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2. How future surgery will benefit from SARS-COV-2-related measures: a SPIGC survey conveying the perspective of Italian surgeons

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Siragusa, L, Angelico, R, Angrisani, M, Zampogna, B, Materazzo, M, Sorge, R, Giordano, L, Meniconi, R, Coppola, A, Marino, A, Giraudo, G, Esposito, S, Urbani, A, De Pastena, M, Mastrapasqua, R, Garancini, M, Frontal, A, Pascal, G, Martellucc, J, Falb, F, Boscarelli, A, Bertoglio, P, Trecca, E, Galassi, L, Vento, V, Chiappini, A, Antonelli, A, Bennardo, F, Familiari, F, Giannaccare, G, Zappia, A, Giuliani, G, Falcone, F, Sebastiani, S, Montuori, M, Rossi, S, Sagnotta, A, Giuliani, B, Imbriani, G, Restaino, S, Andreani, L, Di Maria, F, Lagana, A, Vitiello, L, Berton, F, Virgilio, E, Palisi, M, Portigliotti, L, Calussi, M, Conti, L, Mauriello, C, Barone, M, Saladino, E, Giaquinta, A, Zerb, D, Frazzetta, G, Merola, G, Chierici, A, Bini, R, Centonze, L, De Carlis, R, Ferrario, L, Giani, A, Lauterio, A, Tamini, N, Corti, S, Botteri, E, Andreuccetti, J, D'Alessio, R, Cestaro, G, Clarizia, G, Spolini, A, Carboni, A, Benzoni, E, Galiffa, G, Perotti, B, Veroux, M, Randazzo, V, Topa, D, Pranteda, C, Contini, G, Iacusso, C, Voglino, V, Vita, P, Carrano, F, Ambrosio, L, Cammarata, R, Capolupo, G, Caputo, D, Carannante, F, Cascone, C, Esperto, F, Farolfi, T, Frasca, L, Gallo, I, Gibin, G, Giurazza, G, Improta, L, La Vaccara, V, Luffarelli, P, Luvero, D, Marangi, G, Masciana, G, Mazzola, A, Mazzotta, E, Miligi, C, Montelione, N, Nenna, A, Orsaria, P, Papalia, R, Papalia, G, Parisi, F, Prata, F, Salzillo, R, Santini, S, Sofo, F, Zampoli, A, Tanda, C, Altieri, G, Ardito, F, Belia, F, Bianchi, V, Biondi, A, Brisinda, G, Chiappetta, M, Ciolli, G, Ciolli, A, Ferracci, F, Ferri, L, Fico, V, Fiorillo, C, Fransvea, P, Galiandro, F, Giovinazzo, F, La Greca, A, Litta, F, Mele, C, Pafundi, D, Panettieri, E, Papa, V, Patini, R, Perrotta, G, Puccioni, C, Santocchi, P, Armatura, G, Olmi, S, Casoni Pattacini, G, Salgarello, S, Trompetto, M, Bombardini, C, La Rocca, R, Celentano, G, Micalef, A, Mazzella, A, Settembrini, A, Zoia, C, Degrate, L, Musumeci, G, Palopoli, C, Montori, G, Bonati, E, Dinuzzi, V, Velluti, F, Balla, A, Bonasia, D, Coletta, D, Berardi, G, Colasanti, M, Ferretti, S, Gasparoli, C, Mariano, G, Avenia, S, Cianci, P, Cestino, L, Festa, F, Fazio, F, Ascari, F, Desio, M, Arroyo Murillo, G, Cereda, M, Galleano, R, David, G, Pansini, A, Gazia, C, Atzori, G, Desideri, L, Famularo, S, Galvanin, J, Giudici, V, Mangiameli, G, Mei, S, Milana, F, Pansa, A, Sacchi, M, Testori, A, Di Carlo, G, Paratore, M, Perrone, U, Vagge, A, Vigano, J, Torre, B, Scotti, M, Carbone, G, Cerchione, R, De Nardi, P, Gozzini, L, Ottaviani, L, Senni, C, Piccin, O, Pio, L, Colombo, F, Avantifiori, R, Baldassarri, V, Caronna, R, Cicerchia, P, Corallino, D, Crocetti, D, Gallo, G, Giovanardi, F, Giovannetti, F, Hassan, R, Iossa, A, Lai, Q, Lancellotti, F, Lucarini, A, Lucchese, S, Mazzarella, G, Melandro, F, Minervini, A, Muttillo, E, Palmieri, L, Pasqua, R, Rosiello, F, Salina, G, Sibio, S, Sirignano, P, Tarallo, M, Usai, S, Vanni, C, Viglietta, E, Zambon, M, Conversano, N, Epifani, A, Milano, V, Sacco, L, Nava, M, Maffioli, A, Giuratrabocchetta, S, Baracchi, F, Zuolo, M, Ceresoli, M, Verdi, D, Belli, A, Pata, F, Piovano, E, Pastore, G, Bernabei, F, Deiana, S, Arceri, A, D'Agostino, C, Marafante, C, Moggia, E, Parini, S, Moretti, M, Uggeri, F, Pontarolo, N, Fontana, T, Palmisano, G, Giuffrida, M, Guaitoli, E, Ferretti, C, Iacopino, G, Gioco, R, Roscitano, G, Montanelli, P, Pinotti, E, Monati, E, Fazio, G, Di Pietro, F, Damarco, F, Barberis, A, Razzore, A, Pascale, A, Loi, S, Ferrara, F, Rossi, M, Lisi, G, Viel, G, Sasia, D, Bono, D, Cordaro, E, Giacomelli, E, Giani, I, Seriau, L, Pellino, G, Sparavigna, M, Trigiante, G, D'Ambrogio, R, Cardella, F, Guzzetti, S, Luzzi, A, Carganico, G, Drago, B, Micheletto, G, Orlandi, R, Cutolo, C, Gibello, U, Mistrangelo, M, Forcignano, E, D'Ugo, S, Losurdo, P, Manitto, M, Caroli, G, Franco, M, Tilocca, P, Mendogni, P, Sena, G, Sambucci, D, Luciani, C, Atelli, P, Guida, A, Marino, F, Morini, A, Sibilla, M, Longo, F, Giaccari, S, Vigorita, V, Balduzzi, A, Barra, F, Delogu, D, Milone, E, Bencini, L, Aprile, V, Papini, P, Montemurro, N, Cavallo, M, Picciariello, A, Tomasicchio, G, Fittipaldi, A, Maruccia, M, Gerardi, S, Cillara, N, Deidda, S, Demarinis, G, Peiretti, E, Tatti, F, Iovino, C, Isola, G, Progno, V, Migliore, M, Badessi, G, Barilla, C, Calleri, G, Cianci, S, Fama, F, Fleres, F, Mazzeo, C, Visaloco, M, Marchetto, C, Bolognesi, F, Benuzzi, L, Bracchetti, G, Brucchi, F, Manzo, C, Scaravilli, L, Ferrari, C, Rocca, A, Napolitano, P, Anoldo, P, Caricato, C, Manigrasso, M, Milone, M, Napolitano, L, Palomba, G, Schiavone, V, Vetrella, M, Grossi, U, Moletta, L, Annicchiarico, A, Vella, I, Talesa, G, Boggi, U, Aiello, F, Anselmo, A, Bacchiocchi, G, Beati, F, Bellato, V, Billeci, F, Blasi, F, Buonomo, O, Campanelli, M, Coco, G, Contadini, A, Conte, L, D'Ippolito, G, Di Marcantonio, A, Spicchiale, C, Afflitto, G, Gismondi, A, Gorgolini, G, Granai, A, Grande, S, Gravina, A, Ingallinella, S, Keci, L, Latini, E, Marino, D, Oddi, F, Orecchia, L, Don, C, Pellicciaro, M, Petagna, L, Pirozzi, B, Quaranta, C, Rho, M, Rosina, A, Santicchia, M, Saraceno, F, Schiavone, A, Sensi, B, Spina, A, Sullo, L, Tacconi, F, Taje, R, Vanni, G, Vinci, D, Vita, G, Alba, G, Badalucco, S, Carbone, L, Samorani, O, Chisci, G, Cuomo, R, Francia, A, Fusario, D, Gargiulo, B, Pasqui, E, Pasquetti, L, Puoti, P, Resca, L, Cumbo, J, Ganio, S, Vizzielli, G, Anastasi, M, Guerra, D, Romanzi, A, Vannelli, A, Baia, M, Siragusa L., Angelico R., Angrisani M., Zampogna B., Materazzo M., Sorge R., Giordano L., Meniconi R., Coppola A., Marino A., Giraudo G., Esposito S., Urbani A., De Pastena M., Mastrapasqua R., Garancini M., Frontal A., Pascal G., Martellucc J., Falb F., Boscarelli A., Bertoglio P., Trecca E., Galassi L., Vento V., Chiappini A., Antonelli A., Bennardo F., Familiari F., Giannaccare G., Zappia A. S., Giuliani G., Falcone F., Sebastiani S., Montuori M., Rossi S., Sagnotta A., Giuliani B., Imbriani G. C., Restaino S., Andreani L., Di Maria F., Lagana A. S., Vitiello L., Berton F., Virgilio E., Palisi M., Portigliotti L., Calussi M., Conti L., Mauriello C., Barone M., Saladino E., Giaquinta A., Zerb D., Frazzetta G., Merola G., Chierici A., Bini R., Centonze L., De Carlis R., Ferrario L., Giani A., Lauterio A., Tamini N., Corti S., Botteri E., Andreuccetti J., D'Alessio R., Cestaro G., Clarizia G., Spolini A., Carboni A. S., Benzoni E., Galiffa G., Perotti B., Veroux M., Randazzo V., Topa D., Pranteda C., Contini G., Iacusso C., Voglino V., Vita P., Carrano F. M., Ambrosio L., Cammarata R., Capolupo G. T., Caputo D., Carannante F., Cascone C., Esperto F., Farolfi T., Frasca L., Gallo I. F., Gibin G., Giurazza G., Improta L., La Vaccara V., Luffarelli P., Luvero D., Marangi G., Masciana G., Mazzola A., Mazzotta E., Miligi C. I., Montelione N., Nenna A., Orsaria P., Papalia R., Papalia G. F., Parisi F. R., Prata F., Salzillo R., Santini S., Sofo F., Zampoli A., Tanda C., Altieri G., Ardito F., Belia F., Bianchi V., Biondi A., Brisinda G., Chiappetta M., Ciolli G., Ciolli A., Ferracci F., Ferri L., Fico V., Fiorillo C., Fransvea P., Galiandro F., Giovinazzo F., La Greca A., Litta F., Mele C., Pafundi D. P., Panettieri E., Papa V., Patini R., Perrotta G., Puccioni C., Santocchi P., Armatura G., Olmi S., Casoni Pattacini G., Salgarello S., Trompetto M., Bombardini C., La Rocca R., Celentano G., Micalef A., Mazzella A., Settembrini A., Zoia C., Degrate L., Musumeci G., Palopoli C. A. M., Montori G., Bonati E., Dinuzzi V. P., Velluti F., Balla A., Bonasia D. E., Coletta D., Berardi G., Colasanti M., Ferretti S., Gasparoli C., Mariano G., Avenia S., Cianci P., Cestino L., Festa F., Fazio F., Ascari F., Desio M., Arroyo Murillo G. A., Cereda M., Galleano R., David G., Pansini A., Gazia C., Atzori G., Desideri L. F., Famularo S., Galvanin J., Giudici V. M., Mangiameli G., Mei S., Milana F., Pansa A., Sacchi M., Testori A., Di Carlo G., Paratore M., Perrone U., Vagge A., Vigano J., Torre B., Scotti M. A., Carbone G., Cerchione R., De Nardi P., Gozzini L., Ottaviani L., Senni C., Piccin O., Pio L., Colombo F., Avantifiori R., Baldassarri V., Caronna R., Cicerchia P. M., Corallino D., Crocetti D., Gallo G., Giovanardi F., Giovannetti F., Hassan R., Iossa A., Lai Q., Lancellotti F., Lucarini A., Lucchese S., Mazzarella G., Melandro F., Minervini A., Muttillo E. M., Palmieri L., Pasqua R., Rosiello F., Salina G., Sibio S., Sirignano P., Tarallo M., Usai S., Vanni C., Viglietta E., Zambon M., Conversano N. I., Epifani A. G., Milano V., Sacco L., Nava M., Maffioli A., Giuratrabocchetta S., Baracchi F., Zuolo M., Ceresoli M., Verdi D., Belli A., Pata F., Piovano E., Pastore G., Bernabei F., Deiana S., Arceri A., D'Agostino C., Marafante C., Moggia E., Parini S., Moretti M., Uggeri F., Pontarolo N., Fontana T., Palmisano G., Giuffrida M., Guaitoli E., Ferretti C., Iacopino G., Gioco R., Roscitano G., Montanelli P., Chiappetta M. F., Pinotti E., Monati E., Fazio G., Di Pietro F., Damarco F., Barberis A., Razzore A., Pascale A., Loi S., Ferrara F., Rossi M., Lisi G., Viel G., Sasia D., Bono D., Cordaro E. R., Giacomelli E., Giani I., Seriau L., Pellino G., Sparavigna M., Trigiante G., D'Ambrogio R. G., Cardella F., Guzzetti S., Luzzi A. -P., Carganico G., Drago B., Micheletto G., Orlandi R., Cutolo C., Gibello U., Mistrangelo M., Forcignano E., D'Ugo S., Losurdo P., Manitto M., Caroli G., Franco M., Tilocca P. L., Mendogni P., Sena G., Sambucci D., Luciani C., Atelli P., Guida A., Marino F., Morini A., Sibilla M. G., Longo F., Giaccari S., Vigorita V., Balduzzi A., Barra F., Delogu D., Milone E., Bencini L., Aprile V., Papini P., Montemurro N., Cavallo M., Picciariello A., Tomasicchio G., Fittipaldi A., Maruccia M., Gerardi S., Cillara N., Deidda S., Demarinis G., Peiretti E., Tatti F., Iovino C., Isola G., Progno V. C., Migliore M., Badessi G., Barilla C., Calleri G. S., Cianci S., Fama F., Fleres F., Mazzeo C., Visaloco M. G., Marchetto C., Bolognesi F., Benuzzi L., Bracchetti G., Brucchi F., Manzo C. A., Scaravilli L., Ferrari C., Rocca A., Napolitano P., Anoldo P., Caricato C., Manigrasso M., Milone M., Napolitano L., Palomba G., Schiavone V., Vetrella M., Grossi U., Moletta L., Annicchiarico A., Vella I., Talesa G., Boggi U., Aiello F., Anselmo A., Bacchiocchi G., Beati F., Bellato V., Billeci F., Blasi F., Buonomo O. C., Campanelli M., Coco G., Contadini A., Conte L. E., D'Ippolito G., Di Marcantonio A., Spicchiale C. F., Afflitto G. G., Gismondi A., Gorgolini G., Granai A. V., Grande S., Gravina A., Guida