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PurposeThe study analyses how management control supports the organisation's response to the COVID-19 pandemic lockdown.Design/methodology/approachVideo interviews with top and middle-level managers who were directly involved in handling the response to the COVID-19 crisis in late winter and spring 2020 form the empirical base. The object-of-control framework and the distinction between organic and mechanistic management controls inform the exploratory case analysis of a large food retail cooperative in Italy.FindingsBoth organic and mechanistic management control mechanisms enabled an immediate response and management of the crisis. The use of cultural, action and results controls supported employees' health and safety coordination, a tight monitoring of financial performance and social interventions in support of the local community.Originality/valueThe study provides original exploratory insights on the use and role of management control in the context of an unprecedented emergency and an unplanned setting (i.e. a pandemic crisis), which is an under-investigated topic in the accounting literature. The study shows how management control operated, linking moral and technical aspects as well as facilitating organisational adaptation and pandemic effects mitigation.

The primary aim of this study was to evaluate the 30-day survival of nonagenarian patients who underwent non-traumatic emergency abdominal surgery. Other aims were: 90-day and 12-month survival rates, the postoperative complications rate, the impact of the emergency operation on postoperative functional status, the accuracy of the P-POSSUM in predicting 30-day postoperative mortality and changes in care services after surgery. This was a retrospective cohort study of nonagenarian patients who underwent non-traumatic emergency abdominal surgery between January 2010 and June 2017. Patients were divided in two groups according to the 30-day survival status to compare the distribution of patients’ characteristics and postoperative outcomes. Overall survival was estimated using the Kaplan–Meier method. To assess the accuracy of P-POSSUM to predict 30-day mortality, a receiver operating characteristic curve and the Hosmer–Lemeshow goodness of fit test were used. 85 nonagenarian patients were enrolled in this study; of these, 27 (31.8%) died within 30 days. The Kaplan–Meier curve showed a rapid decline in survival over the first 30 postoperative days, followed by a more gradual reduction during the rest of the first year. The majority of patients (92.6%) who died within 30 days experienced a medical complication, with a preponderance of respiratory failure (48.2%) and multiple organ failure (33.3%). In the surviving patients, the postoperative functional status had worsened, and 64.2% of patients did not return to their original housing situation or were institutionalized. The accuracy of P-POSSUM in predicting 30-day mortality in nonagenarian patients was poor. This study may help doctors convey the postoperative risks of morbidity and mortality, and also to adequately inform relatives about the possible adverse discharge destination of surviving nonagenarian patients with a consequent increase in care needs.

Private governance channelled through social compliance programmes and gender initiatives of multinational companies (MNC) are ineffective in tackling gender discrimination in global value chains. The United Nations Guiding Principles on Business and Human Rights (UNGP) provide a public-private governance framework to address human rights globally, including gender equality. This paper asks whether the UNGP can provide a more effective governance framework for addressing women workers' rights in global value chains. It argues interlayered forms of governance (involving public, private and social actors) are critical to addressing gender discrimination and advancing a gendered approach to human rights due diligence.

Breast cancer is still considered a high-incidence disease, and numerous are the research efforts for the development of new useful and effective therapies. Among anticancer drugs, carbazole compounds are largely studied for their anticancer properties and their ability to interfere with specific targets, such as microtubule components. The latter are involved in vital cellular functions, and the perturbation of their dynamics leads to cell cycle arrest and subsequent apoptosis. In this context, we report the anticancer activity of a series of carbazole analogues 1–8. Among them, 2-nitrocarbazole 1 exhibited the best cytotoxic profile, showing good anticancer activity against two breast cancer cell lines, namely MCF-7 and MDA-MB-231, with IC50 values of 7 ± 1.0 and 11.6 ± 0.8 μM, respectively. Furthermore, compound 1 did not interfere with the growth of the normal cell line MCF-10A, contrarily to Ellipticine, a well-known carbazole derivative used as a reference molecule. Finally, in vitro immunofluorescence analysis and in silico studies allowed us to demonstrate the ability of compound 1 to interfere with tubulin organization, similarly to vinblastine: a feature that results in triggering MCF-7 cell death by apoptosis, as demonstrated using a TUNEL assay.

