Speech listening entails neural encoding of invisible articulatory features.

Speech processing entails a complex interplay between bottom-up and top-down computations. The former is reflected in the neural entrainment to the quasi-rhythmic properties of speech acoustics while the latter is supposed to guide the selection of the most relevant input subspace. Top-down signals are believed to originate mainly from motor regions, yet similar activities have been shown to tune attentional cycles also for simpler, non-speech stimuli. Here we examined whether, during speech listening, the brain reconstructs articulatory patterns associated to speech production. We measured electroencephalographic (EEG) data while participants listened to sentences during the production of which articulatory kinematics of lips, jaws and tongue were also recorded (via Electro-Magnetic Articulography, EMA). We captured the patterns of articulatory coordination through Principal Component Analysis (PCA) and used Partial Information Decomposition (PID) to identify whether the speech envelope and each of the kinematic components provided unique, synergistic and/or redundant information regarding the EEG signals. Interestingly, tongue movements contain both unique as well as synergistic information with the envelope that are encoded in the listener's brain activity. This demonstrates that during speech listening the brain retrieves highly specific and unique motor information that is never accessible through vision, thus leveraging audio-motor maps that arise most likely from the acquisition of speech production during development.

NMR-based metabolomics to evaluate the milk composition from Friesian and autochthonous cows of Northern Italy at different lactation times.

It is well established that different factors affect milk composition in cows and that milk composition, in turn, affect both technological and nutritional qualities. In this respect the comprehension of the metabolic variability of milk composition in relation to the lactation time as well as to the genetic background may be of paramount importance for the agri-food industries. In the present study we investigated the variations of the metabolic profiles during lactation in milks obtained from Friesian and autochthonous races from Northern Italy by 1H NMR metabolomics. Furthermore, the external factors influencing the milk composition were minimized: the cows were breeded in the same farm, were fed with the same diet and were paired for the lactation interval and lactation stage. Our results showed a difference in milk composition between races and in relation to late lactation. The PLS-DA analysis permitted to distinguish the Friesian and autochthonous cow milks at the investigated different lactation times. Interestingly, the metabolites significantly involved into the discrimination between races appeared to be also technological property parameters, highlighting the importance of maintaining the biodiversity of cow breeds. Therefore, NMR-based metabolomics of milk could represent an informative tool to identify metabolites involved in milk quality both from a nutritional and industrial perspective.

Binding space and time through action.

Space and time are intimately coupled dimensions in the human brain. Several lines of evidence suggest that space and time are processed by a shared analogue magnitude system. It has been proposed that actions are instrumental in establishing this shared magnitude system. Here we provide evidence in support of this hypothesis, by showing that the interaction between space and time is enhanced when magnitude information is acquired through action. Participants observed increases or decreases in the height of a visual bar (spatial magnitude) while judging whether a simultaneously presented sequence of acoustic tones had accelerated or decelerated (temporal magnitude). In one condition (Action), participants directly controlled the changes in bar height with a hand grip device, whereas in the other (No Action), changes in bar height were externally controlled but matched the spatial/temporal profile of the Action condition. The sign of changes in bar height biased the perceived rate of the tone sequences, where increases in bar height produced apparent increases in tone rate. This effect was amplified when the visual bar was actively controlled in the Action condition, and the strength of the interaction was scaled by the magnitude of the action. Subsequent experiments ruled out that this was simply explained by attentional factors, and additionally showed that a monotonic mapping is also required between grip force and bar height in order to bias the perception of the tones. These data provide support for an instrumental role of action in interfacing spatial and temporal quantities in the brain.

Urinary (1)H-NMR-based metabolic profiling of children with NAFLD undergoing VSL#3 treatment.

