The teaching of clinical oncology in Italian medical schools. A survey among teachers and students

BACKGROUND: Oncologists, health care workers and health organizations consider well-performed teaching programs in clinical oncology a fundamental step in cancer control. The aim of our study was to assess the views of teachers and students on the present status of oncology teaching in Italian medical schools and on the most common shortcomings in cancer education. MATERIALS AND METHODS: A survey was carried out among teachers and students of 17 Italian medical schools using two different questionnaires. Six hundred forty-seven students of Northern, Central and Southern Italy in the final two years (5th and 6th) of their medical curriculum and 87 professors of pathology, surgery, internal medicine and medical oncology completed the questionnaires. RESULTS: Doctor/patient relationships and integration among disciplines were the most unsatisfactory aspects of oncology teaching, according to students. Biology, epidemiology, radiotherapy, and medical treatment were felt to be insufficiently treated, whilst diagnostic aspects, clinical management and surgery were rated sufficient. The median number of cancer patients to whom each student had access during his/her training was limited, averaging only 13 patients; however, a high degree of variability was noted. A larger number of patients was generally observed in smaller, less crowded medical schools, with notable exceptions. Although the majority of teachers had clinical practices related to their disciplines, only a small number of students underwent a period of clinical training. Traditional methods of teaching were preferred to innovative methods, while interaction among disciplines was uncommon. CONCLUSIONS: This survey emphasizes the dualism between students' expectations and teachers' ideas about cancer teaching. Doctor/patient relationships and poor attention to practical clinical problems seem the most critical issues for clinical oncology training in Italian medical schools.     

Neuroendocrine tumors of the gastroenteric canal. Anatomopathological and diagnostic-therapeutic definition. Description of a case with a rare cecal localisation

The E1 and E2 reading frames of 158 cervical carcinoma samples containing human papillomavirus (HPV) 16 were mapped using polymerase chain reaction (PCR). The reading frames were amplified using primers spanning the entire genes. Of the analyzed samples, 23% showed no amplification with the E1 primers and 29% showed no amplification with the E2 primers. There was an overlap, but not complete identity, between the E1- and E2-disrupted groups. All E1- and E2-negative samples were further analyzed with primers spanning subsections of the E1 and E2 reading frames, which together covered the entire genes. Of the 35 samples negative for E1, 11 were positive in specific amplification of the 3' end of the E1 gene. Several different subsections of E2 could be amplified from most samples negative for the entire gene (37/46). Five classes of patterns were found, in which either all subsections of the E2 gene or subsections in the 5', middle, or 3' end were disrupted. Although a variable pattern of disruption/deletion in the E1-E2 area of the HPV 16 genome was found in cervical carcinoma, the 5' end disruption was the most common one in both E1 and E2. Patients with carcinomas showing disruptions in E1/E2 had a poorer survival than those without such changes, and E1 disruptions were the most important prognostically.     

Visuospatial properties of ventral premotor cortex

In macaque ventral premotor cortex, we recorded the activity of neurons that responded to both visual and tactile stimuli. For these bimodal cells, the visual receptive field extended from the tactile receptive field into the adjacent space. Their tactile receptive fields were organized topographically, with the arms represented medially, the face represented in the middle, and the inside of the mouth represented laterally. For many neurons, both the visual and tactile responses were directionally selective, although many neurons also responded to stationary stimuli. In the awake monkeys, for 70% of bimodal neurons with a tactile response on the arm, the visual receptive field moved when the arm was moved. In contrast, for 0% the visual receptive field moved when the eye or head moved. Thus the visual receptive fields of most "arm + visual" cells were anchored to the arm, not to the eye or head. In the anesthetized monkey, the effect of arm position was similar. For 95% of bimodal neurons with a tactile response on the face, the visual receptive field moved as the head was rotated. In contrast, for 15% the visual receptive field moved with the eye and for 0% it moved with the arm. Thus the visual receptive fields of most "face + visual" cells were anchored to the head, not to the eye or arm. To construct a visual receptive field anchored to the arm, it is necessary to integrate the position of the arm, head, and eye. For arm + visual cells, the spontaneous activity, the magnitude of the visual response, and sometimes both were modulated by the position of the arm (37%), the head (75%), and the eye (58%). In contrast, to construct a visual receptive field that is anchored to the head, it is necessary to use the position of the eye, but not of the head or the arm. For face + visual cells, the spontaneous activity and/or response magnitude was modulated by the position of the eyes (88%), but not of the head or the arm (0%). Visual receptive fields anchored to the arm can encode stimulus location in "arm-centered" coordinates, and would be useful for guiding arm movements. Visual receptive fields anchored to the head can likewise encode stimuli in "head-centered" coordinates, useful for guiding head movements. Sixty-three percent of face + visual neurons responded during voluntary movements of the head. We suggest that "body-part-centered" coordinates provide a general solution to a problem of sensory-motor integration: sensory stimuli are located in a coordinate system anchored to a particular body part.     