A. M., Ingallinella S., Keci L., Latini E., Marino D., Oddi F. M., Orecchia L., Don C. B. P., Pellicciaro M., Petagna L., Pirozzi B. M., Quaranta C., Rho M., Rosina A., Santicchia M. S., Saraceno F., Schiavone A., Sensi B., Spina A., Sullo L., Tacconi F., Taje R., Vanni G., Vinci D., Vita G., Alba G., Badalucco S., Carbone L., Samorani O. C., Chisci G., Cuomo R., Francia A., Fusario D., Gargiulo B., Pasqui E., Pasquetti L., Puoti P., Resca L., Cumbo J., Ganio S., Vizzielli G., Anastasi M., Guerra D., Romanzi A., Vannelli A., Baia M., Siragusa, L, Angelico, R, Angrisani, M, Zampogna, B, Materazzo, M, Sorge, R, Giordano, L, Meniconi, R, Coppola, A, Marino, A, Giraudo, G, Esposito, S, Urbani, A, De Pastena, M, Mastrapasqua, R, Garancini, M, Frontal, A, Pascal, G, Martellucc, J, Falb, F, Boscarelli, A, Bertoglio, P, Trecca, E, Galassi, L, Vento, V, Chiappini, A, Antonelli, A, Bennardo, F, Familiari, F, Giannaccare, G, Zappia, A, Giuliani, G, Falcone, F, Sebastiani, S, Montuori, M, Rossi, S, Sagnotta, A, Giuliani, B, Imbriani, G, Restaino, S, Andreani, L, Di Maria, F, Lagana, A, Vitiello, L, Berton, F, Virgilio, E, Palisi, M, Portigliotti, L, Calussi, M, Conti, L, Mauriello, C, Barone, M, Saladino, E, Giaquinta, A, Zerb, D, Frazzetta, G, Merola, G, Chierici, A, Bini, R, Centonze, L, De Carlis, R, Ferrario, L, Giani, A, Lauterio, A, Tamini, N, Corti, S, Botteri, E, Andreuccetti, J, D'Alessio, R, Cestaro, G, Clarizia, G, Spolini, A, Carboni, A, Benzoni, E, Galiffa, G, Perotti, B, Veroux, M, Randazzo, V, Topa, D, Pranteda, C, Contini, G, Iacusso, C, Voglino, V, Vita, P, Carrano, F, Ambrosio, L, Cammarata, R, Capolupo, G, Caputo, D, Carannante, F, Cascone, C, Esperto, F, Farolfi, T, Frasca, L, Gallo, I, Gibin, G, Giurazza, G, Improta, L, La Vaccara, V, Luffarelli, P, Luvero, D, Marangi, G, Masciana, G, Mazzola, A, Mazzotta, E, Miligi, C, Montelione, N, Nenna, A, Orsaria, P, Papalia, R, Papalia, G, Parisi, F, Prata, F, Salzillo, R, Santini, S, Sofo, F, Zampoli, A, Tanda, C, Altieri, G, Ardito, F, Belia, F, Bianchi, V, Biondi, A, Brisinda, G, Chiappetta, M, Ciolli, G, Ciolli, A, Ferracci, F, Ferri, L, Fico, V, Fiorillo, C, Fransvea, P, Galiandro, F, Giovinazzo, F, La Greca, A, Litta, F, Mele, C, Pafundi, D, Panettieri, E, Papa, V, Patini, R, Perrotta, G, Puccioni, C, Santocchi, P, Armatura, G, Olmi, S, Casoni Pattacini, G, Salgarello, S, Trompetto, M, Bombardini, C, La Rocca, R, Celentano, G, Micalef, A, Mazzella, A, Settembrini, A, Zoia, C, Degrate, L, Musumeci, G, Palopoli, C, Montori, G, Bonati, E, Dinuzzi, V, Velluti, F, Balla, A, Bonasia, D, Coletta, D, Berardi, G, Colasanti, M, Ferretti, S, Gasparoli, C, Mariano, G, Avenia, S, Cianci, P, Cestino, L, Festa, F, Fazio, F, Ascari, F, Desio, M, Arroyo Murillo, G, Cereda, M, Galleano, R, David, G, Pansini, A, Gazia, C, Atzori, G, Desideri, L, Famularo, S, Galvanin, J, Giudici, V, Mangiameli, G, Mei, S, Milana, F, Pansa, A, Sacchi, M, Testori, A, Di Carlo, G, Paratore, M, Perrone, U, Vagge, A, Vigano, J, Torre, B, Scotti, M, Carbone, G, Cerchione, R, De Nardi, P, Gozzini, L, Ottaviani, L, Senni, C, Piccin, O, Pio, L, Colombo, F, Avantifiori, R, Baldassarri, V, Caronna, R, Cicerchia, P, Corallino, D, Crocetti, D, Gallo, G, Giovanardi, F, Giovannetti, F, Hassan, R, Iossa, A, Lai, Q, Lancellotti, F, Lucarini, A, Lucchese, S, Mazzarella, G, Melandro, F, Minervini, A, Muttillo, E, Palmieri, L, Pasqua, R, Rosiello, F, Salina, G, Sibio, S, Sirignano, P, Tarallo, M, Usai, S, Vanni, C, Viglietta, E, Zambon, M, Conversano, N, Epifani, A, Milano, V, Sacco, L, Nava, M, Maffioli, A, Giuratrabocchetta, S, Baracchi, F, Zuolo, M, Ceresoli, M, Verdi, D, Belli, A, Pata, F, Piovano, E, Pastore, G, Bernabei, F, Deiana, S, Arceri, A, D'Agostino, C, Marafante, C, Moggia, E, Parini, S, Moretti, M, Uggeri, F, Pontarolo, N, Fontana, T, Palmisano, G, Giuffrida, M, Guaitoli, E, Ferretti, C, Iacopino, G, Gioco, R, Roscitano, G, Montanelli, P, Pinotti, E, Monati, E, Fazio, G, Di Pietro, F, Damarco, F, Barberis, A, Razzore, A, Pascale, A, Loi, S, Ferrara, F, Rossi, M, Lisi, G, Viel, G, Sasia, D, Bono, D, Cordaro, E, Giacomelli, E, Giani, I, Seriau, L, Pellino, G, Sparavigna, M, Trigiante, G, D'Ambrogio, R, Cardella, F, Guzzetti, S, Luzzi, A, Carganico, G, Drago, B, Micheletto, G, Orlandi, R, Cutolo, C, Gibello, U, Mistrangelo, M, Forcignano, E, D'Ugo, S, Losurdo, P, Manitto, M, Caroli, G, Franco, M, Tilocca, P, Mendogni, P, Sena, G, Sambucci, D, Luciani, C, Atelli, P, Guida, A, Marino, F, Morini, A, Sibilla, M, Longo, F, Giaccari, S, Vigorita, V, Balduzzi, A, Barra, F, Delogu, D, Milone, E, Bencini, L, Aprile, V, Papini, P, Montemurro, N, Cavallo, M, Picciariello, A, Tomasicchio, G, Fittipaldi, A, Maruccia, M, Gerardi, S, Cillara, N, Deidda, S, Demarinis, G, Peiretti, E, Tatti, F, Iovino, C, Isola, G, Progno, V, Migliore, M, Badessi, G, Barilla, C, Calleri, G, Cianci, S, Fama, F, Fleres, F, Mazzeo, C, Visaloco, M, Marchetto, C, Bolognesi, F, Benuzzi, L, Bracchetti, G, Brucchi, F, Manzo, C, Scaravilli, L, Ferrari, C, Rocca, A, Napolitano, P, Anoldo, P, Caricato, C, Manigrasso, M, Milone, M, Napolitano, L, Palomba, G, Schiavone, V, Vetrella, M, Grossi, U, Moletta, L, Annicchiarico, A, Vella, I, Talesa, G, Boggi, U, Aiello, F, Anselmo, A, Bacchiocchi, G, Beati, F, Bellato, V, Billeci, F, Blasi, F, Buonomo, O, Campanelli, M, Coco, G, Contadini, A, Conte, L, D'Ippolito, G, Di Marcantonio, A, Spicchiale, C, Afflitto, G, Gismondi, A, Gorgolini, G, Granai, A, Grande, S, Gravina, A, Ingallinella, S, Keci, L, Latini, E, Marino, D, Oddi, F, Orecchia, L, Don, C, Pellicciaro, M, Petagna, L, Pirozzi, B, Quaranta, C, Rho, M, Rosina, A, Santicchia, M, Saraceno, F, Schiavone, A, Sensi, B, Spina, A, Sullo, L, Tacconi, F, Taje, R, Vanni, G, Vinci, D, Vita, G, Alba, G, Badalucco, S, Carbone, L, Samorani, O, Chisci, G, Cuomo, R, Francia, A, Fusario, D, Gargiulo, B, Pasqui, E, Pasquetti, L, Puoti, P, Resca, L, Cumbo, J, Ganio, S, Vizzielli, G, Anastasi, M, Guerra, D, Romanzi, A, Vannelli, A, Baia, M, Siragusa L., Angelico R., Angrisani M., Zampogna B., Materazzo M., Sorge R., Giordano L., Meniconi R., Coppola A., Marino A., Giraudo G., Esposito S., Urbani A., De Pastena M., Mastrapasqua R., Garancini M., Frontal A., Pascal G., Martellucc J., Falb F., Boscarelli A., Bertoglio P., Trecca E., Galassi L., Vento V., Chiappini A., Antonelli A., Bennardo F., Familiari F., Giannaccare G., Zappia A. S., Giuliani G., Falcone F., Sebastiani S., Montuori M., Rossi S., Sagnotta A., Giuliani B., Imbriani G. C., Restaino S., Andreani L., Di Maria F., Lagana A. S., Vitiello L., Berton F., Virgilio E., Palisi M., Portigliotti L., Calussi M., Conti L., Mauriello C., Barone M., Saladino E., Giaquinta A., Zerb D., Frazzetta G., Merola G., Chierici A., Bini R., Centonze L., De Carlis R., Ferrario L., Giani A., Lauterio A., Tamini N., Corti S., Botteri E., Andreuccetti J., D'Alessio R., Cestaro G., Clarizia G., Spolini A., Carboni A. S., Benzoni E., Galiffa G., Perotti B., Veroux M., Randazzo V., Topa D., Pranteda C., Contini G., Iacusso C., Voglino V., Vita P., Carrano F. M., Ambrosio L., Cammarata R., Capolupo G. T., Caputo D., Carannante F., Cascone C., Esperto F., Farolfi T., Frasca L., Gallo I. F., Gibin G., Giurazza G., Improta L., La Vaccara V., Luffarelli P., Luvero D., Marangi G., Masciana G., Mazzola A., Mazzotta E., Miligi C. I., Montelione N., Nenna A., Orsaria P., Papalia R., Papalia G. F., Parisi F. R., Prata F., Salzillo R., Santini S., Sofo F., Zampoli A., Tanda C., Altieri G., Ardito F., Belia F., Bianchi V., Biondi A., Brisinda G., Chiappetta M., Ciolli G., Ciolli A., Ferracci F., Ferri L., Fico V., Fiorillo C., Fransvea P., Galiandro F., Giovinazzo F., La Greca A., Litta F., Mele C., Pafundi D. P., Panettieri E., Papa V., Patini R., Perrotta G., Puccioni C., Santocchi P., Armatura G., Olmi S., Casoni Pattacini G., Salgarello S., Trompetto M., Bombardini C., La Rocca R., Celentano G., Micalef A., Mazzella A., Settembrini A., Zoia C., Degrate L., Musumeci G., Palopoli C. A. M., Montori G., Bonati E., Dinuzzi V. P., Velluti F., Balla A., Bonasia D. E., Coletta D., Berardi G., Colasanti M., Ferretti S., Gasparoli C., Mariano G., Avenia S., Cianci P., Cestino L., Festa F., Fazio F., Ascari F., Desio M., Arroyo Murillo G. A., Cereda M., Galleano R., David G., Pansini A., Gazia C., Atzori G., Desideri L. F., Famularo S., Galvanin J., Giudici V. M., Mangiameli G., Mei S., Milana F., Pansa A., Sacchi M., Testori A., Di Carlo G., Paratore M., Perrone U., Vagge A., Vigano J., Torre B., Scotti M. A., Carbone G., Cerchione R., De Nardi P., Gozzini L., Ottaviani L., Senni C., Piccin O., Pio L., Colombo F., Avantifiori R., Baldassarri V., Caronna R., Cicerchia P. M., Corallino D., Crocetti D., Gallo G., Giovanardi F., Giovannetti F., Hassan R., Iossa A., Lai Q., Lancellotti F., Lucarini A., Lucchese S., Mazzarella G., Melandro F., Minervini A., Muttillo E. M., Palmieri L., Pasqua R., Rosiello F., Salina G., Sibio S., Sirignano P., Tarallo M., Usai S., Vanni C., Viglietta E., Zambon M., Conversano N. I., Epifani A. 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L., Mendogni P., Sena G., Sambucci D., Luciani C., Atelli P., Guida A., Marino F., Morini A., Sibilla M. G., Longo F., Giaccari S., Vigorita V., Balduzzi A., Barra F., Delogu D., Milone E., Bencini L., Aprile V., Papini P., Montemurro N., Cavallo M., Picciariello A., Tomasicchio G., Fittipaldi A., Maruccia M., Gerardi S., Cillara N., Deidda S., Demarinis G., Peiretti E., Tatti F., Iovino C., Isola G., Progno V. C., Migliore M., Badessi G., Barilla C., Calleri G. S., Cianci S., Fama F., Fleres F., Mazzeo C., Visaloco M. G., Marchetto C., Bolognesi F., Benuzzi L., Bracchetti G., Brucchi F., Manzo C. A., Scaravilli L., Ferrari C., Rocca A., Napolitano P., Anoldo P., Caricato C., Manigrasso M., Milone M., Napolitano L., Palomba G., Schiavone V., Vetrella M., Grossi U., Moletta L., Annicchiarico A., Vella I., Talesa G., Boggi U., Aiello F., Anselmo A., Bacchiocchi G., Beati F., Bellato V., Billeci F., Blasi F., Buonomo O. C., Campanelli M., Coco G., Contadini A., Conte L. E., D'Ippolito G., Di Marcantonio A., Spicchiale C. F., Afflitto G. G., Gismondi A., Gorgolini G., Granai A. V., Grande S., Gravina A., Guida A. M., Ingallinella S., Keci L., Latini E., Marino D., Oddi F. M., Orecchia L., Don C. B. P., Pellicciaro M., Petagna L., Pirozzi B. M., Quaranta C., Rho M., Rosina A., Santicchia M. S., Saraceno F., Schiavone A., Sensi B., Spina A., Sullo L., Tacconi F., Taje R., Vanni G., Vinci D., Vita G., Alba G., Badalucco S., Carbone L., Samorani O. C., Chisci G., Cuomo R., Francia A., Fusario D., Gargiulo B., Pasqui E., Pasquetti L., Puoti P., Resca L., Cumbo J., Ganio S., Vizzielli G., Anastasi M., Guerra D., Romanzi A., Vannelli A., and Baia M.