BACKGROUND: Nowadays, non-alcoholic fatty liver disease (NAFLD) is one of the most common chronic liver diseases in children. Our recent clinical trial demonstrated that dietary and VSL#3-based interventions may improve fatty liver by ultrasound and body mass index (BMI) after 4 months. OBJECTIVES: As in this short-term trial, as in others, it is impracticable to monitor response to therapy or treatment by liver biopsy, we aimed to identify a panel of potential non-invasive metabolic biomarkers by a urinary metabolic profiling. METHODS: Urine samples from a group of 31 pediatric NAFLD patients, enrolled in a VSL#3 clinical trial, were analyzed by high-resolution proton nuclear magnetic resonance spectroscopy in combination with analysis of variance-Simultaneous Component Analysis model and multivariate data analyses. Urinary metabolic profiles were interpreted in terms of clinical patient feature, treatment and chronology pattern correlations. RESULTS: VSL#3 treatment induced changes in NAFLD urinary metabolic phenotype mainly at level of host amino-acid metabolism (that is, valine, tyrosine, 3-amino-isobutyrate or ß-aminoisobutyric acid (BAIBA)), nucleic acid degradation (pseudouridine), creatinine metabolism (methylguanidine) and secondarily at the level of gut microbial amino-acid metabolism (that is, 2-hydroxyisobutyrate from valine degradation). Furthermore, some of these metabolites correlated with clinical primary and secondary trial end points after VSL#3 treatment: tyrosine and the organic acid U4 positively with alanine aminotransferase (R=0.399, P=0.026) and BMI (R=0.36, P=0.045); BAIBA and tyrosine negatively with active glucagon-like-peptide 1 (R=-0.51, P=0.003; R=-0.41, P=0.021, respectively). CONCLUSIONS: VSL#3 treatment-dependent urinary metabotypes of NAFLD children may be considered as non-invasive effective biomarkers to evaluate the response to treatment.

Burnout among therapists working with persons with autism after the 2009 earthquake in L'Aquila, Italy: a longitudinal comparative study.

The aim of this study was to follow up the occurrence of burnout in therapists of children and adolescents with autism experiencing the 2009 earthquake in L'Aquila, and to discuss implications for burnout prevention after disasters. A longitudinal study was carried out, measuring burnout outcomes according to the Maslach Burnout Inventory in 11 exposed and 53 unexposed therapists. Staff in the exposed group appeared to report significantly higher levels of emotional exhaustion after 1 and 2 years of follow-up than the unexposed staff. As to lack of personal accomplishment, the exposed groups shows increasingly lower scores with respect to the unexposed group, with personal accomplishment (PA) values falling from 41.0 [standard deviation (SD) 3.7] to 33.4 (SD 4.1) after 2 years, whereas PA values remain stable over time in the unexposed group. As to depersonalization, data show no significant difference between groups. Burnout occurrence is induced by the exceptional stressors related with natural disasters like earthquakes. Efforts are required to help mental health workers, including psychiatric nurses, to cope with the devastating situation determined by an earthquake. A periodical monitoring of mental health status is recommended in mental health works, especially with regard to help with post-traumatic stress disorder, coping with work and therapeutic relationships, family and social life and economic impact.

Pyrosequencing as a tool for the detection of Phytophthora species: error rate and risk of false Molecular Operational Taxonomic Units.

AIMS: To evaluate the accuracy of pyrosequencing for the description of Phytophthora communities in terms of taxa identification and risk of assignment for false Molecular Operational Taxonomic Units (MOTUs). METHODS AND RESULTS: Pyrosequencing of Internal Transcribed Spacer 1 (ITS1) amplicons was used to describe the structure of a DNA mixture comprising eight Phytophthora spp. and Pythium vexans. Pyrosequencing resulted in 16 965 reads, detecting all species in the template DNA mixture. Reducing the ITS1 sequence identity threshold resulted in a decrease in numbers of unmatched reads but a concomitant increase in the numbers of false MOTUs. The total error rate was 0·63% and comprised mainly mismatches (0·25%) CONCLUSIONS: Pyrosequencing of ITS1 region is an efficient and accurate technique for the detection and identification of Phytophthora spp. in environmental samples. However, the risk of allocating false MOTUs, even when demonstrated to be low, may require additional validation with alternative detection methods. SIGNIFICANCE AND IMPACT OF THE STUDY: Phytophthora spp. are considered among the most destructive groups of invasive plant pathogens, affecting thousands of cultivated and wild plants worldwide. Simultaneous early detection of Phytophthora complexes in environmental samples offers an unique opportunity for the interception of known and unknown species along pathways of introduction, along with the identification of these organisms in invaded environments.

Monitoring of metabolic profiling and water status of Hayward kiwifruits by nuclear magnetic resonance.