Isothermal crystallization kinetics of polypropylene by differential scanning calorimetry. I. Experimental conditions

Reliable isothermal crystallization kinetic studies can be achieved by differential scanning calorimetric techniques only under restricted conditions. In the case of isotactic polypropylene, our results indicate that those conditions are met in the range of 3°C below the isothermal crystallization temperature T_c. Experimentally, it is only in this range when the complete crystallization peak can be registered by the DSC and depicted in a thermogram. Just around this temperature interval, the Avrami exponent n = 3 for bulk crystallization, whereas for any other test the isothermal temperature T_it, nonisothermal conditions prevail and the Avrami exponent deviates from the expected value. © 2004 Wiley Periodicals, Inc. J Appl Polym Sci 92: 970–978, 2004     

Efficiency in the Consolidation of the Italian Water Sector

Despite since the mid-90s the regulation has encouraged horizontal and vertical bundling, the Italian water and sewerage industry is still largely fragmented. This work investigates the potential benefits of the process of consolidation, relying on realistic ex-ante merger hypotheses. A parametric methodology is used to implement the Bogetoft and Wang 2005’s decomposition of potential gains from mergers (J Prod Anal 23:145–171). When looking at strictly technological aspects, results do not provide univocal evidence in favor or against merger strategies, recommending a case-by-case approach in evaluating real merger projects. Moreover, the largest potential gains are due to managerial rather than technological inefficiency, thus their effective ex-post attainment ultimately depend on the ability to tackle the change and on political will.     

Fragility analysis of bridges due to overweight traffic load

In the U.S. overloading represents the third cause of bridge failures just after hydraulic events and collisions. Large data assembled by Weigh-In-Motion (WIM) systems can be used to obtain improved region-specific or network-specific characterization of vehicle loads on highway bridges for a more accurate evaluation of the safety of critical bridges and the failure consequences to the concerned communities. To achieve this goal it is important to develop tools that allow engineers to estimate the reliability of various types of bridges subjected to realistic ranges of heavy truck load intensities as encountered on highway networks. The objective of this paper is to describe an approach that combines field data and numerical simulations to perform the fragility analysis of bridges due to different percentages of overweight loads and truck traffic. Numerical examples are provided by analyzing typical bridges using field truck data collected at WIM sites in upstate New York. The results of the analysis show that the fragility curves for fatigue are function of the percentage of overweight trucks in New York as a second order polynomial, while the fragility curves of bridges for overstress can be modeled with a copula using both normal distributions for the overweight percentages and Average Daily Truck Traffic.     

Time-invariant uncertain systems: A necessary and sufficient condition for stability and instability via homogeneous parameter-dependent quadratic Lyapunov functions

This paper investigates linear systems with polynomial dependence on time-invariant uncertainties constrained in the simplex via homogeneous parameter-dependent quadratic Lyapunov functions (HPD-QLFs). It is shown that a sufficient condition for establishing whether the system is either stable or unstable can be obtained by solving a generalized eigenvalue problem. Moreover, this condition is also necessary by using a sufficiently large degree of the HPD-QLF.     

Short- and long-term analytical solutions for composite beams with partial interaction and shear-lag effects

This paper presents an analytical model for the short- and long-term analysis of composite steel-concrete beams with partial shear interaction and accounting for shear-lag effects. The material properties of the concrete have been assumed to be time-dependent and have been modelled by means of the algebraic methods while the remaining materials forming the cross-section have been supposed to behave in a linear-elastic manner. The global balance condition of the problem has been obtained by means of the principle of virtual work and, integrating this by parts, the governing system of differential equations and corresponding boundary conditions have been determined. Analytical expressions for both short- and long-term solutions have been derived and, to outline their ease of use, a number of case studies relevant for bridge applications have been proposed.