Many studies highlight how health is influenced by the settings in which people live, work, and receive health care. in particular, the setting in which childbirth takes place is highly influential. The physiological processes of women's labor and birth are enhanced in optimal ("salutogenic," or health promoting) environments. Settings can also make a difference in the way maternity staff practice. This paper focuses on how positive examples of italian birth places incorporate principles of healthy settings. The "Margherita" Birth centre in Florence and the Maternity Home "il Nido" in Bologna were purposively selected as cases where the physical-environmental setting seemed to reflect an embedded model of care that promotes health in the context of childbirth. Narrative accounts of the project design were collected from lead professional and direct inspections performed to elicit the key salutogenic components of the physical layout. comparisons between cases with a standard hospital labor ward layout were performed. cross-case similarities emerged. The physical characteristics mostly related to optimal settings were a result of collaborative design decisions with stakeholders and users, and the resulting local intention to maximize safe physiological birth, psychosocial wellbeing, facilitate movement and relaxation, prioritize space for privacy, intimacy, and favor human contact and relationships. The key elements identified in this paper have the potential to inform further investigations for the design or renovation of all birth places (including hospitals) in order to optimize the salutogenic component of any setting in any country.

PurposeAnthracyclines and taxanes are considered the standard for neoadjuvant chemotherapy of breast cancer, although they are often associated with serious side effects and wide variability of individual response. In this study, we analyzed the value of topoisomerase II alpha (TOP2A) and transducin-like enhancer of split 3 (TLE3) as predictive markers of response to therapy with anthracyclines and taxanes.Materials and methodsTOP2A and TLE3 protein expressions were evaluated using immunohistochemistry on 28 samples, obtained by core needle biopsy in patients with locally advanced breast carcinoma, subsequently subjected to epirubicin- and paclitaxel-based neoadjuvant chemotherapy. The immunohistochemical staining was correlated with the clinical response measured by the tumor size reduction evaluated by breast magnetic resonance imaging, prior and after chemotherapy, and by pathologic evaluation of the surgical specimen.ResultsNeoadjuvant chemotherapy achieved a size reduction in 26/28 tumors (92.9%), with an average percentage decrease of 45.6%. A downstaging was achieved in 71.4% of the cases of locally advanced carcinoma. TOP2A positivity was correlated with a greater reduction in tumor diameter (P=0.06); negative staining for TLE3 was predictive of a better response to neoadjuvant chemotherapy (P=0.07). A higher reduction in tumor diameter (P=0.03) was also found for tumors that were concurrently TLE3-negative and TOP2A-positive.ConclusionTOP2A and TLE3 showed a correlation with response to neoadjuvant chemotherapy. While TOP2A is a well-known marker of response to anthracyclines-based chemotherapy, TLE3 is a new putative predictor of response to taxanes. Data from the current study suggest that TOP2A and TLE3 warrant further investigation in a larger series as predictors of response to neoadjuvant chemotherapy for locally advanced breast carcinoma.

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This paper aims to present preliminary textual and historical observations towards a more comprehensive interpretation of a late 5th-4th cent. BC fragmentary letter of a Persian official from the corpus of Aramaic papyri of Saqqâra (NSaqPap 26). The understanding of this document, which deals with some situation of turbulence arisen between the Persian administration at Memphis/Saqqâra and the Ionians and Carians who lived and worked on the spot, is rendered complicated by the poor conditions of preservation of the papyrus, whose top and right portions are lost. Apart from the editio princeps by J.B. Segal (Aramaic Texts from North Saqqâra, London 1983, no. 26) and few additional notes in the reviews of it by J. Teixidor (JAOS1985) and S. Shaked (Orientalia1987), specific contributions on the piece are lacking. More in particular, despite its relevance to the study of the long-established communities of Greeks and Carians in Egypt, the letter has not received yet an adequate treatment from the historical point of view.   Following a lexical and syntactical revision, I provide a new tentative translation of the text, with the aim to reach as thorough and coherent an interpretation of the document as possible, and to shed further light on the living conditions of the communities of Ionians and Carians in Egypt under the Persian rule. By further contextualizing the events described in the letter with the aid of external sources, I argue for a mercenary revolt that affected the storehouses at the port of Memphis as the situation that prompted the response of the local Persian administration.