The metabolic profiling of kiwifruit (Actinidia deliciosa, Hayward cultivar) aqueous extracts and the water status of entire kiwifruits were monitored over the season (June-December) using nuclear magnetic resonance (NMR) methodologies. The metabolic profiling of aqueous kiwifruit extracts was investigated by means of high field NMR spectroscopy. A large number of water-soluble metabolites were assigned by means of 1D and 2D NMR experiments. The change in the metabolic profiles monitored over the season allowed the kiwifruit development to be investigated. Specific temporal trends of aminoacids, sugars, organic acids and other metabolites were observed. The water status of kiwifruits was monitored directly on the intact fruit measuring the T(2) spin-spin relaxation time by means of a portable unilateral NMR instrument, fully non-invasive. Again, clear trends of the relaxation time were observed during the monitoring period. The results show that the monitoring of the metabolic profiling and the monitoring of the water status are two complementary means suitable to have a complete view of the investigated fruit.

[An injuries prevention programme in the transport and cargo handling sector, implemented by the ASL 10 Local Health Unit, Florence]. / Intervento di prevenzione, nel comparto trasporto e movimentazione merci, ASL 10 Firenze zona Nordovest.

BACKGROUND: There are doubts about the ability of public health services to significantly reduce occupational injuries through non-targeted investigations and surveillance programmes. METHODS: For this reason an intervention was designed specifically for the transport and cargo handling sector, in which inspections are concentrated on the minority of higher risk companies, followed by ex-post assessment of the outcomes. RESULTS AND DISCUSSION: The goal of identifying the most hazardous companies through injury data appears to be successful in companies with more than 3 employees. Some problems remain for smaller companies and for the large porterage cooperatives, where the official data on the number of employees is unreliable.

[Early diagnosis of dysmorphophobia and others dysmorphic disorders: a possible operative model]. / Dismorfofobia e diagnosi precoce: un modello operativo possibile.

AIMS: Body Dismorphic Disorder interest the 1-2% of the general population. It is characterized by an unfavorable prognosis and an elevated comorbidity with others psychiatric disorders. Approximately 6-15% of people with body image disorder refer for aesthetic surgery without any benefit indeed the outcome is, often, to request others surgery procedure. The aim of study has been to investigate the presence of dismorphophobia, others dismorphic disorders and psychiatric symptoms in a sample of patients candidates to aesthetic surgery procedure. MATERIALS AND METHODS: It has been recruited 109 patients of mean age 27.21 years, coming to the department of Plastic Surgery of L'Aquila (Italy). To all the patients have been delivered a questionnaire for socio-demographic data and two clinical standardized instruments: Self-report Symptom Inventory-Revised (SCL-90) and the Body Uneasiness Test (BUT). The psychometric and clinical evaluations have been performed by SMILE center (Service for Monitoring and early Intervention against psychoLogical and mEntal suffering in young people), the mission of which is to reduce the burden of mental suffering in young people by of an earlier recognition of signs and symptoms of psychiatric disorders. RESULTS: 42.67% of sample showed positive results to BUT, while 57.33% reported negative results. Moreover, BUT-positive subjects achieved significantly higher results in all SCL-90 items. CONCLUSIONS: A liaison between psychiatrists and plastic surgery equipe is essential for an early diagnosis of Dismorphophobia and others Dismorphic Disorders, to begin an eventual treatment and to supply indications for the surgical candidability. Our study confirm the high prevalence of body image disorders and the presence of other psychiatric symptoms and diseases in patients who demand aesthetic procedure. The detection of early signs of any psychiatric and psychological apparent discomfort represent a priority because this correlate, in most cases, with late diagnosis and intervention because awareness of these types of disease is usually very low and therefore the possibility that subjects with this type of problems are requested to psychiatric services is rare.

Subjective and psychopathological response in patients under different antipsychotic treatments: are there differences in real clinical practice?

The aim of this study is to investigate whether subjective well-being in patients under treatment with typical (ATPs) and atypical antipsychotic (ATPsA) compounds can be compared with the improvement of psychopathological state and to verify if both variables correlate to adherence to treatment. We assessed 106 consecutive patients receiving ATPs or ATPsA in the University Psychiatric Ward of L?Aquila, according to DSM-IV diagnosis of Schizophrenia and Bipolar Disorder. Psychopathological state was assessed by Brief Psychiatric Rating Scale-4.0 version (BPRS), adherence to treatment and subjective well-being was assessed by Drug Attitude Inventory (DAI-10) and Subjective Well-being under Neuroleptics (SWN), respectively. BPRS and DAI-10 were administered on admission (T0) and at the end of recovery (T1). The subjects enrolled in this study were divided into 2 groups according to ATP prescribed. We observed an improvement of BPRS and SWN total scores in each group, and increasing scores in DAI-10, from admission to discharge, both in total samples and in each group. There were statistical differences between the patients receiving ATPs and those receving ATPsA regardindg the SWN total score and its different dimensions. This study emphasizes that patients receiving ATPsA show better subjective response compared with patients undergoing ATP treatment, although the adherence to pharmacotherapy and clinical improvement do not differ between the groups.

