive time periods. The periods were from 1992 to 1996, 1997 to 1999, and 2000 to 2005. Surgical and pathological outcomes included age of the patient at the time of the diagnosis, partial breast resections, mastectomies, axillary lymphadenectomies, tumor size, histological type and stage, and lymph node status. Results: The study group was comprised of 3050 patients who underwent breast resection between 1992 and 2005. Quadrantectomy was the preferred surgical approach in 1759 patients (58%). Throughout the longitudinal study, the tumors measuring less than 1cm increased from 13.4% to 15.4%; the number of tumors diagnosed at stage I increased from 44.1% to 56.8%; the most frequent histological type was ductal carcinoma; the number of ductal carcinomas in situ (DCIS) increased from 4% to 6%; and the incidence of lymphadenectomies decreased from 71.6% to 52.5%. Perioperative factors that correlated with the decreased size of the tumor over time were: screening, improvement of diagnostic and therapeutic techniques, and the increased operative use of sentinel lymph node biopsy (SLNB). Conclusions: There has been an evolving refinement in surgical technique and perioperative management of breast cancer patients undergoing surgical resection at the Department of Surgical Sciences, University of Insubria, Varese, Italy, during the past decades. The present longitudinal study on 3050 surgical breast cancer patients confirmed the progressive reduction of tumor size at the time of the diagnosis. Perioperative factors that correlated with the decreased tumor size over time were mammography screening, improvement of diagnostic and therapeutic techniques, and the use of SLNB. Furthermore, the study showed that the progressive reduced number of useless axillary lymphadenectomies was mainly due to the increased intraoperative use of axillary SLNB. [Copyright &y& Elsevier]