Twenty-two novel, variously substituted nitroazetidines were designed as both sulfonamide and urethane vinylogs possibly endowed with antimicrobial activity. The compounds under study were obtained following a general procedure recently developed, starting from 4-nitropentadienoates deriving from a common β-nitrothiophenic precursor. While being devoid of any activity against fungi and Gram-negative bacteria, most of the title compounds performed as potent antibacterial agents on Gram-positive bacteria (E. faecalis and three strains of S. aureus), with the most potent congener being the 1-(4-chlorobenzyl)-3-nitro-4-(p-tolyl)azetidine 22, which displayed potency close to that of norfloxacin, the reference antibiotic (minimum inhibitory concentration values 4 and 1–2 μg/mL, respectively). Since 22 combines a relatively efficient activity against Gram-positive bacteria and a cytotoxicity on eucharyotic cells only at 4-times higher concentrations (inhibiting concentration on 50% of the cultured eukaryotic cells: 36 ± 10 μM, MIC: 8.6 μM), it may be considered as a promising hit compound for the development of a new series of antibacterials selectively active on Gram-positive pathogens. The relatively concise synthetic route described herein, based on widely available starting materials, could feed further structure–activity relationship studies, thus allowing for the fine investigation and optimization of the toxico-pharmacological profile.

Is handgrip strength assessment in the supine position valid and reliable as compared to the traditional sitting position? Grip strength values assessed in the sitting position highly correlated with the values of strength assessed in the sitting position without significant differences in the mean values of the two different assessment methods. Results were consistent across gender, cognitive status and body side. In bedridden patients grip strength assessment using the supine position can be considered a valid alternative to the sitting position. Muscle strength evaluation is important in older people’s functional assessment. We investigated the validity of grip strength measurement in a supine position as compared to the traditional one. Cross-sectional study conducted in older people hospitalized in a medical unit. Patients underwent measurements of grip strength in both supine and sitting positions. Agreement between results was evaluated using Pearson correlation and Infraclass correlation coefficient. The two measurements techniques were graphically compared with Bland–Altman plot. Forty four participants enrolled (21 females), mean age 80.6. Correlation coefficients demonstrated a strong positive relationship between the two different measurement positions (all values greater than 0.9). Results were consistent and similar across gender, body side and were not affected by cognitive impairment. Infraclass correlation analyses demonstrate a very good inter-rate reliability. Grip strength assessed in the supine position can be considered a valid alternative in bedridden individuals.

Aggressive cytoreduction can prolong survival in patients with unresectable liver metastases (LM) from neuroendocrine neoplasms (NEN), and minimally invasive, liver-directed therapies are gaining increasing interest. Catheter-based treatments are used in disseminated disease, whereas ablation techniques are usually indicated when the number of LM is limited. Although radiofrequency ablation (RFA) is by far the most used ablative technique, the goal of this opinion review is to explore the potential role of laser ablation (LA) in the treatment of LM from NEN. LA uses thinner needles than RFA, and this is an advantage when the tumors are in at-risk locations. Moreover, the multi-fiber technique enables the use of one to four laser fibers at once, and each fiber provides an almost spherical thermal lesion of 12-15 mm in diameter. Such a characteristic enables to tailor the size of each thermal lesion to the size of each tumor, sparing the liver parenchyma more than any other liver-directed therapy, and allowing for repeated treatments with low risk of liver failure. A recent retrospective study reporting the largest series of LM treated with LA documents both safety and effectiveness of LA, that can play a useful role in the multimodality approach to LM from NEN.

Our research groups have been involved for many years in studies aimed at identifying new active organic compounds endowed with pharmacological properties. In this work, we focused our attention on the evaluation of cardiovascular and molecular drug resistance (MDR) reverting activities of some nitrosubstituted sulphur-containing heterocycles. Firstly, we have examined the effects of 4-nitro-3-(4-methylphenyl)-3,6-dihydro-2H-thiopyran S,S-dioxide 5, and have observed no activity. Then we have extended our investigation to the 3-aryl-4-nitrobenzothiochromans S,S-dioxide 6 and 7, and have observed an interesting biological profile. Cardiovascular activities were assessed for all compounds using ex vivo studies, while the MDR reverting effect was evaluated only for selected compounds using tumor cell lines. All compounds were shown to affect cardiovascular parameters. Compound 7i exerted the most effect on negative inotropic activity, while 6d and 6f could be interesting molecules for the development of more active ABCB1 inhibitors. Both 6 and 7 represent structures of large possible biological interest, providing a scaffold for the identification of new ABCB1 inhibitors.