Abstract

COVID-19 negatively affected surgical activity, but the potential benefits resulting from adopted measures remain unclear. The aim of this study was to evaluate the change in surgical activity and potential benefit from COVID-19 measures in perspective of Italian surgeons on behalf of SPIGC. A nationwide online survey on surgical practice before, during, and after COVID-19 pandemic was conducted in March–April 2022 (NCT:05323851). Effects of COVID-19 hospital-related measures on surgical patients’ management and personal professional development across surgical specialties were explored. Data on demographics, pre-operative/peri-operative/post-operative management, and professional development were collected. Outcomes were matched with the corresponding volume. Four hundred and seventy-three respondents were included in final analysis across 14 surgical specialties. Since SARS-CoV-2 pandemic, application of telematic consultations (4.1% vs. 21.6%; p < 0.0001) and diagnostic evaluations (16.4% vs. 42.2%; p < 0.0001) increased. Elective surgical activities significantly reduced and surgeons opted more frequently for conservative management with a possible indication for elective (26.3% vs. 35.7%; p < 0.0001) or urgent (20.4% vs. 38.5%; p < 0.0001) surgery. All new COVID-related measures are perceived to be maintained in the future. Surgeons’ personal education online increased from 12.6% (pre-COVID) to 86.6% (post-COVID; p < 0.0001). Online educational activities are considered a beneficial effect from COVID pandemic (56.4%). COVID-19 had a great impact on surgical specialties, with significant reduction of operation volume. However, some forced changes turned out to be benefits. Isolation measures pushed the use of telemedicine and telemetric devices for outpatient practice and favored communication for educational purposes and surgeon–patient/family communication. From the Italian surgeons’ perspective, COVID-related measures will continue to influence

Published
2023

3. BREAST EDEMA AFTER CONSERVATIVE SURGERY FOR EARLY-STAGE BREAST CANCER: A RETROSPECTIVE SINGLE-CENTER ASSESSMENT OF RISK FACTORS

Author

Cornacchia, C., primary, Dessalvi, S., additional, Santori, G., additional, Canobbio, F., additional, Atzori, G., additional, De Paoli, F., additional, Diaz, R., additional, Franchelli, S., additional, Gipponi, M., additional, Murelli, F., additional, Sparavigna, M., additional, Pitto, F., additional, Fozza, A., additional, Boccardo, F., additional, Friedman, D., additional, and Fregatti, P., additional

Published
2023
Full Text
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5. How future surgery will benefit from SARS-COV-2-related measures: a SPIGC survey conveying the perspective of Italian surgeons

Author

Siragusa, L., Angelico, R., Angrisani, M., Zampogna, B., Materazzo, M., Sorge, R., Giordano, Lucia, Meniconi, R., Coppola, A., Marino, A., Giraudo, G., Esposito, S., Urbani, A., De Pastena, M., Mastrapasqua, R., Garancini, M., Frontal, A., Pascal, G., Martellucc, J., Falb, F., Boscarelli, A., Bertoglio, P., Trecca, E., Galassi, L., Vento, V., Chiappini, A., Antonelli, A., Bennardo, F., Familiari, F., Giannaccare, G., Zappia, A. S., Giuliani, G., Falcone, F., Sebastiani, S., Montuori, M., Rossi, S., Sagnotta, A., Giuliani, B., Imbriani, G. C., Restaino, S., Andreani, L., Di Maria, F., Lagana, A. S., Vitiello, L., Berton, F., Virgilio, E., Palisi, M., Portigliotti, L., Calussi, M., Conti, L., Mauriello, C., Barone, Alessia Maria Addolorata, Saladino, E., Giaquinta, A., Zerb, D., Frazzetta, G., Merola, G., Chierici, A., Bini, R., Centonze, L., De Carlis, R., Ferrario, L., Giani, A., Lauterio, A., Tamini, N., Corti, Serafino, Botteri, E., Andreuccetti, J., D'Alessio, R., Cestaro, G., Clarizia, G., Spolini, A., Carboni, A. S., Benzoni, E., Galiffa, G., Perotti, B., Veroux, M., Randazzo, V., Topa, D., Pranteda, C., Contini, G., Iacusso, C., Voglino, V., Vita, P., Carrano, F. M., Ambrosio, L., Cammarata, R., Capolupo, G. T., Caputo, D., Carannante, F., Cascone, C., Esperto, F., Farolfi, T., Frasca, L., Gallo, I. F., Gibin, G., Giurazza, G., Improta, L., La Vaccara, V., Luffarelli, P., Luvero, D., Marangi, Giuseppe, Masciana, G., Mazzola, A., Mazzotta, E., Miligi, C. I., Montelione, N., Nenna, A., Orsaria, P., Papalia, R., Papalia, G. F., Parisi, F. R., Prata, F., Salzillo, R., Santini, Stefano Angelo, Sofo, F., Zampoli, A., Tanda, C., Altieri, G., Ardito, Francesco, Belia, Francesco, Bianchi, V., Biondi, Alberto, Brisinda, Giuseppe, Chiappetta, M., Ciolli, G., Ciolli, Alessandro, Ferracci, Federica, Ferri, L., Fico, V., Fiorillo, Claudio, Fransvea, Pietro, Galiandro, F., Giovinazzo, F., La Greca, Antonio, Litta, Francesco, Mele, C., Pafundi, D. P., Panettieri, Elena, Papa, Valerio, Patini, Romeo, Perrotta, Generoso, Puccioni, Caterina, Santocchi, P., Armatura, G., Olmi, S., Casoni Pattacini, G., Salgarello, S., Trompetto, M., Bombardini, C., La Rocca, R., Celentano, G., Micalef, A., Mazzella, A., Settembrini, A., Zoia, C., Degrate, L., Musumeci, Giampaolo, Palopoli, C. A. M., Montori, G., Bonati, E., Dinuzzi, V. P., Velluti, F., Balla, A., Bonasia, D. 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M., Palmieri, L., Pasqua, R., Rosiello, F., Salina, Giulia, Sibio, S., Sirignano, P., Tarallo, M., Usai, S., Vanni, C., Viglietta, E., Zambon, M., Conversano, N. I., Epifani, A. G., Milano, Valentina, Sacco, L., Nava, Bruna Maria, Maffioli, A., Giuratrabocchetta, S., Baracchi, F., Zuolo, M., Ceresoli, M., Verdi, D., Belli, Andrea, Pata, F., Piovano, E., Pastore, G., Bernabei, F., Deiana, S., Arceri, A., D'Agostino, Cinzia, Marafante, C., Moggia, E., Parini, S., Moretti, M., Uggeri, F., Pontarolo, N., Fontana, T., Palmisano, Gerardo, Giuffrida, M., Guaitoli, E., Ferretti, C., Iacopino, G., Gioco, R., Roscitano, G., Montanelli, P., Chiappetta, M. F., Pinotti, E., Monati, E., Fazio, G., Di Pietro, F., Damarco, F., Barberis, A., Razzore, A., Pascale, A., Loi, S., Ferrara, F., Rossi, Marco, Lisi, G., Viel, G., Sasia, D., Bono, D., Cordaro, E. R., Giacomelli, E., Giani, I., Seriau, L., Pellino, Giuseppe, Sparavigna, M., Trigiante, G., D'Ambrogio, R. 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A., Scaravilli, L., Ferrari, C., Rocca, A., Napolitano, Paola, Anoldo, P., Caricato, Chiara, Manigrasso, M., Milone, Maria, Napolitano, L., Palomba, G., Schiavone, V., Vetrella, M., Grossi, U., Moletta, L., Annicchiarico, A., Vella, I., Talesa, G., Boggi, U., Aiello, F., Anselmo, Anna, Bacchiocchi, G., Beati, F., Bellato, V., Billeci, F., Blasi, F., Buonomo, O. C., Campanelli, M., Coco, G., Contadini, A., Conte, L. E., D'Ippolito, G., Di Marcantonio, A., Spicchiale, C. F., Afflitto, G. G., Gismondi, A., Gorgolini, G., Granai, A. V., Grande, S., Gravina, A., Guida, A. M., Ingallinella, S., Keci, L., Latini, E., Marino, D., Oddi, F. M., Orecchia, L., Don, C. B. P., Pellicciaro, M., Petagna, L., Pirozzi, B. M., Quaranta, Caterina, Rho, M., Rosina, Alessandro, Santicchia, M. S., Saraceno, F., Schiavone, A., Sensi, B., Spina, A., Sullo, L., Tacconi, F., Taje, R., Vanni, G., Vinci, D., Vita, G., Alba, G., Badalucco, S., Carbone, Luigi, Samorani, O. 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E., Coletta, D., Berardi, Giulia, Colasanti, M., Ferretti, Serena, Gasparoli, C., Mariano, Giuseppantonio, Avenia, S., Cianci, P., Cestino, L., Festa, F., Fazio, F., Ascari, F., Desio, M., Arroyo Murillo, G. A., Cereda, M., Galleano, R., David, G., Pansini, A., Gazia, C., Atzori, G., Desideri, L. F., Famularo, S., Galvanin, J., Giudici, V. M., Mangiameli, Gaetano, Mei, S., Milana, F., Pansa, A., Sacchi, Dario Marco, Testori, A., Di Carlo, Giampiero, Paratore, Mattia, Perrone, U., Vagge, A., Vigano, J., Torre, B., Scotti, M. A., Carbone, G., Cerchione, R., De Nardi, P., Gozzini, L., Ottaviani, Letizia, Senni, C., Piccin, O., Pio, L., Colombo, F., Avantifiori, R., Baldassarri, V., Caronna, R., Cicerchia, P. M., Corallino, D., Crocetti, D., Gallo, Giuseppe, Giovanardi, F., Giovannetti, F., Hassan, R., Iossa, A., Lai, Q., Lancellotti, F., Lucarini, A., Lucchese, S., Mazzarella, Giulio, Melandro, F., Minervini, A., Muttillo, E. M., Palmieri, L., Pasqua, R., Rosiello, F., Salina, Giulia, Sibio, S., Sirignano, P., Tarallo, M., Usai, S., Vanni, C., Viglietta, E., Zambon, M., Conversano, N. I., Epifani, A. G., Milano, Valentina, Sacco, L., Nava, Bruna Maria, Maffioli, A., Giuratrabocchetta, S., Baracchi, F., Zuolo, M., Ceresoli, M., Verdi, D., Belli, Andrea, Pata, F., Piovano, E., Pastore, G., Bernabei, F., Deiana, S., Arceri, A., D'Agostino, Cinzia, Marafante, C., Moggia, E., Parini, S., Moretti, M., Uggeri, F., Pontarolo, N., Fontana, T., Palmisano, Gerardo, Giuffrida, M., Guaitoli, E., Ferretti, C., Iacopino, G., Gioco, R., Roscitano, G., Montanelli, P., Chiappetta, M. F., Pinotti, E., Monati, E., Fazio, G., Di Pietro, F., Damarco, F., Barberis, A., Razzore, A., Pascale, A., Loi, S., Ferrara, F., Rossi, Marco, Lisi, G., Viel, G., Sasia, D., Bono, D., Cordaro, E. R., Giacomelli, E., Giani, I., Seriau, L., Pellino, Giuseppe, Sparavigna, M., Trigiante, G., D'Ambrogio, R. G., Cardella, F., Guzzetti, S., Luzzi, A. -P., Carganico, G., Drago, B., Micheletto, G., Orlandi, R., Cutolo, C., Gibello, U., Mistrangelo, M., Forcignano, E., D'Ugo, S., Losurdo, P., Manitto, M., Caroli, G., Franco, Manuela, Tilocca, P. L., Mendogni, P., Sena, G., Sambucci, D., Luciani, C., Atelli, P., Guida, Maria Antonietta, Marino, Filippo, Morini, A., Sibilla, M. G., Longo, Fabio, Giaccari, S., Vigorita, V., Balduzzi, A., Barra, F., Delogu, D., Milone, E., Bencini, L., Aprile, V., Papini, P., Montemurro, N., Cavallo, Michele, Picciariello, A., Tomasicchio, G., Fittipaldi, A., Maruccia, M., Gerardi, S., Cillara, N., Deidda, Silvia, Demarinis, G., Peiretti, E., Tatti, F., Iovino, C., Isola, G., Progno, V. C., Migliore, M., Badessi, G., Barilla, C., Calleri, G. S., Cianci, Stefano, Fama, F., Fleres, F., Mazzeo, C., Visaloco, M. G., Marchetto, C., Bolognesi, F., Benuzzi, L., Bracchetti, G., Brucchi, F., Manzo, C. A., Scaravilli, L., Ferrari, C., Rocca, A., Napolitano, Paola, Anoldo, P., Caricato, Chiara, Manigrasso, M., Milone, Maria, Napolitano, L., Palomba, G., Schiavone, V., Vetrella, M., Grossi, U., Moletta, L., Annicchiarico, A., Vella, I., Talesa, G., Boggi, U., Aiello, F., Anselmo, Anna, Bacchiocchi, G., Beati, F., Bellato, V., Billeci, F., Blasi, F., Buonomo, O. C., Campanelli, M., Coco, G., Contadini, A., Conte, L. E., D'Ippolito, G., Di Marcantonio, A., Spicchiale, C. F., Afflitto, G. G., Gismondi, A., Gorgolini, G., Granai, A. V., Grande, S., Gravina, A., Guida, A. M., Ingallinella, S., Keci, L., Latini, E., Marino, D., Oddi, F. M., Orecchia, L., Don, C. B. P., Pellicciaro, M., Petagna, L., Pirozzi, B. M., Quaranta, Caterina, Rho, M., Rosina, Alessandro, Santicchia, M. S., Saraceno, F., Schiavone, A., Sensi, B., Spina, A., Sullo, L., Tacconi, F., Taje, R., Vanni, G., Vinci, D., Vita, G., Alba, G., Badalucco, S., Carbone, Luigi, Samorani, O. C., Chisci, G., Cuomo, Rosa, Francia, A., Fusario, D., Gargiulo, B., Pasqui, E., Pasquetti, L., Puoti, P., Resca, L., Cumbo, J., Ganio, S., Vizzielli, Giuseppe, Anastasi, M., Guerra, D., Romanzi, A., Vannelli, A., Baia, M., Giordano L., Barone M., Corti S., Marangi G. (ORCID:0000-0002-6898-8882), Santini S. (ORCID:0000-0003-1956-5899), Ardito F. (ORCID:0000-0003-1596-2862), Belia F., Biondi A. (ORCID:0000-0002-2470-7858), Brisinda G. (ORCID:0000-0001-8820-9471), Ciolli A., Ferracci F., Fiorillo C. (ORCID:0000-0001-7681-3567), Fransvea P. (ORCID:0000-0003-4969-3373), La Greca A. (ORCID:0000-0002-7587-7427), Litta F., Panettieri E., Papa V. (ORCID:0000-0002-3709-8924), Patini R. (ORCID:0000-0001-7358-8763), Perrotta G., Puccioni C., Musumeci G., Berardi G., Ferretti S., Mariano G., Mangiameli G., Sacchi M. (ORCID:0000-0003-2826-8431), Di Carlo G., Paratore M., Ottaviani L. (ORCID:0009-0001-0967-8809), Gallo G., Mazzarella G., Salina G., Milano V., Nava M., Belli A., D'Agostino C., Palmisano G., Rossi M. (ORCID:0000-0002-4539-5670), Pellino G., Franco M., Guida A., Marino F., Longo F., Cavallo M., Deidda S., Cianci S., Napolitano P., Caricato C., Milone M., Anselmo A., Quaranta C., Rosina A. (ORCID:0000-0002-0158-0583), Carbone L., Cuomo R., and Vizzielli G.

