Prognostic importance of the preoperative New-Naples prognostic score for patients with gastric cancer

BACKGROUND

The wide applicability of the Naples prognostic score (NPS) is still worthy of further study in gastric cancer (GC). This study aimed to construct a New-NPS based on the differences in immunity and nutrition in patients with upper and lower gastrointestinal tumors to help obtain an individualized prediction of prognosis.

METHODS

This study retrospectively analyzed patients who underwent radical gastrectomy from April 2014 to September 2016. The cutoff values of the preoperative neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), serum albumin (Alb), and total cholesterol (TC) were calculated by ROC curve analysis. ROC and t-ROC were used to evaluate the accuracy of the prognostic markers. The Kaplan-Meier method and log-rank test were used to analyze the overall survival probability. Univariate and multivariate analyses based on Cox risk regression were used to show the independent predictors. The nomogram was made by R studio. The predictive accuracy of nomogram was assessed using a calibration plot, concordance index (C-index), and decision curve.

RESULTS

A total of 737 patients were included in training cohort, 411 patients were included in validation cohort. ROC showed that the New-NPS was more suitable for predicting the prognosis of GC patients. NPS = 2 indicated a poor prognosis. Multivariate analysis showed that CEA (P = 0.026), Borrmann type (P = 0.001), pTNM (P < 0.001), New-NPS (P < 0.001), and nerve infiltration (P = 0.035) were independent risk factors for prognosis.

CONCLUSION

The New-NPS based on the cutoff values of NLR, LMR, Alb, and TC is not only suitable for predicting prognosis but can also be combined with clinicopathological characteristics to construct a nomogram model for GC patients.

A terrifying poison or a cheap fertilizer? The life and death of Mount Vesuvius ash

During the eighteenth century, chemists in the Kingdom of Naples (the South of Italy) were very busy analyzing the chemical composition of ash from Mount Vesuvius. Undoubtedly, after a huge eruption this dusty phenomenon was the most important scientific object of debate. In fact, it was crucial to determine if there were dangerous elements in the ash so that the population could be warned about the potential hazards, such as polluted drinking water. This was not at all a simple issue, as on the other hand there were scholars who realized that ash could be beneficial as a fertilizer, even as clouds of ash had obscured the sun. As chemical inquiries became more precise and the toxic concentration of many elements became known, this double life of Vesuvian ash as a scientific object gradually died.

Baroque Science, Experimental Art? Jusepe de Ribera and other Neapolitan Sceptics

Current attempts by historians of science to revise the narrative of the Scientific Revolution by using the concept of the Baroque have important implications for art history. Correspondences between baroque art and baroque science gain new complexity when the rational, epistemologically optimistic image of the New Science is put in doubt. Rather than a method of objective observation, early seventeenth-century science and art share an acceptance of the constructed nature of reality, of human epistemological limitations and of the role of passions in the observation of the world. While Caravaggio has revolutionised art precisely through his interest in questions of knowledge and sensorial perception and by his subversive transformation of Renaissance epistemological values and ideals, this article concentrates on the work of Jusepe de Ribera, who made the senses and their shortcomings a major theme of his pictorial research. Ribera's epistemology is examined in the context of contemporary Neapolitan philosophy and science. Through the confrontation of some of the Spagnoletto's paintings with the work of figures such as Giovanni Battista della Porta, Federico Cesi and particularly Colantonio Stigliola, it becomes clear that early modern Neapolitan faith in rational knowledge was more ambiguous than is sometimes assumed.

Participation to Leisure Activities and Well-Being in a Group of Residents of Naples-Italy: The Role of Resilience

We explored the relationship between cultural and social participation, physical activity, and well-being in a group of residents of the metropolitan area of Naples, Italy and the role that resilience plays in this relationship. Naples offers a remarkable urban environment with the potentially beneficial psychological effects of outstanding natural beauty, and one of the world’s most impressive repositories of tangible and intangible cultural heritage. However, Naples was also, and still is, heavily affected by the 2008 economic crisis, in addition to preexisting social and economic issues. The major finding of this study is that, despite this highly contrasting urban environment, the combination of physical activity and engagement in social and cultural activities has a positive effect on subjective (self-reported) psychological well-being (SPWB) in a group of residents, and that resilience mediates this relationship.

The occurrence of OCPs, PCBs, and PAHs in the soil, air, and bulk deposition of the Naples metropolitan area, southern Italy: Implications for sources and environmental processes

I am often reminded of the famous saying of Goethe: "Vedi Napoli e poi muori! - See Naples and die!". Sadly, Naples is now confronted with a number of serious, ongoing problems with a need to alleviate pressure on the worsening environment. One serious problem facing the environment is the presence of the potentially hazardous persistent organic pollutants (POPs), although few systematic studies at regional scale have been conducted. In this study, samples of soil, air, and bulk deposition were collected in Naples metropolitan area (NMA) to characterize the status of POPs, including organochlorine pesticides (OCPs), polychlorinated biphenyls (PCBs), and polycyclic aromatic hydrocarbons (PAHs). The results obtained showed that most of these compounds are pervasive in all the studied environmental matrices, especially in some hotspot areas, such as the Bagnoli Brownfield Site and the infamous "Triangle of the Death", where unwanted ecological risk conditions for PAHs and Endosulfan were determined, respectively. The interactional complexity between urban and the surrounding rural areas was also confirmed, as is the role that urban areas play in the migration and transformation process of POPs. High urban-rural gradients for atmospheric PAHs and PCBs were observed in the NMA, and the urban areas were identified as the emission source of these contaminants. Similarly, the OCP residues, historically originated from the nearby agricultural regions, experience long-term soil re-emission and continuously influence the connected urban environment via atmospheric transport processes.