CT Perfusion Evaluation of Cerebral Haemodynamics before and after Cranioplasty.

CT Perfusion imaging is usually applied to assess perfusion abnormalities in acute stroke. This prospective study applied the technique to monitor cerebral haemodynamics before and after cranioplasty. Cranioplasty is the surgical correction of a skull defect using autologous or heterologous material to obtain cosmetic repair, restoration of brain protection and neurological improvement (1). As far as we know the effect of cranioplasty on cerebral haemodynamics flow has been analysed by CT perfusion only in one article (2). We tested the examination as method of monitoring intracranial haemodynamics in a larger number of patients evaluating its reliability and efficacy. We prospectively examined cerebral haemodynamics with Perfusion CT before and after (two weeks, three and six months) cranioplasty in ten patients. The data evaluation of dynamic CT was done by an application software package on a workstation (Leonardo) permitting the use of visual assessment combined with quantitative analysis with ROIs. There was a comparison of CBF, CBV and TTP values between the regions of interest and mirror-image control regions, and in the three different examinations for each patient. After cranioplasty there was clearly an improvement in neurological symptoms and CT perfusion in the majority of cases showed a slight increase in CBF, CBV and decrease of TTP in the cerebral parenchyma close to the cranioplasty, not only on the symptomatic side but also on the opposite side. Even though there was neurological improvement and improved cranial perfusion from the first to the last examinations, our data were not statistically significant. The method is easily reproducible, well tolerated by all patients but has several limitations related to data processing and radiation exposure.

[Risperidone-induced symptomatic hyperprolactinemia in youth with schizophrenia: efficacy and tolerability of cabergoline treatment]. / Iperprolattinemia sintomatica da risperidone in pazienti giovani affetti da schizofrenia e trattamento con cabergolina: studio di efficacia e tollerabilità.

OBJECTIVES: The aim of our study is to evaluate, in youth schizophrenic responders outpatients coming to the SMILE (Service for Monitoring and for early Intervention Looking at the fight against the onset of mental Even psychological suffering of youths of the Psychiatric Department of the University of L'Aquila), the efficacy and tolerability of a low dose of cabergoline, in the treatment of risperidone-induced symptomatic hyperprolactinemia. MATERIALS AND METHODS: Ten schizophrenic young patients (6 male and 4 female; mean age: 23.3 +/- 0.5 years) who were clinical responders to risperidone treatment and showed symptomatic hyperprolactinemia, were treated with low dosage of cabergoline, 0.125 to 0.250 mg/week for 16 weeks. Plasma prolactin level, clinical symptomatology of hyperprolactinemia (UKU) and psychopathology (PANSS) was assessed at baseline and for three times (4, 8 and 16 week) along the follow-up of the study. RESULTS: After cabergoline treatment, the mean decrease in plasma prolactin levels was statistically significant (p < 0.05) for the global sample of youths with schizophrenia. Nine of these patients showed remission of clinical signs of hyperprolactinemia with normalization of prolactin values. No side effect was observed neither patients' psychopathological worsening. CONCLUSIONS: Our data confirm previous studies results, suggesting that low-dose cabergoline treatment of risperidone-induced symptomatic hyperprolactinemia may be safe and clinically effective in a relevant number of schizophrenic patients. Our sample didn't show any side-effects associated to cabergoline use, neither any cardiopulmonary complications as recently reported in literature data. These therapeutic strategies seem to be not influencing psychopathological outcome and for such reason could be a good strategy in clinical practice for the treatment of youths with schizophrenia especially when the efficacy of risperidone is so good to not indicate its withdrawal.

[Antipsychotic-induced symptomatic hyperprolactinemia: clinical consequences and therapeutic strategies]. / Iperprolattinemia sintomatica da antipsicotici: conseguenze cliniche ed indicazioni terapeutiche.