Abstract

COVID-19 negatively affected surgical activity, but the potential benefits resulting from adopted measures remain unclear. The aim of this study was to evaluate the change in surgical activity and potential benefit from COVID-19 measures in perspective of Italian surgeons on behalf of SPIGC. A nationwide online survey on surgical practice before, during, and after COVID-19 pandemic was conducted in March–April 2022 (NCT:05323851). Effects of COVID-19 hospital-related measures on surgical patients’ management and personal professional development across surgical specialties were explored. Data on demographics, pre-operative/peri-operative/post-operative management, and professional development were collected. Outcomes were matched with the corresponding volume. Four hundred and seventy-three respondents were included in final analysis across 14 surgical specialties. Since SARS-CoV-2 pandemic, application of telematic consultations (4.1% vs. 21.6%; p < 0.0001) and diagnostic evaluations (16.4% vs. 42.2%; p < 0.0001) increased. Elective surgical activities significantly reduced and surgeons opted more frequently for conservative management with a possible indication for elective (26.3% vs. 35.7%; p < 0.0001) or urgent (20.4% vs. 38.5%; p < 0.0001) surgery. All new COVID-related measures are perceived to be maintained in the future. Surgeons’ personal education online increased from 12.6% (pre-COVID) to 86.6% (post-COVID; p < 0.0001). Online educational activities are considered a beneficial effect from COVID pandemic (56.4%). COVID-19 had a great impact on surgical specialties, with significant reduction of operation volume. However, some forced changes turned out to be benefits. Isolation measures pushed the use of telemedicine and telemetric devices for outpatient practice and favored communication for educational purposes and surgeon–patient/family communication. From the Italian surgeons’ perspective, COVID-related measures will continue to influence

Published
2023

6. The response of halophyte (Tetragonia tetragonioides (Pallas) Kuntz) and glycophyte (Lactuca sativa L.) crops to diluted seawater and NaCl solutions: a comparison between two salinity stress types

Author

Guidi Nissim, W, Masi, E, Pandolfi, C, Mancuso, S, Atzori, G, Guidi Nissim W, Masi E, Pandolfi C, Mancuso S, Atzori G., Guidi Nissim, W, Masi, E, Pandolfi, C, Mancuso, S, Atzori, G, Guidi Nissim W, Masi E, Pandolfi C, Mancuso S, and Atzori G.

Abstract

The use of seawater in horticulture is underestimated. Although pure seawater is harm-ful to most living plants, diluted seawater could represent a promising integration to meet the crop’s nutrient and water requirements. In the current trial, we compared the effects of moderate and high concentrations of seawater and a comparable NaCl solution on a salt-tolerant (Tetragonia tetragonioides) and a salt-sensitive (Lactuca sativa) crop grown in hydroponics. We tested the hy-pothesis that, due to its mineral composition, diluted seawater would result in a less stressful growing medium than NaCl. We observed that diluted seawater resulted in a less detrimental growing medium compared to an EC-comparable NaCl solution, with remarkable differences between the salt-tolerant and the salt-sensitive species. While the growth rates in Tetragonia did not vary between the two types of stress, diluted seawater led to a higher FW and DW biomass yield in the salt-sensitive lettuce compared to the NaCl treatment. Moreover, NaCl reduced the water consumption and water productivity in Tetragonia. In lettuce, NaCl-treated plants demonstrated lower water use efficiency and water productivity compared to the EC-comparable seawater treatment. Physiological parameters and the concentration of mineral elements, phenolics and proline also demonstrated that, due to different mineral composition, seawater is a less stressful growing medium compared to a NaCl solution at comparable EC.

Published
2021

7. Intercropping Salt-Sensitive Lactuca sativa L. and Salt-Tolerant Salsola soda L. in a Saline Hydroponic Medium: An Agronomic and Physiological Assessment

Author

Atzori, G, Guidi Nissim, W, Mancuso, S, Palm, E, Atzori, G, Guidi Nissim, W, Mancuso, S, and Palm, E

Abstract

Competition for freshwater is increasing, with a growing population and the effects of climate change limiting its availability. In this experiment, Lactuca sativa plants were grown hydroponically with or without a 15% share of seawater (12 dS m(-1)) alone or intercropped with Salsola soda to demonstrate if L. sativa benefits from sodium removal by its halophyte companion. Contrary to the hypothesis, saline-grown L. sativa plants demonstrated reduced growth compared to the control plants regardless of the presence or absence of S. soda. Both limitations in CO2 supply and photosystem efficiency may have decreased CO2 assimilation rates and growth in L. sativa plants grown in the seawater-amended solutions. Surprisingly, leaf pigment concentrations increased in salt-treated L. sativa plants, and most notably among those intercropped with S. soda, suggesting that intercropping may have led to shade-induced increases in chlorophyll pigments. Furthermore, increased levels of proline indicate that salt-treated L. sativa plants were experiencing stress. In contrast, S. soda produced greater biomass in saline conditions than in control conditions. The mineral element, carbohydrate, protein, polyphenol and nitrate profiles of both species differed in their response to salinity. In particular, salt-sensitive L. sativa plants had greater accumulations of Fe, Ca, P, total phenolic compounds and nitrates under saline conditions than salt-tolerant S. soda. The obtained results suggest that intercropping salt-sensitive L. sativa with S. soda in a hydroponic system did not ameliorate the growing conditions of the salt-sensitive species as was hypothesized and may have exacerbated the abiotic stress by increasing competition for limited resources such as light. In contrast, the saline medium induced an improvement in the nutritional profile of S. soda. These results demonstrate an upper limit of the seawater share and planting density that can be used in saline agriculture when inte

Published
2022

9. BREAST EDEMA AFTER CONSERVATIVE SURGERY FOR EARLY-STAGE BREAST CANCER: A RETROSPECTIVE SINGLE-CENTER ASSESSMENT OF RISK FACTORS.

Author

Cornacchia, C., Dessalvi, S., Santori, G., Canobbio, F., Atzori, G., De Paoli, F., Diaz, R., Franchelli, S., Gipponi, M., Murelli, F., Sparavigna, M., Pitto, F., Fozza, A., Boccardo, F., Friedman, D., and Fregatti, P.

Abstract

Breast-conserving surgery (BCS) is the standard of care for early-stage breast cancer. We retrospectively enrolled 530 patients (mean age: 62.96 ± 12.69 years) undergoing BCS between January 1, 2018, and December 31, 2019. During the COVID-19 pandemic, all patients with at least 1 year of follow-up were telephonically asked after surgery to provide clinical signs and symptoms attributable to postoperative breast cancer-related lymphedema of the breast (BCRL-B). Thirty-one (5.8%) patients reported breast edema and were visited to measure the tissue dielectric constant (TDC) and to assess the induration of the skin. There was a difference seen in treatment with lumpectomy + ALND performed more frequently in patients with (29%) than without (12%) BCRL-B. In the subgroup of patients with BCRL-B (n=31), significantly higher values of local total water were calculated in the nine patients who underwent Lump + ALND procedure (1.86 ± 0.48 vs. 1.48 ± 0.38; p = 0.046). Among patients with BCRL-B (n=31), in eight patients (25.8%) tissue induration measured with SkinFibroMeter was >0.100 N, thus suggesting tissue fibrosis. Cumulative survival probability at 1-year after surgery was 0.992. No statistical differences in 1-year survival after surgery were found for type of surgery (p = 0.890) or absence/presence of BCRL-B (p = 0.480). In univariate logistic regression, only lumpectomy + ALND surgery (p = 0.009) and any subsequent axillary lymph node removal surgery (p = 0.003) were associated with BCRL-B. Both of these variables were also found to be statistically significant in the multivariate regression model. Further prospective research is warranted to analyze potentential predictors of BCRL-B and to reduce/ prevent this complication. [ABSTRACT FROM AUTHOR]

Published
2022

12. Tetragonia tetragonioides (Pallas) Kuntz. as promising salt-tolerant crop in a saline agricultural context

Author

Atzori, G, Guidi Nissim, W, Macchiavelli, T, Vita, F, Azzarello, E, Pandolfi, C, Masi, E, Mancuso, S, Atzori, G, Guidi Nissim, W, Macchiavelli, T, Vita, F, Azzarello, E, Pandolfi, C, Masi, E, and Mancuso, S

Abstract

The lack of natural resources, especially good-quality cropland and renewable water resources is threatening food production potential in marginal agricultural ecosystems, which are already negatively affected by climate change. Since the world's major crops are proving inadequate to supply the calories and nutrients for people in these areas, new crops are sought that can withstand harsh ecological environmental conditions. In the current trial, we assessed the growth and productivity of Tetragonia tetragonioides (Pallas) Kuntz. in a floating hydroponic system supplied with different seawater proportions (i.e. 15% and 30% seawater, EC = 9.8 and 18.0 dS m−1). Moreover, the effects of different salinity levels on mineral elements accumulation, production of osmotic solutes and secondary metabolites were determined, along with the salt removal capacity of the crop. The results indicated that plant growth was not affected by either of the seawater treatments used in this study. The increased leaf succulence and the reduction of both leaf area and specific leaf area with increasing salinity might represent an essential feature of this salt-tolerant species associated to the plants need of limiting transpiration. Low seawater treated plants showed a significantly higher biomass yield per liter of (sea)water used (117%) than the control. Under these conditions plants accumulated the highest amount of Mg (+31% and 48% in medium and high seawater treated plants compared with the control) and Cu (+14% and 30%, respectively) along with increasing proline and decreasing nitrate concentrations. By contrast, we found that seawater supply resulted in a Na-enriched leaf biomass that may represent an issue for human health. We concluded that Tetragonia tetragonioides can be grown in saline agriculture up to a salinity level characterized by an EC of 18 dS m-1 but further investigation is required to address Na accumulation in leaves.

Published
2020

13. Algae and Bioguano as promising source of organic fertilizers

Author

Atzori, G, GUIDI NISSIM, W, Rodolfi, L, Niccolai, A, Biondi, N, Mancuso, S, Tredici, M, Giulia Atzori, Werther Guidi Nissim, Liliana Rodolfi, Alberto Niccolai, Natascia Biondi, Stefano Mancuso, Mario R. Tredici, Atzori, G, GUIDI NISSIM, W, Rodolfi, L, Niccolai, A, Biondi, N, Mancuso, S, Tredici, M, Giulia Atzori, Werther Guidi Nissim, Liliana Rodolfi, Alberto Niccolai, Natascia Biondi, Stefano Mancuso, and Mario R. Tredici

Abstract

The projected population growth implies an increased food demand with a severe impact on Earth’s natural resources. Improving crops yield without compromising the environment will be one of the main challenges of the next decades. Among the practices that can promote sustainable agriculture, organic fertilizers, and seaweeds in particular, are receiving growing attention. The aim of the current study was to test two macroalgae (Chaetomorpha sp. and Cystoseira sp.), one microalga (Chlorella CH2) and Bioguano (a mixture of macroalgae, spirulina, and guano) as organic fertilizers for the growth of barley seedlings. Remarkable plant growth was obtained on Bioguano, with seedlings showing a comparable total biomass yield with respect to the positive control plants on mineral fertilizer. Plants growth on macroalgae was reduced, even if in Chaetomorpha sp. not significantly compared to the positive control. Plants growth on Chlorella CH2 was close to that of the negative control (only water). Plants on Bioguano attained high uptake efficiencies of N (60%) and K (41%). Plants on macroalgae showed high N, and especially P (about 30%) uptake efficiency. Our results suggest a high potential for Bioguano and, to a lesser extent, for macroalgae without any synthetic fertilizer application to be used as growing substrates for crops.

