BackgroundCase control studies that randomly assign patients with diagnosis of acute appendicitis to either surgical or non-surgical treatment yield a relapse rate of approximately 14% at one year. It would be useful to know the relapse rate of patients who have, instead, been selected for a given treatment based on a thorough clinical evaluation, including physical examination and laboratory results (Alvarado Score) as well as radiological exams if needed or deemed helpful. If this clinical evaluation is useful, the investigators would expect patient selection to be better than chance, and relapse rate to be lower than 14%. Once the investigators have established the utility of this evaluation, the investigators can begin to identify those components that have predictive value (such as blood analysis, or US/CT findings). This is the first step toward developing an accurate diagnostic-therapeutic algorithm which will avoid risks and costs of needless surgery.Methods/designThis will be a single-cohort prospective observational study. It will not interfere with the usual pathway, consisting of clinical examination in the Emergency Department (ED) and execution of the following exams at the physician's discretion: full blood count with differential, C reactive protein, abdominal ultrasound, abdominal CT. Patients admitted to an ED with lower abdominal pain and suspicion of acute appendicitis and not needing immediate surgery, are requested by informed consent to undergo observation and non operative treatment with antibiotic therapy (Amoxicillin and Clavulanic Acid). The patients by protocol should not have received any previous antibiotic treatment during the same clinical episode. Patients not undergoing surgery will be physically examined 5 days later. Further follow-up will be conducted at 7, 15 days, 6 months and 12 months. The study will conform to clinical practice guidelines and will follow the recommendations of the Declaration of Helsinki. The protocol was approved on November 2009 by Maggiore Hospital Ethical Review Board (ID CE09079).Trial RegistrationClinicalTrials.gov identifier: NCT01096927.
This work aims to describe and analyze the new socio economic phenomenon of waste-based circularity. To describe this process of recovery and transformation of waste, which represents the basis of circular economy, it is necessary to understand the complex articulation of the production of goods and materials, their yield and their capacity of transformation. At the heart of all this is a series of human behaviors and habits dictated by legal rules and economic and cultural approaches. If we manage to better understand these behaviors, we can activate a series of processes which could help us to determine and encourage more sustainable behaviors from an environmental, economic and social point of view. Received: 11 March 2021 / Accepted: 18 April 2021 / Published: 17 May 2021
This paper aims to highlight the close connection existing between the main leading scholars, those considered the contemporary theorists of environmentalism and ecologism and some groups and movements that developed in Russia in IntroduzioneLa questione ambientale è stata scarsamente trattata in Russia come in Europa occidentale fino agli anni Sessanta del novecento. A partire dal 1988 Douglas Weiner, attraverso una serie di ricerche pubblicate proprio in quegli anni, ha fornito una nuova interpretazione (Weiner 2005) di quelle che sono state le scelte di politica ambientale legate allo sviluppo della Russia bolscevica prima e dell'Unione Sovietica dopo. Questa ampia e dettagliata ricerca si è basata soprattutto su una documentazione archivistica, su corrispondenza istituzionale e privata, su dichiarazioni e conclusioni scientifiche che hanno fatto emergere l'importanza delle iniziative intraprese a favore della conservazione della naturaintesa come tutela e utilizzo razionale delle risorse -e dal ruolo strategico giocato dal movimento ambientalista russo (movimento per la protezione della natura russo), d'dapprima formato da un élite di scienziati e poi sviluppatosi negli anni come un vero e proprio movimento di opinione. La ricerca di Weiner, testimonia l'esistenza di questo movimento autonomo a favore della protezione ambientale nato nel periodo leniniano e perdurato per tutta la fase staliniana e oltre. Esso si è esplicato attraverso una serie di società controllate da botanici, zoologi, e geografi in particolare: VOOP (società russa per la protezione della natura); MOIP (società dei naturalisti di Mosca); MGO (filiale moscovita della società geografica dell'URSS) e Società Botanica Unita (Weiner 1988). Queste società hanno tutte avuto il merito di fornire una visione alternativa dell'utilizzo della terra. Inoltre hanno rappresentato una visione alternativa circa lo sfruttamento delle risorse, della protezione dell'habitat naturale, dello sviluppo, arrivando a considerare come possibile e fattibile uno sviluppo economico razionale e forse, 681
The following work analyzes the principal differences in the implementation of the circular economy model between Europe and China, with a focus on practices and strategies set in place by the asiatic Popular Republic to promote the sustainable development. For that purpose, in this work, relevant trial studies on the management and deployment of circular economy in China and on green behaviors of Chinese population have been examined Received: 20 July 2021 / Accepted: 30 August 2021 / Published: 5 September 2021
This work analyzes the phenomenon of SDGs localization paths in an international networking process through one of the main network drivers of sustainable local development (ICLEI). To favor the localization paths means to increase the ability of the single territories to construct new forms of coordination between the different institutional levels, in line with the principles of vertical integration. Sustainable development cannot be just a vague and indeterminate concept and it cannot be considered just as the passive implementation of rules or standards resulting from international guidelines often irreconcilable with local contexts, but it should be a participatory action of local institutional bodies, citizens and multistakeholders. There is a strong demand for social participation in the definition of collective and individual behavior, which cannot be disregarded. Received: 25 February 2021 / Accepted: 4 May 2021 / Published: 17 May 2021
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