Stefano Volpato,1 Romina Custureri,2 Matteo Puntoni,3 Lara Bianchi,1 Julia Daragjati,4 Sara Garaboldi,2 Matteo Simonato,4 Antonio Greco,5 Emanuele Rizzo,6 Pierluigi Dal Santo,7 Antonio Mangiacotti,5 Ekaterini Zigoura,2 Giacomo Siri,3 Alberto Pilotto2 1Department of Medical Science, University of Ferrara, Ferrara, Italy; 2Department of Geriatric Care, Orthogeriatrics and Rehabilitation, E.O. Galliera Hospital, Genova, Italy; 3Clinical Trial Unit, Scientific Directorate, E.O. Galliera Hospital, Genoa, Italy; 4Geriatrics Unit, San Antonio Hospital, ULSS 6 Euganea, Padova, Italy; 5Geriatrics Unit, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy; 6Geriatrics Unit, ULSS 2 Marca Trevigiana, Montebelluna, Italy; 7Geriatrics Unit, ULSS 5 Polesana, Rovigo, Italy Background: It is not known whether amino acid supplementations may influence health status in hospitalized older acutely ill patients. Aim: The aim of this study was to determine whether nutritional supplementation with amino acids (Aminoglutam®) is associated with multidimensional improvement assessed with the Multidimensional Prognostic Index (MPI). Methods: In this randomized, double-blind, placebo-controlled pilot clinical trial, 126 patients aged ≥65years were enrolled from 6 Italian geriatric wards. A multidimensional assessment to calculate the MPI was performed at baseline and after 4weeks of treatment with nutritional supplementation (96kcal, 12g amino acids, 0.18g fat, 11.6g carbohydrate, and vitamins B1, B6, and C) or placebo administered twice a day. Logistic regression modeling was applied to determine the effect of treatment on the improvement of MPI (vs no-change/worsening), adjusting for gender, age, and MPI at baseline. Treatment’s interactions with age, gender, and MPI at baseline were tested adding the appropriate interaction parameter in the regression models. Results: Of the 126 patients included, 117 patients (93%) completed the study. A significant improvement in the MPI score was detected in the overall population (mean difference post-pretreatment: -0.03, p=0.001), with no differences between active and placebo arms. Men in the amino acid supplementation group had a significantly higher rate of improvement in MPI (81%) compared to the placebo group (46%) (Fisher’s exact test p=0.03). Adjusting for age, diagnosis, and MPI at baseline, amino acid treatment was shown to be associated with an improvement in MPI in men (OR=4.82, 95% confidence interval [CI]: 0.87–26.7) and not in women (OR=0.70, 95% CI: 0.27–1.81). The interaction effect between active treatment and gender was significant (p=0.04). Conclusion: A 4-week amino acid supplementation improved the MPI significantly in hospitalized older male patients but not in female patients. Further studies are needed to confirm the gender effect of amino acid supplementation on MPI in older patients. Keywords: Multidimensional Prognostic Index, aging, hospitalization, oral supplementation, amino acids

Novel, densely functionalized 2-methylideneazetidines can be obtained in high yields and mild conditions from the reaction of nitropentadienoates with primary amines, most likely through an aza-Michael addition followed by a 4-exo-trig cyclization. The initial, selective trans arrangement for the C3 and C4 ring hydrogens undergoes stereomutation due to the presence of an easily enolisable site at C3, eventually leading to mixtures where the cis isomer generally prevails.

Background New evidence is emerging on the importance of lean body mass during periods of illness and recovery. The preservation of lean body mass during such periods of intense stress impacts both patient and treatment outcomes. However, data concerning the incidence of sarcopenia among older people during hospitalization are scarce. The objective of this study was to evaluate the development of sarcopenia in a sample of hospitalized older subjects. Methods We used data of 394 participants from the multicentre Italian Study conducted by the Gruppo Lavoro Italiano Sarcopenia—Trattamento e Nutrizione (GLISTEN) in 12 Acute Care Wards (Internal Medicine and Geriatrics) of University Hospitals across Italy. This study was designed to determine the prevalence of sarcopenia at hospital admission and the change in muscle mass and strength during hospitalization. Sarcopenia was defined as low skeletal mass index (kg/m2) along with either low handgrip strength or slow walking speed [European Working Groups on Sarcopenia in Older People (EWGSOP) criteria]. Estimation of skeletal muscle mass was performed by bioelectrical impedance analysis (BIA). Results The mean age of the 394 enrolled patients (including 211 females who accounted for 53% of the sample) was 79.6 ± 6.4 years. Among those without sarcopenia at hospital admission, 14.7% of the study sample met the EWGSOP sarcopenia diagnostic criteria at discharge. The incidence of sarcopenia during hospitalization was significantly associated with the number of days spent in bed but was not correlated with the total length of hospital stay. In particular, patients who developed sarcopenia spent an average of 5.1 days in bed compared with 3.2 days for those with no sarcopenia at discharge (P = 0.02). Patients with sarcopenia showed a significantly lower body mass index compared with non-sarcopenic peers (25.0 ± 3.8 kg/m2 vs. 27.6 ± 4.9 kg/m2, respectively; P

Herein we report a significant, valuable extension of a recently implemented pyrrole benzannulation methodology that, employing versatile nitrodienes from our lab as useful C4 building blocks, led to indole derivatives characterized by unusual patterns of substitution. The 6-nitro-7-arylindoles resulting from suitably derivatized, non-symmetric dienes are of foreseeable synthetic interest in search for new polyheterocyclic systems. As an example, pyrrolocarbazoles with a rarely reported ring fusion were synthesized with the classical Cadogan protocol. Furthermore, the proven easy reducibility of the nitro group to amine will surely open the way to further interesting elaborations.