Published
2020

14. Seawater and water footprint in different cropping systems: A chicory (Cichorium intybus L.) case study

Author

Atzori, G, GUIDI NISSIM, W, Caparrotta, S, Santantoni, F, Masi, E, Giulia Atzori, Werther Guidi Nissim, Stefania Caparrotta, Federico Santantoni, Elisa Masi, Atzori, G, GUIDI NISSIM, W, Caparrotta, S, Santantoni, F, Masi, E, Giulia Atzori, Werther Guidi Nissim, Stefania Caparrotta, Federico Santantoni, and Elisa Masi

Abstract

The world population is forecast to rise, needing a remarkable increase in food production. As agriculture is among the most water-demanding sectors, such augmentation could negatively affect water resource. Thus actions should be taken both to improve the water efficiency of current cropping systems and to seek alternative water sources for agriculture. The improvement of water efficiency in agriculture has been long investigated. Soilless culture, especially hydroponics, is characterized by a particular attention to the water resource. A different approach is represented by alternative water sources, i.e. seawater, considered as a realistic option in agriculture, either desalinized or blended with freshwater. This study compared the water footprint (WF) of the chicory crop (Cichorium intybus L. var. silvestre) grown in the following cropping systems: a conventional soilless system using freshwater (blue-hydroponics); conventional soil cultivation (blue-pots and open field); a soilless system integrated with a 10% share of seawater (sea-hydroponics); pots irrigated with a 10% share of seawater (sea-pots).By adding seawater to irrigation, we also introduced the "seawater footprint" concept, discussing the environmental implications of the provenience of the irrigation water. Our results showed a significant reduction in WF in both blue-hydroponic and sea-hydroponic (i.e. 64% and 75%, respectively) systems compared to soil cultivation with sea-hydroponics providing the best result in terms of biomass production and water saving. By contrast, sea-pots' performances in terms of WF were significantly lower (at P≤0.05), with an increase of WF of 104% compared to open field cultivation. As the seawater share led to very different results in the two systems, it can be speculated that seawater is not the only reason for the sea-pots' poor performance. Nevertheless, the combination of poor results in terms of both biomass production and water saving and the detrimental effec

Published
2019

15. Potential and constraints of different seawater and freshwater blends as growing media for three vegetable crops

Author

Atzori, G, GUIDI NISSIM, W, Caparrotta, S, Masi, E, Azzarello, E, Pandolfi, C, Vignolini, P, Gonnelli, C, Mancuso, S, ATZORI, GIULIA, GUIDI NISSIM, WERTHER, CAPARROTTA, STEFANIA, MASI, ELISA, AZZARELLO, ELISA, PANDOLFI, CAMILLA, VIGNOLINI, PAMELA, GONNELLI, CRISTINA, MANCUSO, STEFANO, Atzori, G, GUIDI NISSIM, W, Caparrotta, S, Masi, E, Azzarello, E, Pandolfi, C, Vignolini, P, Gonnelli, C, Mancuso, S, ATZORI, GIULIA, GUIDI NISSIM, WERTHER, CAPARROTTA, STEFANIA, MASI, ELISA, AZZARELLO, ELISA, PANDOLFI, CAMILLA, VIGNOLINI, PAMELA, GONNELLI, CRISTINA, and MANCUSO, STEFANO

Abstract

Alternative water sources for irrigation are needed to be found, as agriculture is currently using the 70% of total freshwater. Seawater use for growing crops has long been studied; while an agriculture based on pure seawater is currently impossible, seawater hydroponics may be viable, not aggravating salinization problems in soils. This work aimed at assessing the possibility of growing lettuce, chard and chicory with 3 seawater and freshwater blends (i.e. 5%–10%–15% of seawater). We investigated: i) crops growth, water consumptions, water use efficiency (WUE), water productivity (WP); ii) photosynthetic parameters; iii) principal mineral elements, soluble sugars and phenolics concentration. Lettuce productivity was negatively affected by 10% and 15% of seawater, whereas chard and chicory's growth were not affected by any blend. Interestingly, water consumptions dropped and WUE significantly upturned in every tested crop accordingly with increased seawater concentrations. Leaf concentration of Na+ and of some other ions increased. We concluded that certain amounts of seawater can be practically used in hydroponics, allowing freshwater saving and increasing certain mineral nutrients concentrations.

Published
2016

17. A method to assess the dissipation of residual hypnotics: Eszopiclone versus zopiclone

Author

Boyle, J, Atzori, G, Dijk, D-J, Groeger, JA, Paska, W, Jones, S, Scott, J, Cooper, JA, Gandhi, P, and Rockett, C

Abstract

Next-day residual effects of single evening doses of 3 mg of eszopiclone, 7.5 mg of zopiclone, and placebo were assessed in a randomized, double-blind, placebo-controlled, 3-way crossover study that used a mild sleep restriction protocol (sleep duration, 7 hours). During each period, 91 healthy volunteers spent 2 consecutive nights in the laboratory with time in bed restricted to 7 hours. Volunteers completed the Continuous Tracking Test, Critical Flicker Fusion task, Digit Symbol Substitution Test, N-back tasks, and Linear Analogue Rating Scales every half-hour from 7.5 to 11.5 hours after dose, commencing 15 minutes after awakening. Nighttime dosing of both eszopiclone (3 mg) and racemic zopiclone (7.5 mg) was associated with next-day performance impairment, and these residual effects dissipated over time. Eszopiclone did not differ from zopiclone on the primary end point, mean Continuous Tracking Test tracking error averaged from 7.5 to 9.5 hours after dose; however, a prespecified post hoc parametric analysis of reciprocal-transformed data favored eszopiclone over racemic zopiclone (P = 0.026). © 2012 Lippincott Williams & Wilkins.

Published
2012

19. Osservazioni sul regime alimentare di Diplodus annularis (Linnaeus, 1758) nello stagno di Calich (Sardegna nord occidentale) = Observations on the feeding behaviour of Diplodus annularis (Linnaeus, 1758) in the Calich Lagoon (North Western Sardinia)

Author

Chessa, Lorenzo Antonio, Pais, Antonio, Scardi, Michele, Serra, S., and Atzori, G.

Subjects
BIO/07 Ecologia, AGR/20 Zoocolture
Abstract

Feeding behaviour of the annular sea bream Diplodus annularis was investigated in the Calich lagoon (NW Sardinia, Italy). The stomach contents of 130 adult specimens (TL=15.2±1.4 cm) collected in spring and summer 1998 were examined. Benthic fauna such as Mollusca, Amphipoda and Polychaeta were the main food items (23.4%, 18% and 5.7% respectively), but a large amount of detritus was also found (44%). Furthermore, significant differences in the diet of smaller and larger size classes were observed.

Published
2004

20. Beta-Globin Haplotype And Xmni Polymorphism At Position G-Gamma-158 And Hbf Production In Fanconis Anemia

Author

ROSATELLI, MC, ALTAY, C, ONER, R, LEONI, GB, MOI, B, ATZORI, G, CAO, A, and İç Hastalıkları

Subjects
congenital, hereditary, and neonatal diseases and abnormalities, hemic and lymphatic diseases, Hematology
Abstract

Background. Patients with aplastic anemia show to a variable degree an increase of the red blood cell volume and percentage of HbF. The extent of HbF reactivation in sickle cell anemia and thalassemia major is related to the presence of XmnI polymorphism at -158 G(gamma). In this study, we have investigated whether in Fanconi's anemia the increase of the HbF is also related to the XmnI polymorphism. Methods. Restriction site polymorphisms in the beta-globin gene cluster were analyzed to define the beta-globin haplotype. The presence of a C- > T substitution at position -158 G(gamma) was investigated by XmnI digestion. Results. We found that patients with the XmnI site at -158 G(gamma), which was contained either in the 5' - + - + + or in the rare - + --- sub-haplotype, tend to have higher HbF and MCV values. The differences between XmnI positive and XmnI negative patients were highly significative (p < 0.0025) for the MCV values, but barely significant for HbF levels (p < 0.05). Conclusions. Our results suggest that in Fanconi's anemia both the extent of HbF reactivation and the fetal-like erythropoiesis, which is responsible for high MCV, are at least partially related to the beta-globin haplotype.

Published
1992

21. Eswl for Ureteral Calculi

Author

Ayyoub, M., primary, Usai, M., additional, Malloci, S., additional, Solinas, A., additional, Atzori, G., additional, and Frongia, M., additional

Published
2005
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22. The macrozoobenthic community of the Santa Gilla lagoon (Southern Sardinia, Italy).

Author

Cabiddu, S., Culurgioni, J., Palmas, F., Soldovilla, G., and Atzori, G.

Subjects
BENTHIC animals, BRACKISH waters
Abstract

1 - Macrozoobenthos is one of the most significant communities of hydrobionts for assessing the ecological state of a water body. In spite of its importance, only few data concerning the macrobenthic community of Santa Gilla lagoon are available; 2 - Santa Gilla is one of the most important wetlands in Sardinia. The aim of this study is to give data on species composition of its macrozoobenthic community; 3 - Sampling has been carried out in 2010-2011 in July, October, January and April, in three stations located along a salinity gradient and the main environmental parameters were measured; 4 - A total of 13031 specimens belonging to 92 taxonomic groups and 5 main phyla (Anellida, Mollusca, Arthropoda, Cnidaria and Nemertea) were found. Among them, 52 different taxa were collected and pointed out for the first time in Santa Gilla lagoon in this work. 5 - Finally, seasonal and space differences were observed in the abundance values of the main taxonomic groups and in the diversity indices values. [ABSTRACT FROM AUTHOR]

Published
2014
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23. Occurence of the alien species Caprella scaura (Amphipoda: Caprellidae) in three Tyrrhenian lagoons.

Author

Cabiddu, S., Atzori, G., Gallo, M., Cau, A., and Gravina, M. F.

Subjects
INTRODUCED species, CAPRELLIDAE, ENVIRONMENTAL protection, AMPHIPODA, LAGOONS
Abstract

1 - Alien species represent a recognized worldwide threat to the integrity of the native communities, to the economy and even to human health; hence the understanding of invasive processes and their impact on the invaded ecosystems are essential to environmental conservation and management. 2 - In this paper we have reported, for some Italian lagoons, the first record of the alien species Caprella scaura Templeton, 1836, an amphipod species native to the Indian Ocean and now recorded worldwide. 3 - Specimens of C. scaura were collected in three Tyrrhenian lagoons (Santa Gilla, Caprolace and Fogliano), sorted into 5 categories (juveniles, males, immature females, mature females, breeding females) counted and measured for their total length. 4 - In Caprolace and Fogliano lagoons very few specimens were collected, while in the Santa Gilla samples a considerable number of individuals were found, particularly juveniles and immature females. 5 - Total length values of our specimens were lower than those reported from others Mediterranean areas. 6 - The introduction of this species in Caprolace and Fogliano lagoons is clearly a recent event while in Santa Gilla lagoon it is undefined. [ABSTRACT FROM AUTHOR]

Published
2013
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27. Intercropping Salt-Sensitive Lactuca sativa L. and Salt-Tolerant Salsola soda L. in a Saline Hydroponic Medium: An Agronomic and Physiological Assessment

Author

Giulia Atzori, Werther Guidi Nissim, Stefano Mancuso, Emily Palm, Atzori, G, Guidi Nissim, W, Mancuso, S, and Palm, E

Subjects
obligate halophyte, photosynthesi, Ecology, biosaline agriculture, glycophyte, seawater irrigation, photosynthesis, nutritional profile, Plant Science, Ecology, Evolution, Behavior and Systematics
Abstract

Competition for freshwater is increasing, with a growing population and the effects of climate change limiting its availability. In this experiment, Lactuca sativa plants were grown hydroponically with or without a 15% share of seawater (12 dS m−1) alone or intercropped with Salsola soda to demonstrate if L. sativa benefits from sodium removal by its halophyte companion. Contrary to the hypothesis, saline-grown L. sativa plants demonstrated reduced growth compared to the control plants regardless of the presence or absence of S. soda. Both limitations in CO2 supply and photosystem efficiency may have decreased CO2 assimilation rates and growth in L. sativa plants grown in the seawater-amended solutions. Surprisingly, leaf pigment concentrations increased in salt-treated L. sativa plants, and most notably among those intercropped with S. soda, suggesting that intercropping may have led to shade-induced increases in chlorophyll pigments. Furthermore, increased levels of proline indicate that salt-treated L. sativa plants were experiencing stress. In contrast, S. soda produced greater biomass in saline conditions than in control conditions. The mineral element, carbohydrate, protein, polyphenol and nitrate profiles of both species differed in their response to salinity. In particular, salt-sensitive L. sativa plants had greater accumulations of Fe, Ca, P, total phenolic compounds and nitrates under saline conditions than salt-tolerant S. soda. The obtained results suggest that intercropping salt-sensitive L. sativa with S. soda in a hydroponic system did not ameliorate the growing conditions of the salt-sensitive species as was hypothesized and may have exacerbated the abiotic stress by increasing competition for limited resources such as light. In contrast, the saline medium induced an improvement in the nutritional profile of S. soda. These results demonstrate an upper limit of the seawater share and planting density that can be used in saline agriculture when intercropping S. soda plants with other salt-sensitive crops.

