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Alessio Lucarini, Giovanni Maria Garbarino, Pierfrancesco Orlandi, Eleonora Garofalo, Lorenzo Bragaglia, Giovanni Guglielmo Laracca, Giulia Canali, Alessandra Pecoraro, Paolo Mercantini On behalf of the Sant’Andrea GLAM collaborative groupDepartment of Medical and Surgical Sciences and Translational Medicine, Sapienza University of Rome, Sant’Andrea Hospital, Rome, ItalyCorrespondence: Alessio Lucarini, Department of Medical and Surgical Sciences and Translational Medicine, Sapienza University of Rome, Sant’Andrea Hospital, Rome, Italy, Email alessio.lucarini@uniroma1.itBackground: MultiDisciplinary Team (MDT) are held to undertake decisions regarding the whole aspect of oncological diseases. Over the years, they acquired a collaborative approach where clinical decisions are shared by all members. Different guidelines recommend the implementation of MDT, in order to improve the outcomes of these patients. Our aim is to evaluate how the implementation of MDT affects the patients’ satisfaction and adherence to treatment.Methods: A survey was submitted to every patient affected by colorectal cancer treated by the MDT of Sant’Andrea Hospital (Rome, IT). The investigation period was January 2017–March 2020. Data from patients inside the MDT were compared with patients outside the MDT to evaluate a reduction in waiting times.Results: A total of 591 patients were collected. A total of 355 patients with colorectal neoplasia were included in our analysis. Cumulative overall survival was 79%. The average waiting time for computed tomography or colonoscopy was 14.9 days for patients in the MDT versus 24.5. A total of 201 patients were eligible for our satisfaction survey. An 89.5% of patients felt followed in their treatment. A 93.5% of patients expressed a high grade of satisfaction for the MDT design.Conclusion: Our study confirms the importance of a well-structured MDT. Dedicated slots shorten the waiting time, leading to better satisfaction and faster diagnosis. Patients’ satisfaction should be considered as an index of good practice when it comes to oncological patients’ treatment.Keywords: cancer, multidisciplinary team meeting, patient assessment, patient management, patient outcomes

In this contribution, new data concerning bryophytes, fungi and lichens of the Italian flora are presented. It includes new records and confirmations for the algal genus Chara, for the bryophyte genera Bryum, Grimmia, Cephaloziella, Hypnum, Nogopterium, Physcomitrium, Polytrichastrum, Rhynchostegiella, Saelania, and Schistostega, the fungal genera Cortinarius, Lentinellus, Omphalina, and Xerophorus, and the lichen genera Acarospora, Agonimia, Candelariella, Cladonia, Graphis, Gyalolechia, Hypogymnia, Lichinella, Megalaria, Nephroma, Ochrolechia, Opegrapha, Peltigera, Placidium, Ramalina, Rhizoplaca, Ropalospora, Strangospora, Toniniopsis, Usnea, and Zahlbrucknerella.

Lichens are poikilohydric organisms, whose internal water content tends to reflect external humidity conditions. After drying, they can reactivate their metabolic activity through water vapor uptake or liquid water input. Thus, lichen water-related functional traits are important as they are involved in the duration of the hydrated period. Models predicting the effect of environmental conditions on lichens are based mainly on the presence or absence of adult thalli. Nevertheless, ecological conditions required by lichens might vary during their life cycle, for example during propagule establishment or in the first stages of thallus development. Little is known about the different ecological requirements at the different development stages in lichens. In this work, we measured water holding capacity (WHC) and specific thallus mass (STM) of adult and juvenile thalli of the model species Lobaria pulmonaria along a climatic gradient to constrain the process-based model LiBry. The LiBry model allows accounting for the productivity of lichens with different physiological strategies under various environmental conditions. We simulated the activity and performance of adult and juvenile thalli in 9 regions of Italy and Corsica. The model was used to test if adult thalli of L. pulmonaria have a higher survival probability due to their higher aerodynamic resistance. In the current climatic condition, the LiBry model predicts a higher survival probability of adults with decreasing absolute survival rates of both life stages with increasing temperature. Adult thalli also result in having higher active time, STM, and relative growth rate (RGR). We discuss the main implications of our simulation outputs, provide future perspectives and possible implementations of the LiBry model.

IntroductionThis study aimed to evaluate the impact of anastomotic leakage (AL) on oncological outcomes after restorative rectal cancer surgery.MethodsPatients who underwent anterior resection for rectal adenocarcinoma between January 2011 and December 2017 were retrospectively reviewed. Data were collected from three colorectal surgery centers. Patients with grade B and C leaks according to the International Study Group of Rectal Cancer classification were identified and compared with the control group. Estimated recurrence and survival rates were compared using the log-rank method and Cox regression analysis.ResultsA total of 367 patients were included in the study, with a mean follow-up of 59.21 months. AL occurred in 64 patients (17.4%). Fifteen patients with AL (23.5%) developed local recurrence (LR) compared to 17 (4.8%) in the control group (p p = 0.914) between the groups. Kaplan-Meier curves showed that patients with AL had a reduced 5-years local recurrence-free survival (96% vs. 78%, log-rank p p p = 0.014) were significantly associated with LR in multivariate analysis. AL was significantly associated with DFS only at univariate analysis (HR 1.654; 95% CI: 1.024–2.672; p = 0.037), with a difference between 5-year DFS of patients with and without AL (71.6% vs. 86.4%, log-rank p = 0.04). Only male gender, pT3-4 stage, and node involvement were identified as independent prognostic factors for reduced DFS in the multivariate Cox regression analysis.ConclusionIn this cohort of patients, AL was associated with a significant risk of LR after rectal cancer surgery.