To retrospectively assess safety and efficacy of laser ablation (LA) of multiple liver metastases (LM) from neuroendocrine neoplasms (NEN). Twenty-one patients with NEN and at least 3 LM ≤ 4 cm in diameter underwent ultrasonography-guided LA. Up to seven LM were ablated in a single session; if the number of LM exceeded seven, the remaining LM were ablated in further LA sessions with a time interval of 3–4 weeks. LA was performed according to the multifiber technique. The patients underwent contrast-enhanced CT 1 month after LA, and were subsequently monitored every 3 months for the first 2 years and then every 6 months. In total, 189 LM were treated in 21 patients (mean 9 ± 8.2, median 6) in 41 LA sessions (range 1–5). The diameter of LM ranged from 5 to 35 mm (median 19 mm, mean 17.9 ± 6.4 mm). One grade 4 complication occurred (0.53%): a bowel perforation managed by surgery. Technical efficacy was 100%, primary efficacy rate 94.7%, and secondary efficacy rate 100%. Complete relief of hormone-related symptoms was obtained in all the 13 symptomatic patients. Median follow-up was 39 months (range 12–99). 1-, 2-, 3-, and 5-year survival rates were 95%, 86%, 66%, and 40%, respectively. Overall survival resulted higher for patients with Ki-67 expression ≤ 7% than for those with Ki-67 > 7% (p = 0.0347). LA is a promising and safe technique to treat LM from NEN. A longer follow-up should provide definitive information on the long-term efficacy of this liver-directed therapy. Retrospective study, local non-random sample, level 3.

© 2017, Springer Science+Business Media Dordrecht. Stakeholder engagement and dialogue have a central role in defining the relations between organisations and their internal and external interlocutors. Drawing upon the analysis of dialogic motifs, power–conflict dynamics and sociopolitical perspectives, and based on a set of interviews with the stakeholders of a consumer-owned cooperative, the research explores the dialogic potential of stakeholder engagement. The analysis revealed a fragmented picture where the co-design and co-implementation aspects were mainly related to the non-business areas of cooperative life, while business logic dominated the most central aspects. Stakeholder engagement was mainly related to consensus building, while dialogic engagement based on a pluralistic understanding was only partially considered and then neglected. The social capital in the local area, the growing size of the organisation and the related power structure embrace stakeholder engagement, influencing the orientation of the (un)dialogic dynamic. The analysis indicates that a dialogic exchange is a relative concept which depends on the interests involved and the topics discussed. It also reveals that the key factors in the democratisation of stakeholder engagement are a mutual understanding and long-term opportunities. Common sociopolitical aspects are also important, but they do not necessarily guarantee the creation of dialogism paths. The research contributes to the critical dialogic literature in revealing whether and how stakeholder engagement has been implemented in a specific setting. It also shows the limitations of voluntarist stakeholder engagement initiatives.

We report herein an original protocol to the indole nucleus, which could contribute to significantly expand the synthetic access to a heterocyclic moiety of undeniable paramount importance. The protocol consists in the construction of the benzene ring onto a pyrrole (benzannulation) starting from 2,3-dinitro-1,3-butadienes. This appealing, metal-free process characterized by high atom economy and mild reaction conditions allows to synthesize indoles possessing nitro group(s) on the benzene ring: a result which cannot be likewise easily obtained by exploiting most common pathways such as functionalization of a preformed indole or heteroannulation of a suitable benzene derivative. From a mechanistic point of view, a stepwise, ionic process is suggested by the identification of a pivot dihydroindole intermediate whose interception facilitates some selectivity in the preparation of different nitroindoles.

Medications with anticholinergic properties, although widely used, may negatively affect cognitive and functional status in older patients. To date there is still no standardized method to quantify anticholinergic exposure. We analyzed the relationship of two different tools for the evaluation of the anticholinergic drug burden with cognitive and functional impairment in a sample of older hospitalized patients. A retrospective and longitudinal analysis with 1-year follow-up of 1123 older hospitalized patients enrolled in seven Italian acute care wards was conducted. We assessed anticholinergic burden with the Anticholinergic Cognitive Burden (ACB) and Anticholinergic Risk Scale (ARS). Cognitive and functional status were evaluated at hospital discharge and during follow-up (3, 6, 12 months) using the Mini Mental State Examination (MMSE) and five basic activities of daily living (ADLs). Associations between anticholinergic burden and cognitive decline and incident disability were estimated using linear regression models for repeated measures and logistic models, respectively. The mean age of the study population was 81 ± 7.5 years. ACB and ARS classifications showed low correlation (Spearman’s rho = 0.39–0.43). Anticholinergic burden increased during hospitalization and was associated with cognitive and functional status. Patients with an ARS of ≥ 1 at discharge had significantly lower baseline MMSE scores (ARS = 0: 23.1; ARS ≥ 1: 20.8; p = 0.002) and during follow-up presented a significantly steeper MMSE score decline (− 0.15/month). Moreover, patients with an ACB of ≥ 1 at discharge had an almost threefold increased risk of developing disability (odds ratio 2.77, 95% confidence interval 1.39–5.54). ACB and ARS have only a moderate degree of correlation. Use of drugs with anticholinergic properties in elderly patients is independently associated with cognitive and functional decline.