Published
2022

28. The Response of Halophyte (Tetragonia tetragonioides (Pallas) Kuntz.) and Glycophyte (Lactuca sativa L.) Crops to Diluted Seawater and NaCl Solutions: A Comparison between Two Salinity Stress Types

Author

Giulia Atzori, Stefano Mancuso, Werther Guidi Nissim, Camilla Pandolfi, Elisa Masi, Guidi Nissim, W, Masi, E, Pandolfi, C, Mancuso, S, and Atzori, G

Subjects
0106 biological sciences, Technology, QH301-705.5, QC1-999, NaCl salt stress, Lactuca, 01 natural sciences, Nutrient, Salt stre, Halophyte, seawater salt stress, General Materials Science, Proline, Water-use efficiency, Biology (General), seawater irrigation, Instrumentation, QD1-999, New Zealand spinach, salt stress, Seawater salt stre, Fluid Flow and Transfer Processes, saline agriculture, Tetragonia, salt tolerance, Hydroponic, biology, Chemistry, Process Chemistry and Technology, Physics, General Engineering, hydroponics, 04 agricultural and veterinary sciences, Hydroponics, biology.organism_classification, Engineering (General). Civil engineering (General), NaCl salt stre, Computer Science Applications, lettuce, Horticulture, 040103 agronomy & agriculture, 0401 agriculture, forestry, and fisheries, Seawater, TA1-2040, 010606 plant biology & botany
Abstract

The use of seawater in horticulture is underestimated. Although pure seawater is harmful to most living plants, diluted seawater could represent a promising integration to meet the crop’s nutrient and water requirements. In the current trial, we compared the effects of moderate and high concentrations of seawater and a comparable NaCl solution on a salt-tolerant (Tetragonia tetragonioides) and a salt-sensitive (Lactuca sativa) crop grown in hydroponics. We tested the hypothesis that, due to its mineral composition, diluted seawater would result in a less stressful growing medium than NaCl. We observed that diluted seawater resulted in a less detrimental growing medium compared to an EC-comparable NaCl solution, with remarkable differences between the salt-tolerant and the salt-sensitive species. While the growth rates in Tetragonia did not vary between the two types of stress, diluted seawater led to a higher FW and DW biomass yield in the salt-sensitive lettuce compared to the NaCl treatment. Moreover, NaCl reduced the water consumption and water productivity in Tetragonia. In lettuce, NaCl-treated plants demonstrated lower water use efficiency and water productivity compared to the EC-comparable seawater treatment. Physiological parameters and the concentration of mineral elements, phenolics and proline also demonstrated that, due to different mineral composition, seawater is a less stressful growing medium compared to a NaCl solution at comparable EC.

Published
2021
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29. Seawater and water footprint in different cropping systems: A chicory (Cichorium intybus L.) case study

Author

Federico Santantoni, Giulia Atzori, Werther Guidi Nissim, Stefania Caparrotta, Elisa Masi, Atzori, G, GUIDI NISSIM, W, Caparrotta, S, Santantoni, F, and Masi, E

Subjects
Irrigation, Chicory crop, 0208 environmental biotechnology, Seawater irrigation, Soil Science, 02 engineering and technology, Water-use efficiency, Earth-Surface Processes, Water Science and Technology, Hydroponic, Water productivity, business.industry, 04 agricultural and veterinary sciences, Water efficiency, Seawater footprint, 020801 environmental engineering, Tillage, Water resources, Agronomy, Agriculture, 040103 agronomy & agriculture, 0401 agriculture, forestry, and fisheries, Environmental science, Seawater, Water footprint, business, Agronomy and Crop Science, Water use
Abstract

The world population is forecast to rise, needing a remarkable increase in food production. As agriculture is among the most water-demanding sectors, such augmentation could negatively affect water resource. Thus actions should be taken both to improve the water efficiency of current cropping systems and to seek alternative water sources for agriculture. The improvement of water efficiency in agriculture has been long investigated. Soilless culture, especially hydroponics, is characterized by a particular attention to the water resource. A different approach is represented by alternative water sources, i.e. seawater, considered as a realistic option in agriculture, either desalinized or blended with freshwater. This study compared the water footprint (WF) of the chicory crop (Cichorium intybus L. var. silvestre) grown in the following cropping systems: a conventional soilless system using freshwater (blue-hydroponics); conventional soil cultivation (blue-pots and open field); a soilless system integrated with a 10% share of seawater (sea-hydroponics); pots irrigated with a 10% share of seawater (sea-pots).By adding seawater to irrigation, we also introduced the "seawater footprint" concept, discussing the environmental implications of the provenience of the irrigation water. Our results showed a significant reduction in WF in both blue-hydroponic and sea-hydroponic (i.e. 64% and 75%, respectively) systems compared to soil cultivation with sea-hydroponics providing the best result in terms of biomass production and water saving. By contrast, sea-pots' performances in terms of WF were significantly lower (at P ≤ 0.05), with an increase of WF of 104% compared to open field cultivation. As the seawater share led to very different results in the two systems, it can be speculated that seawater is not the only reason for the sea-pots' poor performance. Nevertheless, the combination of poor results in terms of both biomass production and water saving and the detrimental effects of salinity on soil make the option of soil cropping with seawater unrealistic. However a controlled use of seawater in soilless culture could reduce, without any negative environmental concern, the freshwater withdrawal dedicated to food production. Moreover, our results also suggested a higher salt tolerance in hydroponic conditions compared to soil cultivation for the tested crop.

Published
2019

30. Algae and Bioguano as promising source of organic fertilizers

Author

Natascia Biondi, Liliana Rodolfi, Giulia Atzori, Alberto Niccolai, Mario R. Tredici, Werther Guidi Nissim, Stefano Mancuso, Atzori, G, GUIDI NISSIM, W, Rodolfi, L, Niccolai, A, Biondi, N, Mancuso, S, and Tredici, M

Subjects
0106 biological sciences, Cystoseira, Chlorella, Plant Science, Aquatic Science, engineering.material, Phaeophyta, 01 natural sciences, Algae, Chlorophyta, Barley, Spirulina (genus), biology, 010604 marine biology & hydrobiology, fungi, Plant physiology, food and beverages, Bioguano, biology.organism_classification, Biofertilizers, Chlorophyta, Phaeophyta, Chaetomorpha, Cystoseira, Chlorella, Bioguano, Barley, Agronomy, Guano, engineering, Environmental science, Biofertilizer, Fertilizer, Chaetomorpha, 010606 plant biology & botany
Abstract

The projected population growth implies an increased food demand with a severe impact on Earth’s natural resources. Improving crops yield without compromising the environment will be one of the main challenges of the next decades. Among the practices that can promote sustainable agriculture, organic fertilizers, and seaweeds in particular, are receiving growing attention. The aim of the current study was to test two macroalgae (Chaetomorphasp. andCystoseirasp.), one microalga (ChlorellaCH2) and Bioguano (a mixture of macroalgae, spirulina, and guano) as organic fertilizers for the growth of barley seedlings. Remarkable plant growth was obtained on Bioguano, with seedlings showing a comparable total biomass yield with respect to the positive control plants on mineral fertilizer. Plants growth on macroalgae was reduced, even if inChaetomorphasp. not significantly compared to the positive control. Plants growth onChlorellaCH2 was close to that of the negative control (only water). Plants on Bioguano attained high uptake efficiencies of N (60%) and K (41%). Plants on macroalgae showed high N, and especially P (about 30%) uptake efficiency. Our results suggest a high potential for Bioguano and, to a lesser extent, for macroalgae without any synthetic fertilizer application to be used as growing substrates for crops.

Published
2020

31. Tetragonia tetragonioides (Pallas) Kuntz. as promising salt-tolerant crop in a saline agricultural context

Author

Camilla Pandolfi, Werther Guidi Nissim, Tania Macchiavelli, Giulia Atzori, Federico Vita, Elisa Masi, Elisa Azzarello, Stefano Mancuso, Atzori, G, Guidi Nissim, W, Macchiavelli, T, Vita, F, Azzarello, E, Pandolfi, C, Masi, E, and Mancuso, S

Subjects
Specific leaf area, 0208 environmental biotechnology, Seawater irrigation, Soil Science, Context (language use), 02 engineering and technology, Nutrient, Salt-tolerant crop, New Zealand spinach, Earth-Surface Processes, Water Science and Technology, Transpiration, Tetragonia, Hydroponic, fungi, food and beverages, 04 agricultural and veterinary sciences, Hydroponics, Salt removing crop, 020801 environmental engineering, Seawater footprint, Salinity, Agronomy, 040103 agronomy & agriculture, 0401 agriculture, forestry, and fisheries, Environmental science, Seawater, Saline agriculture, Agronomy and Crop Science
Abstract

The lack of natural resources, especially good-quality cropland and renewable water resources is threatening food production potential in marginal agricultural ecosystems, which are already negatively affected by climate change. Since the world's major crops are proving inadequate to supply the calories and nutrients for people in these areas, new crops are sought that can withstand harsh ecological environmental conditions. In the current trial, we assessed the growth and productivity of Tetragonia tetragonioides (Pallas) Kuntz. in a floating hydroponic system supplied with different seawater proportions (i.e. 15% and 30% seawater, EC = 9.8 and 18.0 dS m−1). Moreover, the effects of different salinity levels on mineral elements accumulation, production of osmotic solutes and secondary metabolites were determined, along with the salt removal capacity of the crop. The results indicated that plant growth was not affected by either of the seawater treatments used in this study. The increased leaf succulence and the reduction of both leaf area and specific leaf area with increasing salinity might represent an essential feature of this salt-tolerant species associated to the plants need of limiting transpiration. Low seawater treated plants showed a significantly higher biomass yield per liter of (sea)water used (117%) than the control. Under these conditions plants accumulated the highest amount of Mg (+31% and 48% in medium and high seawater treated plants compared with the control) and Cu (+14% and 30%, respectively) along with increasing proline and decreasing nitrate concentrations. By contrast, we found that seawater supply resulted in a Na-enriched leaf biomass that may represent an issue for human health. We concluded that Tetragonia tetragonioides can be grown in saline agriculture up to a salinity level characterized by an EC of 18 dS m-1 but further investigation is required to address Na accumulation in leaves.

Published
2020

32. Potential and constraints of different seawater and freshwater blends as growing media for three vegetable crops

Author

Cristina Gonnelli, Pamela Vignolini, Stefania Caparrotta, Camilla Pandolfi, Giulia Atzori, Elisa Azzarello, Werther Guidi Nissim, Elisa Masi, Stefano Mancuso, Atzori, G, GUIDI NISSIM, W, Caparrotta, S, Masi, E, Azzarello, E, Pandolfi, C, Vignolini, P, Gonnelli, C, and Mancuso, S

Subjects
0106 biological sciences, Irrigation, Soil salinity, Soil Science, Chard, Photosynthesis, 01 natural sciences, Chicory, Nutrient, WUE, Water-use efficiency, Earth-Surface Processes, Water Science and Technology, 04 agricultural and veterinary sciences, Lettuce, Hydroponics, Agronomy, Soil water, 040103 agronomy & agriculture, 0401 agriculture, forestry, and fisheries, Environmental science, Seawater, Saline agriculture, Agronomy and Crop Science, Biofortification, 010606 plant biology & botany
Abstract

Alternative water sources for irrigation are needed to be found, as agriculture is currently using the 70% of total freshwater. Seawater use for growing crops has long been studied; while an agriculture based on pure seawater is currently impossible, seawater hydroponics may be viable, not aggravating salinization problems in soils. This work aimed at assessing the possibility of growing lettuce, chard and chicory with 3 seawater and freshwater blends (i.e. 5%–10%–15% of seawater). We investigated: i) crops growth, water consumptions, water use efficiency (WUE), water productivity (WP); ii) photosynthetic parameters; iii) principal mineral elements, soluble sugars and phenolics concentration. Lettuce productivity was negatively affected by 10% and 15% of seawater, whereas chard and chicory’s growth were not affected by any blend. Interestingly, water consumptions dropped and WUE significantly upturned in every tested crop accordingly with increased seawater concentrations. Leaf concentration of Na+ and of some other ions increased. We concluded that certain amounts of seawater can be practically used in hydroponics, allowing freshwater saving and increasing certain mineral nutrients concentrations.

Published
2016

33. P-tau217 and other blood biomarkers of dementia: variation with time of day.

Author

Della Monica C, Revell V, Atzori G, Laban R, Skene SS, Heslegrave A, Hassanin H, Nilforooshan R, Zetterberg H, and Dijk DJ

Subjects
Humans, Female, Male, Aged, Phosphorylation, Circadian Rhythm physiology, Middle Aged, Peptide Fragments blood, Neurofilament Proteins blood, Aged, 80 and over, Dementia blood, Dementia diagnosis, Sleep physiology, Caregivers, Glial Fibrillary Acidic Protein, tau Proteins blood, Biomarkers blood, Amyloid beta-Peptides blood, Alzheimer Disease blood, Alzheimer Disease diagnosis
Abstract

Plasma biomarkers of dementia, including phosphorylated tau (p-tau217), offer promise as tools for diagnosis, stratification for clinical trials, monitoring disease progression, and assessing the success of interventions in those living with Alzheimer's disease. However, currently, it is unknown whether these dementia biomarker levels vary with the time of day, which could have implications for their clinical value. In two protocols, we studied 38 participants (70.8 ± 7.6 years; mean ± SD) in a 27-h laboratory protocol with either two samples taken 12 h apart or 3-hourly blood sampling for 24 h in the presence of a sleep-wake cycle. The study population comprised people living with mild Alzheimer's disease (PLWA, n = 8), partners/caregivers of PLWA (n = 6) and cognitively intact older adults (n = 24). Single-molecule array technology was used to measure phosphorylated tau (p-tau217) (ALZpath), amyloid-beta 40 (Aβ40), amyloid-beta 42 (Aβ42), glial fibrillary acidic protein, and neurofilament light (NfL) (Neuro 4-Plex E). Analysis with a linear mixed model (SAS, PROC MIXED) revealed a significant effect of time of day for p-tau217, Aβ40, Aβ42, and NfL, and a significant effect of participant group for p-tau217. For p-tau217, the lowest levels were observed in the morning upon waking and the highest values in the afternoon/early evening. The magnitude of the diurnal variation for p-tau217 was similar to the reported increase in p-tau217 over one year in amyloid-β-positive mild cognitively impaired people. Currently, the factors driving this diurnal variation are unknown and could be related to sleep, circadian mechanisms, activity, posture, or meals. Overall, this work implies that the time of day of sample collection may be relevant in the implementation and interpretation of plasma biomarkers in dementia research and care., (© 2024. The Author(s).)