Studies of the Seasonal Pattern of Multiple Maternities

The seasonality of population data has been of great interest in demographic studies. When seasonality is analyzed, the population at risk plays a central role. In a study of the monthly number of births and deaths, the population at risk is the product of the size of the population and the length of the month. Usually, the population can be assumed to be constant, and consequently, the population at risk is proportional to the length of the month. Hence, the number of cases per day has to be analyzed. If one studies the seasonal variation in twin or multiple maternities, the population at risk is the total number of monthly confinements, and the study should be based on the rates of the multiple maternities. Consequently, if one considers monthly twinning rates, the monthly number of birth data is eliminated and one obtains an unaffected seasonality measure of the twin maternities. The strength of the seasonality is measured by a chi-squared test or by the standard deviation. When seasonal models are applied, one must pay special attention to how well the model fits the data. If the goodness of fit is poor, it can erroneously result in a statement that the seasonality is slight, although the observed seasonal fluctuations are marked.

Cancer mortality trends between 1988 and 2009 in the metropolitan area of Naples and Caserta, Southern Italy: Results from a joinpoint regression analysis

Mortality data by geographic area and trend-based surveillance are particularly relevant in orienting public health decisions targeting specific populations. We analyzed overall and site-specific cancer mortality between 1988 and 2009 in the metropolitan area of Naples and Caserta in southern Italy. Age-standardized mortality rates (SMR) were computed for each 5-y age group, by gender, primitive cancer site and specific Province in the overall population and age-defined subgroups. Cancer mortality trends were quantified by annual percent change (APC) and 95% confidence interval (CI). From Naples and Caserta, the reduction observed between 1988 and 2009 in SMR in males, but not in females, was significantly lower compared with the decrease reported at a national level (-11.4% and -28.4%, respectively). In elderly men, differences between local and national SMR were more pronounced (+13.6% compared with -2.7%). In males, the joinpoint regression analysis showed the following APC and 95% CI: -0.9%/year (-1.2; -0.7) and -0.6%/year (-1.0; -0.2) for Naples and Caserta, respectively. In females, estimates were -0.6%/year (-0.8; -0.5) and -0.7%/year (-1.2; -0.3). The overall orientation toward declining cancer mortality trends appeared in antithesis with the slight, but significant, increase for some tumors (e.g., pancreatic cancer in both genders). A complex mixture of heterogeneous factors concurs to explain the evidence observed including lifestyle, access to screening procedures, advancements in cancer diagnosis and treatment. Further details might eventually derive from biomonitoring studies for ascertaining the causal link between exposure to potential contaminants in air, water, and soil and cancer-related outcomes in the area of interest.

Cancer prevalence in the city of Naples: Contribution of the GP database analyses to the cancer registries network

The Italian cancer registries network has not been sufficiently developed in the Southern regions. General practitioners (GPs) are knowledgeable about the prevalence, incidence and mortality for different types of cancer in their patient populations. The aim of this pilot study was to verify the feasibility and reliability of the characterization of cancer populations using GP databases in order to evaluate the impact of cancer in the general population of Naples. The characteristics of the cases studied have been collected by interview or electronic health record and recorded on paper or magnetic supports, appropriately conforming to the current privacy law. Databases are centralized, stored and codified on electronic data-sheets and periodically elaborated by the 'Consorzio Nazionale delle Cooperative Mediche' and 'Federico II' University. The present study was initiated on September 15, 2004. The analysed geographical area included the suburbs of 'Stella' and 'San Carlo all'Arena', situated in the historical center of Naples and corresponding to Health Care District 29 of the local health service. The analysis included 16,927 men and women (age range, 6-97 years) from the outpatient offices of 12 GPs who agreed to participate in the study. Results showed that the analysed population represents 16.3% of the general population residing in the area under study. We identified 342 (2%) patients with cancer, 143 (0.8%) of whom were men and 199 (1.2%) women (M/F ratio of 0.7). Of the 342 patients, 10 (5 men and 5 women) had a double cancer; thus, a total of 352 malignancies was characterized. Cancer prevalence was 2,020/100,000 inhabitants. This estimate is lower compared to the national prevalence (2,683/100,000 inhabitants) but higher compared to that in other southern Italian areas. Results, stratified by International Classification of Disease, ninth revision (ICD-IX), based on factors including gender and age, demonstrated that breast cancer, urogenital tumours and colorectal cancer are the most frequently occurring types of cancer identified among the inhabitants of Naples. Cancer prevalence in the historical center of Naples is in concordance with national estimates and projections and National Cancer Registries may be easily and accurately supported by GP medical databases.

The use of mercury against pediculosis in the Renaissance: the case of Ferdinand II of Aragon, King of Naples, 1467-96

The hair samples of Ferdinand II of Aragon (1467-1496), King of Naples, whose mummy is preserved in the Basilica of San Domenico Maggiore in Naples, showed a high content of mercury, with a value of 827ppm. Furthermore, examination using a stereomicroscope and a scanning electron microscope (SEM) of head and pubic hairs of Ferdinand II, revealed a lice infestation. The reasons for the massive presence of the mercury in the king's hair are discussed and contemporary literature regarding the use of this metal in medical therapies and in cosmetic practices is analysed. As a result, the high value of mercury in the hair of Ferdinand II can be attributed to antipediculosis therapy, applied as a topic medicament. This case represents an important finding for the history of medicine, because demonstrates that in the Renaissance mercury was applied locally not only to treat syphilis, as well attested by direct and indirect sources, but also to prevent or eliminate lice infestation.