The aim of this retrospective study was to assess the safety and effectiveness of laser ablation (LA) in patients with small renal cell carcinomas (RCC) and increased risk of bleeding.From 2013 to 2017, nine patients (six males, three females, aged 68.5 ± 12.2 years) at high risk of bleeding underwent ultrasonography-guided LA for an RCC. Patients were considered at increased risk of bleeding because of impairment of coagulation parameters, concomitant antiplatelet therapy, or at-risk location of the tumor (one, five, and three patients, respectively). RCC diameter ranged from 11 to 23 mm. According to tumor size, two or three laser fibers were introduced through 21-gauge needles and 1800 J per fiber were delivered in 6 min with a fixed power of 5 W. Major and minor complications, technical success, and primary and secondary technical effectiveness and tumor recurrence were recorded.Just one Grade 1 complication was observed: a small asymptomatic hematoma that spontaneously resolved. Technical success was 100%, 1 month technical efficacy was 88.9% (8/9 patients). One patient with residual tumor was successfully retreated 1 month later, and secondary efficacy rate was 100%. No local tumor recurrence occurred during a median follow-up of 26 months (range 11-49 months).LA is safe and effective in the treatment of small RCC and might represent a valid option in patients with increased risk of bleeding.

Summary Background & aims To date, studies assessing the relationship between sarcopenia and delirium, two of the most common geriatric syndromes, are lacking. We sought to explore this association by investigating the co-occurrence of these two conditions and the independent association between them in a population of hospitalized older adults. Methods Cross-sectional multicenter analysis of older adults consecutively admitted to 12 acute geriatric units (AGUs). Sarcopenia was assessed upon admission by evaluating the presence of low skeletal mass index (kg/m 2 ), and either low handgrip strength or low walking speed (European Working Group on Sarcopenia in Older People, EWGSOP criteria). Skeletal muscle mass was estimated using bioimpedance analysis. Participants underwent a comprehensive geriatric assessment upon admission; information concerning demographics, cognition (Short Portable Status Mental Questionnaire, SPMSQ) functional (Instrumental Activities of Daily Living, IADL and Basic-Activities of Daily Living, BADL), and health status (Charlson Index and specific diseases) was evaluated. The presence of delirium upon admission was ascertained as an explicit clinical diagnosis recorded by the researcher of each centre on the data form. All association estimates were reported as Prevalence Ratios (PRs) and 95% confidence intervals (CIs), using a Cox hazard proportional regression model with robust variance and constant time. Results Of the 588 analyzed patients (mean age = 80.9 ± 6.8, 53.2% females), 199 (33.8%) had sarcopenia upon admission to the AGU. According to a multivariable Cox regression, delirium upon admission (PR 1.66, 95% CI: 1.12–2.45), IADL total score (PR 0.93, 95% CI: 0.87–0.98), Body Mass Index values (BMI) ranging from 18.5 to 25.0 (PR 1.70, 95% CI: 1.33–2.18), BMI values >18.5 (PR 2.53, 95% CI: 1.81–3.53), previous stroke (PR 1.51, 95% CI: 1.10–2.07) and chronic heart failure (CHF) (PR 1.31, 95% CI: 1.02–1.68) were significantly and independently associated with sarcopenia upon admission to the AGU. Conclusion The study, carried out in a population of hospitalized older patients, shows that a diagnosis of delirium upon admission to the AGU was more frequent in those with sarcopenia than in others. Furthermore, the study found that delirium was independently associated with the risk of being sarcopenic upon admission to the AGU. Future studies are needed to confirm this association.

Catheter ablation is an effective treatment in patients with symptomatic atrial fibrillation. Complications are infrequent and usually resolve with minimal or no intervention, but active bleeding due to arterial injury during the vascular access can sometimes represent a life-threatening complication. Contrast-enhanced computed tomography is the standard technique to detect active bleeding, but it may not be immediately available. We report a case of iatrogenic hemorrhage after catheter ablation, in which contrast-enhanced ultrasonography played a decisive role in the recognition of active arterial bleeding due to injury to the right common femoral artery.