Published
2024
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34. Closed-loop auditory stimulation targeting alpha and theta oscillations during REM sleep induces phase-dependent power and frequency changes.

Author

Jaramillo V, Hebron H, Wong S, Atzori G, Bartsch U, Dijk DJ, and Violante IR

Abstract

Study Objectives: Alpha and theta oscillations characterize the waking human electroencephalogram (EEG) and can be modulated by closed-loop auditory stimulation (CLAS). These oscillations also occur during rapid eye movement (REM) sleep, but their function here remains elusive. CLAS represents a promising tool to pinpoint how these brain oscillations contribute to brain function in humans. Here we investigate whether CLAS can modulate alpha and theta oscillations during REM sleep in a phase-dependent manner., Methods: We recorded high-density EEG during an extended overnight sleep period in 18 healthy young adults. Auditory stimulation was delivered during both phasic and tonic REM sleep in alternating 6 s ON and 6 s OFF windows. During the ON windows, stimuli were phase-locked to four orthogonal phases of ongoing alpha or theta oscillations detected in a frontal electrode., Results: The phases of ongoing alpha and theta oscillations were targeted with high accuracy during REM sleep. Alpha and theta CLAS induced phase-dependent changes in power and frequency at the target location. Frequency-specific effects were observed for alpha trough (speeding up) and rising (slowing down) and theta trough (speeding up) conditions. CLAS-induced phase-dependent changes were observed during both REM sleep substages, even though auditory evoked potentials were very much reduced in phasic compared to tonic REM sleep., Conclusions: This study provides evidence that faster REM sleep rhythms can be modulated by CLAS in a phase-dependent manner. This offers a new approach to investigate how modulation of REM sleep oscillations affects the contribution of this vigilance state to brain function., (© The Author(s) 2024. Published by Oxford University Press on behalf of Sleep Research Society. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Published
2024
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35. Reliable Contactless Monitoring of Heart Rate, Breathing Rate, and Breathing Disturbance During Sleep in Aging: Digital Health Technology Evaluation Study.

Author

G Ravindran KK, Della Monica C, Atzori G, Lambert D, Hassanin H, Revell V, and Dijk DJ

Subjects
Humans, Aged, Male, Female, Aged, 80 and over, Monitoring, Physiologic methods, Monitoring, Physiologic instrumentation, Polysomnography methods, Polysomnography instrumentation, Technology Assessment, Biomedical methods, Digital Health, Heart Rate physiology, Respiratory Rate physiology
Abstract

Background: Longitudinal monitoring of vital signs provides a method for identifying changes to general health in an individual, particularly in older adults. The nocturnal sleep period provides a convenient opportunity to assess vital signs. Contactless technologies that can be embedded into the bedroom environment are unintrusive and burdenless and have the potential to enable seamless monitoring of vital signs. To realize this potential, these technologies need to be evaluated against gold standard measures and in relevant populations., Objective: We aimed to evaluate the accuracy of heart rate and breathing rate measurements of 3 contactless technologies (2 undermattress trackers, Withings Sleep Analyzer [WSA] and Emfit QS [Emfit]; and a bedside radar, Somnofy) in a sleep laboratory environment and assess their potential to capture vital signs in a real-world setting., Methods: Data were collected from 35 community-dwelling older adults aged between 65 and 83 (mean 70.8, SD 4.9) years (men: n=21, 60%) during a 1-night clinical polysomnography (PSG) test in a sleep laboratory, preceded by 7 to 14 days of data collection at home. Several of the participants (20/35, 57%) had health conditions, including type 2 diabetes, hypertension, obesity, and arthritis, and 49% (17) had moderate to severe sleep apnea, while 29% (n=10) had periodic leg movement disorder. The undermattress trackers provided estimates of both heart rate and breathing rate, while the bedside radar provided only the breathing rate. The accuracy of the heart rate and breathing rate estimated by the devices was compared with PSG electrocardiogram-derived heart rate (beats per minute) and respiratory inductance plethysmography thorax-derived breathing rate (cycles per minute), respectively. We also evaluated breathing disturbance indexes of snoring and the apnea-hypopnea index, available from the WSA., Results: All 3 contactless technologies provided acceptable accuracy in estimating heart rate (mean absolute error <2.12 beats per minute and mean absolute percentage error <5%) and breathing rate (mean absolute error ≤1.6 cycles per minute and mean absolute percentage error <12%) at 1-minute resolution. All 3 contactless technologies were able to capture changes in heart rate and breathing rate across the sleep period. The WSA snoring and breathing disturbance estimates were also accurate compared with PSG estimates (WSA snore: r 2 =0.76; P<.001; WSA apnea-hypopnea index: r 2 =0.59; P<.001)., Conclusions: Contactless technologies offer an unintrusive alternative to conventional wearable technologies for reliable monitoring of heart rate, breathing rate, and sleep apnea in community-dwelling older adults at scale. They enable the assessment of night-to-night variation in these vital signs, which may allow the identification of acute changes in health, and longitudinal monitoring, which may provide insight into health trajectories., International Registered Report Identifier (irrid): RR2-10.3390/clockssleep6010010., (©Kiran K G Ravindran, Ciro della Monica, Giuseppe Atzori, Damion Lambert, Hana Hassanin, Victoria Revell, Derk-Jan Dijk. Originally published in JMIR mHealth and uHealth (https://mhealth.jmir.org), 27.08.2024.)

Published
2024
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36. The Sustainable Use of Halophytes in Salt-Affected Land: State-of-the-Art and Next Steps in a Saltier World.

Author

Bazihizina N, Papenbrock J, Aronsson H, Ben Hamed K, Elmaz Ö, Dafku Z, Custódio L, Rodrigues MJ, Atzori G, and Negacz K

Abstract

Salinization is a major cause of soil degradation that affects several million hectares of agricultural land, threatening food security and the sustainability of agricultural systems worldwide. Nevertheless, despite the negative impact of salinity, salt-affected land also provides several important ecosystem services, from providing habitats and nurseries for numerous species to sustainable food production. This opinion paper, written in the framework of the EU COST Action CA22144 SUSTAIN on the sustainable use of salt-affected land, therefore, focuses on the potential of halophytes and saline agriculture to transform and restore key functions of these salt-affected and marginal lands. As the current knowledge on sustainable saline agriculture upscaling is fragmented, we highlight (i) the research gaps in halophyte and salinity research and (ii) the main barriers and potentials of saline agriculture for addressing food security and environmental sustainability in terms of population growth and climate change.

Published
2024
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38. From Scalp to Ear-EEG: A Generalizable Transfer Learning Model for Automatic Sleep Scoring in Older People.

Author

Hammour G, Davies H, Atzori G, Della Monica C, Ravindran KKG, Revell V, Dijk DJ, and Mandic DP

Subjects
Humans, Aged, Aged, 80 and over, Male, Female, Sleep physiology, Signal Processing, Computer-Assisted, Ear physiology, Machine Learning, Polysomnography methods, Electroencephalography methods, Scalp physiology
Abstract

Objective: Sleep monitoring has extensively utilized electroencephalogram (EEG) data collected from the scalp, yielding very large data repositories and well-trained analysis models. Yet, this wealth of data is lacking for emerging, less intrusive modalities, such as ear-EEG., Methods and Procedures: The current study seeks to harness the abundance of open-source scalp EEG datasets by applying models pre-trained on data, either directly or with minimal fine-tuning; this is achieved in the context of effective sleep analysis from ear-EEG data that was recorded using a single in-ear electrode, referenced to the ipsilateral mastoid, and developed in-house as described in our previous work. Unlike previous studies, our research uniquely focuses on an older cohort (17 subjects aged 65-83, mean age 71.8 years, some with health conditions), and employs LightGBM for transfer learning, diverging from previous deep learning approaches., Results: Results show that the initial accuracy of the pre-trained model on ear-EEG was 70.1%, but fine-tuning the model with ear-EEG data improved its classification accuracy to 73.7%. The fine-tuned model exhibited a statistically significant improvement (p < 0.05, dependent t-test) for 10 out of the 13 participants, as reflected by an enhanced average Cohen's kappa score (a statistical measure of inter-rater agreement for categorical items) of 0.639, indicating a stronger agreement between automated and expert classifications of sleep stages. Comparative SHAP value analysis revealed a shift in feature importance for the N3 sleep stage, underscoring the effectiveness of the fine-tuning process., Conclusion: Our findings underscore the potential of fine-tuning pre-trained scalp EEG models on ear-EEG data to enhance classification accuracy, particularly within an older population and using feature-based methods for transfer learning. This approach presents a promising avenue for ear-EEG analysis in sleep studies, offering new insights into the applicability of transfer learning across different populations and computational techniques., Clinical Impact: An enhanced ear-EEG method could be pivotal in remote monitoring settings, allowing for continuous, non-invasive sleep quality assessment in elderly patients with conditions like dementia or sleep apnea., (© 2024 The Authors.)

Published
2024
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39. Effect of 60 days of head down tilt bed rest on amplitude and phase of rhythms in physiology and sleep in men.

Author

Bonmatí-Carrión MÁ, Santhi N, Atzori G, Mendis J, Kaduk S, Dijk DJ, and Archer SN

Abstract

Twenty-four-hour rhythms in physiology and behaviour are shaped by circadian clocks, environmental rhythms, and feedback of behavioural rhythms onto physiology. In space, 24 h signals such as those associated with the light-dark cycle and changes in posture, are weaker, potentially reducing the robustness of rhythms. Head down tilt (HDT) bed rest is commonly used to simulate effects of microgravity but how HDT affects rhythms in physiology has not been extensively investigated. Here we report effects of -6° HDT during a 90-day protocol on 24 h rhythmicity in 20 men. During HDT, amplitude of light, motor activity, and wrist-temperature rhythms were reduced, evening melatonin was elevated, while cortisol was not affected during HDT, but was higher in the morning during recovery when compared to last session of HDT. During recovery from HDT, time in Slow-Wave Sleep increased. EEG activity in alpha and beta frequencies increased during NREM and REM sleep. These results highlight the profound effects of head-down-tilt-bed-rest on 24 h rhythmicity., (© 2024. The Author(s).)

Published
2024
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40. A Protocol for Evaluating Digital Technology for Monitoring Sleep and Circadian Rhythms in Older People and People Living with Dementia in the Community.

Author

Della Monica C, Ravindran KKG, Atzori G, Lambert DJ, Rodriguez T, Mahvash-Mohammadi S, Bartsch U, Skeldon AC, Wells K, Hampshire A, Nilforooshan R, Hassanin H, The Uk Dementia Research Institute Care Research Amp Technology Research Group, Revell VL, and Dijk DJ

Abstract

Sleep and circadian rhythm disturbance are predictors of poor physical and mental health, including dementia. Long-term digital technology-enabled monitoring of sleep and circadian rhythms in the community has great potential for early diagnosis, monitoring of disease progression, and assessing the effectiveness of interventions. Before novel digital technology-based monitoring can be implemented at scale, its performance and acceptability need to be evaluated and compared to gold-standard methodology in relevant populations. Here, we describe our protocol for the evaluation of novel sleep and circadian technology which we have applied in cognitively intact older adults and are currently using in people living with dementia (PLWD). In this protocol, we test a range of technologies simultaneously at home (7-14 days) and subsequently in a clinical research facility in which gold standard methodology for assessing sleep and circadian physiology is implemented. We emphasize the importance of assessing both nocturnal and diurnal sleep (naps), valid markers of circadian physiology, and that evaluation of technology is best achieved in protocols in which sleep is mildly disturbed and in populations that are relevant to the intended use-case. We provide details on the design, implementation, challenges, and advantages of this protocol, along with examples of datasets.

Published
2024
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41. Correction: Three Contactless Sleep Technologies Compared With Actigraphy and Polysomnography in a Heterogeneous Group of Older Men and Women in a Model of Mild Sleep Disturbance: Sleep Laboratory Study.

Author

G Ravindran KK, Della Monica C, Atzori G, Lambert D, Hassanin H, Revell V, and Dijk DJ

Abstract

[This corrects the article DOI: 10.2196/46338.]., (©Kiran K G Ravindran, Ciro della Monica, Giuseppe Atzori, Damion Lambert, Hana Hassanin, Victoria Revell, Derk-Jan Dijk. Originally published in JMIR mHealth and uHealth (https://mhealth.jmir.org), 05.12.2023.)

Published
2023
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42. Plant Physiological Analysis to Overcome Limitations to Plant Phenotyping.

Author

Haworth M, Marino G, Atzori G, Fabbri A, Daccache A, Killi D, Carli A, Montesano V, Conte A, Balestrini R, and Centritto M

Abstract

Plant physiological status is the interaction between the plant genome and the prevailing growth conditions. Accurate characterization of plant physiology is, therefore, fundamental to effective plant phenotyping studies; particularly those focused on identifying traits associated with improved yield, lower input requirements, and climate resilience. Here, we outline the approaches used to assess plant physiology and how these techniques of direct empirical observations of processes such as photosynthetic CO 2 assimilation, stomatal conductance, photosystem II electron transport, or the effectiveness of protective energy dissipation mechanisms are unsuited to high-throughput phenotyping applications. Novel optical sensors, remote/proximal sensing (multi- and hyperspectral reflectance, infrared thermography, sun-induced fluorescence), LiDAR, and automated analyses of below-ground development offer the possibility to infer plant physiological status and growth. However, there are limitations to such 'indirect' approaches to gauging plant physiology. These methodologies that are appropriate for the rapid high temporal screening of a number of crop varieties over a wide spatial scale do still require 'calibration' or 'validation' with direct empirical measurement of plant physiological status. The use of deep-learning and artificial intelligence approaches may enable the effective synthesis of large multivariate datasets to more accurately quantify physiological characters rapidly in high numbers of replicate plants. Advances in automated data collection and subsequent data processing represent an opportunity for plant phenotyping efforts to fully integrate fundamental physiological data into vital efforts to ensure food and agro-economic sustainability.

Published
2023
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43. Three Contactless Sleep Technologies Compared With Actigraphy and Polysomnography in a Heterogeneous Group of Older Men and Women in a Model of Mild Sleep Disturbance: Sleep Laboratory Study.