Esta é uma história que teci a partir do estudo da trajetória do artista e empresário circense português Albano Pereira. Num contexto em que o uso de estruturas provisórias ou móveis era corrente entre as companhias circenses, detive-me aos esforços deste empresário no intuito de erigir e manter estruturas de caráter estável em duas cidades da província do Rio Grande do Sul: Porto Alegre e Rio Grande, entre os anos de 1875 e 1887. A partir da análise dos casos do Circo Universal, do Anfiteatro Albano Pereira, do Teatro de Variedades e do Polytheama Rio-grandense, através de fontes diversas, tais como atas de câmaras municipais, processos judiciais, jornais e textos de memorialistas, investigo o processo de construção e manutenção de tais estruturas, as relações estabelecidas entre empresário e municipalidades, os termos de cedência de áreas públicas ao uso do circo, o estabelecimento de sociedades particulares, bem como aspectos relativos à produção circense ligada à Albano Pereira. Nesse estudo, formulei a hipótese de que o investimento deste empresário na construção de estruturas estáveis representou não apenas, a criação de espaços adequados e capazes de comportar a realização de espetáculos circenses – sob sua direção ou de companhias convidadas – mas também, a criação de espaços disponíveis à realização de variadas atividades culturais locais. Nesse sentido, os circos estáveis de Albano Pereira representaram significativa contribuição à cultura local, dada a criação de espaços voltados ao lazer e à diversão num contexto caracterizado por sua quase escassez ou precariedade. This is a story that I’ve wove from the study of the career of the portuguese artist and circus entrepreneur Albano Pereira. In a context where the use of temporary or mobile structures was current by the circus companies, I’ve stopped in the efforts of this entrepreneur in his intention to build and maintain stable structures in two cities in the province of Rio Grande do Sul: Porto Alegre and Rio Grande, between the years of 1875 and 1887. Since the analysis on the cases of the Circo Universal, the Anfiteatro Albano Pereira, the Teatro de Variedades and the Polytheama Rio-grandense, from different sources, such as the cities councils proceedings, court cases, newspapers and texts from memorialists, I investigate the construction and maintenance process of these structures, the relations established between the entrepreneur and the municipalities, the terms of transfer of public areas to the use of the circus, the establishment of private societies, as well as aspects related to the circus production linked to Albano Pereira. In this study, I’ve formulated a hypothesis that the investment of this entrepreneur in the construction of stable structures represented not only the creation of suitable spaces, capable of accommodating circus spectacles – under his direction or invited companies – but also the creation of available spaces for different cultural local activities. In this way, the permanent circus of Albano Pereira represented a significant contribution for the local culture, given the creation of spaces for leisure and fun in a context characterized by its almost scarcity and precariousness.

The initial ring-opening of 3-nitrothiophene and further structural modifications lead to nitrobutadienic building-blocks whose synthetic usefulness in the field of heterocycles has been widely demonstrated. As a further example, the Michael addition of a hydrazone anion to the nitrovinyl moiety of nitrobutadienes generates 1,2-diazaheterocycles as the final result of an overall MIRC process. Depending on the nature of the substituents on the Michael-type acceptor and on the hydrazono nucleophile, an interesting dichotomy is observed that leads to either five-member or six-member N-heterocycles with complete selectivity. The results obtained appear to be both of mechanistic and synthetic interest e.g., in the field of heterocycles endowed with potential pharmacological/biological activity.

Objective: Delirium is a frequent clinical complication in geriatric patients admitted to the hospital, because of the simultaneous presence and synergistic effect of predisposing and precipitating factors. Also anaemia is a common concern in geriatric population. The aim of this study was to investigate the association between anaemia (precipitating factor) and delirium in a sample of Italian older hospitalized patients with different degree of cognitive impairment (predisposing factor). Design, setting, participants: Cross-sectional analysis of 1069 participants enrolled in the CRIME study, with assessment of hemoglobin levels at hospital admission. Measurements: Delirium was assessed using DSM-IV criteria, whereas cognitive status was categorized as dementia, cognitive impairment or normal, according to clinical history, specific treatment and MMSE score. Anaemia was defined according to sex-specific WHO criteria. The association of hemoglobin levels and delirium was investigated with multivariable logistic regression models. Results: Mean age of study participants was 81.4±7.2 years, 52.2% had prevalent anaemia, 6.1% had delirium. According to cognitive status 20.8% had dementia and 40.9% had cognitive impairment. Overall there was no association between anaemia and delirium. However, among patients with cognitive impairment (MMSE

A series of 1-[(methylsulfonyl)methyl]-2-nitro-5,6,7,8-tetrahydroindolizines and homologs were designed, prepared, and evaluated as non-sugar-type α-glucosidase inhibitors. The inhibitory activity appeared to be related to cyclo homologation with the best congeners being tetrahydroindolizines. The introduction of a methoxycarbonyl group as an additional hydrogen bond acceptor into the exocyclic methylene group was beneficial affording the most potent congener 3e (half maximal inhibitory concentration, IC50=8.0±0.1μM) which displayed 25-fold higher inhibitory activity than 1-deoxynojirimycin (2, IC50=203±9μM)-the reference compound. Kinetic analysis indicated that compound 3e is a mixed inhibitor with preference for the free enzyme over the α-glucosidase-substrate complex (Ki,free=3.6μM; Ki,bound=7.6μM). Molecular docking experiments were in agreement with kinetic results indicating reliable interactions with both the catalytic cleft and other sites. Circular dichroism spectroscopy studies suggested that the inhibition exerted by 3e may involve changes in the secondary structure of the enzyme. Considering the relatively low molecular weight of 3e together with its high fraction of sp3 hybridized carbon atoms, this nitro-substituted tetrahydroindolizine may be considered as a good starting point towards new leads in the area of α-glucosidase inhibitors.

Background There are relatively few prospective studies evaluating the combined effect of abdominal obesity and low muscle strength on mortality, hospitalization, and incident disability. The aim of this study was to prospectively evaluate the prognostic value of dynapenic abdominal obesity on incident disability, hospitalization, and mortality in the population of the InCHIANTI study. Methods In 370 men and 476 women aged between 65 and 95 years, handgrip strength, waist circumference (WC), body mass index, interleukin-6, C-reactive protein, education, medications, smoking status, and comorbidities were evaluated at the baseline. Difficulties in performing basic activities of daily living were assessed at baseline and at 3-, 6-, and 9-year follow-ups, using a standardized questionnaire. Hospitalization and mortality rates were evaluated during an 11-year follow-up. The study population was categorized as nondynapenic nonabdominal obese (ND/NAO, reference group), dynapenic nonabdominal obese (D/NAO), nondynapenic abdominal obese (ND/AO), and dynapenic abdominal obese (D/AO), according to handgrip strength/WC tertiles. Results D/AO participants presented more than a twofold increase in risk of worsening disability (odds ratio = 2.10; 95% confidence interval [CI]: 1.14-3.88) and significantly higher risk of hospitalization (1.36; 95% CI: 1.04-1.78) compared with ND/NAO participants. After adjustment for potential confounders, the relative risk of death was 1.47 (95% CI: 1.09-1.97) for D/NAO compared with the ND/NAO group. Conclusions Dynapenic abdominal obese participants are at higher risk of worsening disability and hospitalization than ND/NAO participants. Mortality risk was higher in participants with dynapenia without central fat distribution compared with the reference group.

Cooperatives are facing the challenge to be competitive in the market, without losing their traditional values of mutuality and democracy. To do that, they need to re-construct open and participative dialogue with their employees and members based on more democratic forms of communication and engagement. From this point of view, the measurement and communication of sustainability aspects may allow a dialogue to be mobilized with shareholders and stakeholders without losing the attention on competitive factors. Based on these premises, the article analyses the experience of a 5-year action research project (from 2006 to mid-2011), carried out within Unicoop Tirreno, an Italian consumers' cooperative, and aimed to implement different tools for sustainability accounting and to embrace a more open dialogue with stakeholders, in particular with employees and members. In this process of change, the tools implemented for sustainability accounting played a key role in supporting the cooperative to reinterpret its own values and in stimulating a new and participative management approach. The results indicate a virtuous circle between the management and measurement of cooperative principles and the management and measurement of sustainability issues.

The ring opening of 3-nitro-4-(phenylsulfonyl)thiophene with amines and proper modification of the resulting 1,3-diene enables a simple and versatile approach to N-fused pyrroles of both synthetic and biological interest through 1,6-H shift followed by 6π 1,5-electrocyclization. This protocol is effectively driven to the isolated pyrroles by an easy aromatization.

Sarcopenia is common among hospitalized older people. The European Working Group on Sarcopenia in Older People (EWGSOP) and the Foundation for the National Institutes of Health (FNIH) Sarcopenia Project proposed similar diagnostic criteria but, although measures of muscle mass and muscle strength overlap, the operational definition differ. Using data from a sample of hospitalized older people, we assessed prevalence agreement of the two definitions and we compared the predictive value for disability, re-hospitalization, and mortality risk in the year following hospital discharge. Data are from the GLISTEN Study, a multicenter observational study of 611 older adults (mean age 80.6 ± 6.6 years, female 51.2%) admitted to 12 Italian hospitals. Appendicular skeletal muscle mass assessed by bioimpendance was standardized for height or BMI according to EWGSOP and FNIH definition respectively. Analyses were performed using Cohen’s kappa, logistic regression, Cox models and negative binomial regression analyses. Sarcopenia prevalence was 24% and 36% using the FNIH and EWGSOP definitions, respectively, with a low classification’s agreement (Kappa Statistic: 0.12). BMI was directly associated with sarcopenia according to FNIH definition and inversely associated with EWGSOP classification. In logistic regression analysis, only FNIH definition was associated with severe disability. Cox models showed that, after multiple adjustment, FNIH but not EWGSOP sarcopenia classification predicted one-year mortality. Negative binomial regression analyses shown a significant higher hospitalization rate for FNIH definition. Agreement between EWGSOP and FNIH sarcopenia definitions is poor. Our findings suggest that FNIH classification might have better prognostic value for important clinical endpoints.