Author

G Ravindran KK, Della Monica C, Atzori G, Lambert D, Hassanin H, Revell V, and Dijk DJ

Subjects
Male, Female, Humans, Aged, Polysomnography, Sleep Duration, Sleep Stages, Actigraphy, Sleep
Abstract

Background: Contactless sleep technologies (CSTs) hold promise for longitudinal, unobtrusive sleep monitoring in the community and at scale. They may be particularly useful in older populations wherein sleep disturbance, which may be indicative of the deterioration of physical and mental health, is highly prevalent. However, few CSTs have been evaluated in older people., Objective: This study evaluated the performance of 3 CSTs compared to polysomnography (PSG) and actigraphy in an older population., Methods: Overall, 35 older men and women (age: mean 70.8, SD 4.9 y; women: n=14, 40%), several of whom had comorbidities, including sleep apnea, participated in the study. Sleep was recorded simultaneously using a bedside radar (Somnofy [Vital Things]: n=17), 2 undermattress devices (Withings sleep analyzer [WSA; Withings Inc]: n=35; Emfit-QS [Emfit; Emfit Ltd]: n=17), PSG (n=35), and actigraphy (Actiwatch Spectrum [Philips Respironics]: n=18) during the first night in a 10-hour time-in-bed protocol conducted in a sleep laboratory. The devices were evaluated through performance metrics for summary measures and epoch-by-epoch classification. PSG served as the gold standard., Results: The protocol induced mild sleep disturbance with a mean sleep efficiency (SEFF) of 70.9% (SD 10.4%; range 52.27%-92.60%). All 3 CSTs overestimated the total sleep time (TST; bias: >90 min) and SEFF (bias: >13%) and underestimated wake after sleep onset (bias: >50 min). Sleep onset latency was accurately detected by the bedside radar (bias: <6 min) but overestimated by the undermattress devices (bias: >16 min). CSTs did not perform as well as actigraphy in estimating the all-night sleep summary measures. In an epoch-by-epoch concordance analysis, the bedside radar performed better in discriminating sleep versus wake (Matthew correlation coefficient [MCC]: mean 0.63, SD 0.12, 95% CI 0.57-0.69) than the undermattress devices (MCC of WSA: mean 0.41, SD 0.15, 95% CI 0.36-0.46; MCC of Emfit: mean 0.35, SD 0.16, 95% CI 0.26-0.43). The accuracy of identifying rapid eye movement and light sleep was poor across all CSTs, whereas deep sleep (ie, slow wave sleep) was predicted with moderate accuracy (MCC: >0.45) by both Somnofy and WSA. The deep sleep duration estimates of Somnofy correlated (r 2 =0.60; P<.01) with electroencephalography slow wave activity (0.75-4.5 Hz) derived from PSG, whereas for the undermattress devices, this correlation was not significant (WSA: r 2 =0.0096, P=.58; Emfit: r 2 =0.11, P=.21)., Conclusions: These CSTs overestimated the TST, and sleep stage prediction was unsatisfactory in this group of older people in whom SEFF was relatively low. Although it was previously shown that CSTs provide useful information on bed occupancy, which may be useful for particular use cases, the performance of these CSTs with respect to the TST and sleep stage estimation requires improvement before they can serve as an alternative to PSG in estimating most sleep variables in older individuals., (©Kiran K G Ravindran, Ciro della Monica, Giuseppe Atzori, Damion Lambert, Hana Hassanin, Victoria Revell, Derk-Jan Dijk. Originally published in JMIR mHealth and uHealth (https://mhealth.jmir.org), 25.10.2023.)

Published
2023
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44. Contactless and longitudinal monitoring of nocturnal sleep and daytime naps in older men and women: a digital health technology evaluation study.

Author

Ravindran KKG, Della Monica C, Atzori G, Lambert D, Hassanin H, Revell V, and Dijk DJ

Abstract

Study Objectives: To compare the 24-hour sleep assessment capabilities of two contactless sleep technologies (CSTs) to actigraphy in community-dwelling older adults., Methods: We collected 7-14 days of data at home from 35 older adults (age: 65-83), some with medical conditions, using Withings Sleep Analyser (WSA, n = 29), Emfit QS (Emfit, n = 17), a standard actigraphy device (Actiwatch Spectrum [AWS, n = 34]), and a sleep diary (n = 35). We compared nocturnal and daytime sleep measures estimated by the CSTs and actigraphy without sleep diary information (AWS-A) against sleep-diary-assisted actigraphy (AWS|SD)., Results: Compared to sleep diary, both CSTs accurately determined the timing of nocturnal sleep (intraclass correlation [ICC]: going to bed, getting out of bed, time in bed >0.75), whereas the accuracy of AWS-A was much lower. Compared to AWS|SD, the CSTs overestimated nocturnal total sleep time (WSA: +92.71 ± 81.16 minutes; Emfit: +101.47 ± 75.95 minutes) as did AWS-A (+46.95 ± 67.26 minutes). The CSTs overestimated sleep efficiency (WSA: +9.19% ± 14.26%; Emfit: +9.41% ± 11.05%), whereas AWS-A estimate (-2.38% ± 10.06%) was accurate. About 65% (n = 23) of participants reported daytime naps either in bed or elsewhere. About 90% in-bed nap periods were accurately determined by WSA while Emfit was less accurate. All three devices estimated 24-hour sleep duration with an error of ≈10% compared to the sleep diary., Conclusions: CSTs accurately capture the timing of in-bed nocturnal sleep periods without the need for sleep diary information. However, improvements are needed in assessing parameters such as total sleep time, sleep efficiency, and naps before these CSTs can be fully utilized in field settings., (© The Author(s) 2023. Published by Oxford University Press on behalf of Sleep Research Society.)

Published
2023
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45. Oncoplastic level II volume displacement surgery for breast cancer: oncological and aesthetic outcomes.

Author

Sparavigna M, Gipponi M, Carmisciano L, Franchelli S, Atzori G, Cornacchia C, Diaz R, Murelli F, Depaoli F, Friedman D, and Fregatti P

Subjects
Female, Humans, Mastectomy, Retrospective Studies, Esthetics, Breast Neoplasms surgery, Breast Neoplasms pathology, Mammaplasty
Abstract

Oncoplastic breast-conserving surgery (OBCS) is increasingly used to treat breast cancer with the dual purpose of performing a radical oncological resection while minimizing the risk of post-operative deformities. The aim of the study was to evaluate the patient outcomes after Level II OBCS as regards oncological safety and patient satisfaction. Between 2015 and 2020, a cohort of 109 women consecutively underwent treatment for breast cancer with bilateral oncoplastic breast-conserving volume displacement surgery; patient satisfaction was measured with BREAST-Q questionnaire. The 5-year overall survival and disease-free survival were 97% (95%CI 92, 100) and 94% (95%CI 90, 99), respectively. In two patients (1.8%), mastectomy was finally performed due to margin involvement. The median patient-reported score for "satisfaction with breast" (BREAST-Q) was 74/100. Factors associated with a lower aesthetic satisfaction index included: location of tumour in central quadrant (p = 0.007); triple negative breast cancer (p = 0.045), and re-intervention (p = 0.044). OBCS represents a valid option in terms of oncological outcomes for patients otherwise candidate to more extensive breast conserving surgery; the high satisfaction index also suggests a superiority in terms of aesthetic outcomes., (© 2023. The Author(s).)

Published
2023
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46. Hearables: Automatic Sleep Scoring from Single-Channel Ear-EEG in Older Adults.

Author

Hammour G, Atzori G, Monica CD, Ravindran KKG, Revell V, Dijk DJ, and Mandic DP

Subjects
Humans, Aged, Polysomnography methods, Sleep Stages, Electroencephalography methods, Sleep, Sleep Wake Disorders
Abstract

Sleep disorders are a prevalent problem among older adults, yet obtaining an accurate and reliable assessment of sleep quality can be challenging. Traditional polysomnography (PSG) is the gold standard for sleep staging, but is obtrusive, expensive, and requires expert assistance. To this end, we propose a minimally invasive single-channel single ear-EEG automatic sleep staging method for older adults. The method employs features from the frequency, time, and structural complexity domains, which provide a robust classification of sleep stages from a standardised viscoelastic earpiece. Our method is verified on a dataset of older adults and achieves a kappa value of at least 0.61, indicating substantial agreement. This paves the way for a non-invasive, cost-effective, and portable alternative to traditional PSG for sleep staging.

Published
2023
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47. A Case of Life-Threatening Bleeding Due to a Locally Advanced Breast Carcinoma Successfully Treated with Transcatheter Arterial Embolization.

Author

Atzori G, Diaz R, Gipponi M, Cornacchia C, Murelli F, Depaoli F, Sparavigna M, Barbero V, Petrocelli F, Pitto F, Franchelli S, Friedman D, and Fregatti P

Subjects
Humans, Female, Embolization, Therapeutic, Breast Neoplasms
Abstract

Locally advanced breast cancer (LABC) may rarely present with acute severe bleeding. A case report dealing with transcatheter arterial embolization to control acute bleeding in a patient with a voluminous ulcerated breast mass is described. Our findings confirm that the endovascular approach is effective in such patients in order to stabilize the patient whenever conventional treatments have failed or bleeding may be life-threatening.

Published
2023
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48. Intercropping Salt-Sensitive Lactuca sativa L. and Salt-Tolerant Salsola soda L. in a Saline Hydroponic Medium: An Agronomic and Physiological Assessment.

Author

Atzori G, Guidi Nissim W, Mancuso S, and Palm E

Abstract

Competition for freshwater is increasing, with a growing population and the effects of climate change limiting its availability. In this experiment, Lactuca sativa plants were grown hydroponically with or without a 15% share of seawater (12 dS m -1 ) alone or intercropped with Salsola soda to demonstrate if L. sativa benefits from sodium removal by its halophyte companion. Contrary to the hypothesis, saline-grown L. sativa plants demonstrated reduced growth compared to the control plants regardless of the presence or absence of S. soda . Both limitations in CO 2 supply and photosystem efficiency may have decreased CO 2 assimilation rates and growth in L. sativa plants grown in the seawater-amended solutions. Surprisingly, leaf pigment concentrations increased in salt-treated L. sativa plants, and most notably among those intercropped with S. soda , suggesting that intercropping may have led to shade-induced increases in chlorophyll pigments. Furthermore, increased levels of proline indicate that salt-treated L. sativa plants were experiencing stress. In contrast, S. soda produced greater biomass in saline conditions than in control conditions. The mineral element, carbohydrate, protein, polyphenol and nitrate profiles of both species differed in their response to salinity. In particular, salt-sensitive L. sativa plants had greater accumulations of Fe, Ca, P, total phenolic compounds and nitrates under saline conditions than salt-tolerant S. soda . The obtained results suggest that intercropping salt-sensitive L. sativa with S. soda in a hydroponic system did not ameliorate the growing conditions of the salt-sensitive species as was hypothesized and may have exacerbated the abiotic stress by increasing competition for limited resources such as light. In contrast, the saline medium induced an improvement in the nutritional profile of S. soda . These results demonstrate an upper limit of the seawater share and planting density that can be used in saline agriculture when intercropping S. soda plants with other salt-sensitive crops.

Published
2022
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49. Inferior Pedicle Reduction Mammoplasty as Corrective Surgery after Breast Conserving Surgery and Radiation Therapy.

Author

Atzori G, Franchelli S, Gipponi M, Cornacchia C, Diaz R, Depaoli F, Murelli F, Sparavigna M, Fregatti P, and Friedman D

Abstract

Background/Aim-Twenty patients had corrective reconstruction surgery by means of a reduction mammaplasty or mastopexy after a previous BCS (Breast Conserving Surgery) and RT (Radiation Therapy); the risk factors and post-operative complications were reported in order to define a safe and effective technique for reduction mammaplasty in previously irradiated breast cancer patients. Materials and Methods-From June 2011 to December 2019, 20 pts. were operated on at the Breast Surgery Clinic of San Martino Policlinic Hospital, Genoa, Italy. Pre- and post-operative parameters included clinic-pathological features of the primary tumor; a lapse of time from primary radio-surgery; the extent of follow-up; the rate of post-operative wound infections; the persistence of breast asymmetry, and a post-operative patient satisfaction index by means of a BREAST-Q questionnaire. Results-Three patients (15%) developed minor complications in the irradiated breast, but no complication was observed into the non-irradiated breast. No statistically significant correlation was found between the post-operative complications and the risk factors. The statistical analysis of BREAST-Q questionnaire responses gave an average patient's satisfaction index that was equal to 90.8/100 (range: 44 to 100). Conclusions-Inferior pedicle reduction mammoplasty is an effective reduction mammoplasty technique in regard to the extent of breast tissues that are to be removed both in irradiated and contralateral breast; moreover, the incidence of post-operative complications is clearly limited when a careful technique is adopted, and it can be reasonably applied also in patients with co-morbidity factors.

Published
2022
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50. Evaluating the Empatica E4 Derived Heart Rate and Heart Rate Variability Measures in Older Men and Women.

Author

Ravindran KKG, Monica CD, Atzori G, Lambert D, Revell V, and Dijk DJ

Subjects
Aged, Female, Heart Rate physiology, Humans, Male, Electrocardiography methods, Wearable Electronic Devices
Abstract

Wearable heart rate monitors offer a cost-effective way of non-invasive, long-term monitoring of cardiac health. Validation of wearable technologies in an older populations is essential for evaluating their effectiveness during deployment in healthcare settings. To this end, we evaluated the validity of heart rate measures from a wearable device, Empatica E4, and compared them to the electrocardiography (ECG). We collected E4 data simultaneously with ECG in thirty-five older men and women during an overnight sleep recording in the laboratory. We propose a robust approach to resolve the missing inter-beat interval (IBI) data and improve the quality of E4 derived measures. We also evaluated the concordance of heart rate (HR) and heart rate variability (HRV) measures with ECG. The results demonstrate that the automatic E4 heart rate measures capture long-term HRV whilst the short-term metrics are affected by missing IBIs. Our approach provides an effective way to resolve the missing IBI issue of E4 and extracts reliable heart rate measures that are concordant with ECG. Clinical Relevance- This work discusses data quality challenges in heart rate data acquired by wearables and provides an efficient and reliable approach for extracting heart rate measures from the E4 wearable device and validates the metrics in older adults.

Published
2022
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