The unusual migration of a nitro group from the - to the -position of a -aryl--nitroethenyl moiety, following a nitrocyclopropane to isoxazoline N-oxide isomerization, has been studied from a mechanistic and synthetic points of view. As a result, two series of isomeric isoxazoline N-oxides could be obtained under controlled conditions. When reacted with diazomethane, a model transposed isoxazoline cleanly furnished a new, interesting pyrazolylisoxazole.

The conjugated bis(sulfonyl)nitrobutadienes 1 undergo, with primary amines, competitive MeSO2 replacement [vinylic substitution at C(1)] versus aza-Michael addition to the nitroethenyl C(3)–C(4) double bond. The latter pathway eventually leads to the trisubstituted pyrroles 2 and conditions have been optimized in order to maximize the yield of such polyfunctionalized heterocycles. Interestingly, in trifluoroethanol tetrasubstituted pyrroles 7 are also formed, thanks to a final aromatization via oxidation by ‘endogenous’ nitrite.

Based on a longitudinal eight-year study (2006–2014) in a large Italian food co-operative, this paper analyses whether and how the development and the use of sustainability control systems have been able to promote the integration of sustainability within organisational strategy. The co-operative has implemented three main instruments (sustainability report, sustainability annual plan and participatory social plan), which have been able to promote sustainability integration by inducing technical integration and reinforcing the cognitive enablers. However, strong cognitive (and organisational) barriers have gradually stifled the cognitive enablers and have not enabled sustainability to be fully integrated into the organisational strategy. As such, the integration process was marginalised, also due to the negative economic performance of the co-operative. The paper shows that sustainability integration remains a fragile concept even in a co-operative, despite the similarities between co-operative values and the principles of corporate social responsibility. Theoretically, the paper offers empirical evidences concerning management control literature for sustainability.

Type 2 diabetes, a common metabolic disease in older people, is a major risk factor for functional limitation, impaired mobility, and loss of independence. In older people, the pathogenesis of functional limitation and disability is complex and multifactorial. A number of potential pathways are involved including cardiovascular disease, peripheral neuropathy, overweight, osteoarthritis, visual deficit, and cognitive impairment, conditions that are all more prevalent among patients with diabetes. Sarcopenia, a geriatric condition characterized by a progressive and generalized loss of skeletal muscle mass and strength, is also involved in the pathogenesis of functional limitations and disability. Recent research has shown that older patients with type 2 diabetes are often affected by skeletal muscle impairment, leading to reduced muscle strength and physical function. Insulin resistance, hyperglycemia, muscle fat infiltration, and peripheral neuropathies are hypothesized as the fundamental biological mechanisms leading to muscle impairment in people with diabetes. This review summarizes the current literature on the biological pathways responsible for skeletal muscle dysfunction in type 2 diabetes and analyzes the role of decline in muscle strength and quality on the association between diabetes and mobility disability.

Background Sarcopenia is associated with increased risk of adverse outcomes in older people. Aim of the study was to explore the predictive value of the European Working Group on Sarcopenia in Older People (EWGSOP) diagnostic algorithm in terms of disability, hospitalization, and mortality and analyze the specific role of grip strength and walking speed as diagnostic criteria for sarcopenia. Methods Longitudinal analysis of 538 participants enrolled in the InCHIANTI study. Sarcopenia was defined as having low muscle mass plus low grip strength or low gait speed (EWGSOP criteria). Muscle mass was assessed using bioimpedance analysis. Cox proportional and logistic regression models were used to assess risk of death, hospitalization, and disability for sarcopenic people and to investigate the individual contributions of grip strength and walking speed to the predictive value of the EWGSOP's algorithm. Results Prevalence of EWGSOP-defined sarcopenia at baseline was 10.2%. After adjusting for potential confounders, sarcopenia was associated with disability (odds ratio 3.15; 95% confidence interval [CI] 1.41-7.05), hospitalization (hazard ratio [HR] 1.57; 95% CI 1.03-2.41), and mortality (HR 1.88; 95% CI 0.91-3.91). The association between an alternative sarcopenic phenotype, defined only by the presence of low muscle mass and low grip strength, and both disability and mortality were similar to the association with the phenotypes defined by low muscle mass and low walking speed or by the EWGSOP algorithm. Conclusions The EWGSOP's phenotype is a good predictor of incident disability, hospitalization and death. Assessment of only muscle weakness, in addition to low muscle mass, provided similar predictive value as compared to the original algorithm.