Hyperprolactinemia is a clinical condition characterized by a stable and persistent increase in the ematic prolactin levels. That condition presents some serious health consequences for the affected subjects determining both sexual and endocrine not sexual dysfunctions. Drugs which act on the dopaminergic system and/or on the dopamine hypophysis receptors, could increase the prolactin levels. Traditional antipsychotics used in the treatment of the schizophrenia, are one of the pharmachological classes more involved in this condition and a wide data from international literature describes its clinical and phisiopathologic characteristics. Generally, the atypical antipsychotic induce a significant lower increase of prolactin levels as regards the traditional ones However, above all in young psychotic patients treated with these new drugs, it has been shown an increase of prolactin levels over the superior limit of the normal range, in 70% of them. One of the reasons which more frequently induce a psychotic patient to interrupt an antipsychotic treatment, is represented by the presence of side effects expecially in the sexual sphere. These consequences are greater and more significant in young patients. For such reasons, the therapeutic alternatives to be consider in symptomatic hyperprolactinemia depend on a complete evaluation of the risk/benefit relationship considering the possibility of shifting to another antipsychotic drug, or using drugs with dopaminergic activity which, however, could be associate to some side effects and could determine a worsening of psychotic symptoms.

Does premorbid IQ have a pathoplastic effect on symptom presentation in schizophrenic and bipolar disorders?

INTRODUCTION: The poor premorbid IQ has been considered as a predisposing factor for the development of schizophrenia and other psychoses as well as predictive of poor long-term outcome. We hypothesise that premorbid IQ could influence symptom expression during an index episode (i.e. a short-term outcome). AIM OF THE STUDY: We studied 48 patients with schizophrenic disorder and 56 with bipolar disorder during an 'index episode' using the test di intelligenza breve (TIB) for the premorbid IQ evaluation, and the positive and negative syndrome scale (PANSS). RESULTS: Using the premorbid IQ as a criterion variable (i.e. low versus high IQ groups) the one-way ANOVA analysis showed that low IQ schizophrenic patients had more PANSS positive symptoms and "thought disturbances" than both high and low IQ bipolars. The low IQ schizophrenic patients showed more cognitive symptoms than bipolar patients with high IQ. Furthermore, no PANSS differences were seen between high IQ schizophrenics and low IQ bipolars. In the total and bipolar groups the correlation coefficients between TIB scores and PANSS scales reached statistical significance for the cognitive cluster only. No correlations were seen in the schizophrenic group. CONCLUSION: This categorisation (i.e. low versus high IQ) adds clinically relevant knowledge to patients who, in spite of having similar symptom profile (i.e. high IQ schizophrenic patients and low IQ bipolar patients), fall into different diagnostic categories.

Metabolic profiling by 13C-NMR spectroscopy: [1,2-13C2]glucose reveals a heterogeneous metabolism in human leukemia T cells.

Metabolic profiling is defined as the simultaneous assessment of substrate fluxes within and among the different pathways of metabolite synthesis and energy production under various physiological conditions. The use of stable-isotope tracers and the analysis of the distribution of labeled carbons in various intermediates, by both mass spectrometry and NMR spectroscopy, allow the role of several metabolic processes in cell growth and death to be defined. In the present paper we describe the metabolic profiling of Jurkat cells by isotopomer analysis using (13)C-NMR spectroscopy and [1,2-(13)C(2)]glucose as the stable-isotope tracer. The isotopomer analysis of the lactate, alanine, glutamate, proline, serine, glycine, malate and ribose-5-phosphate moiety of nucleotides has allowed original integrated information regarding the pentose phosphate pathway, TCA cycle, and amino acid metabolism in proliferating human leukemia T cells to be obtained. In particular, the contribution of the glucose-6-phosphate dehydrogenase and transketolase activities to phosphoribosyl-pyrophosphate synthesis was evaluated directly by the determination of isotopomers of the [1'-(13)C], [4',5'-(13)C(2)]ribosyl moiety of nucleotides. Furthermore, the relative contribution of the glycolysis and pentose cycle to lactate production was estimated via analysis of lactate isotopomers. Interestingly, pyruvate carboxylase and pyruvate dehydrogenase flux ratios measured by glutamate isotopomers and the production of isotopomers of several metabolites showed that the metabolic processes described could not take place simultaneously in the same macrocompartments (cells). Results revealed a heterogeneous metabolism in an asynchronous cell population that may be interpreted on the basis of different metabolic phenotypes of subpopulations in relation to different cell cycle phases.

Gamma knife radiosurgery in skull base meningiomas: a possible relationship between somatostatin receptor decrease and early neurological improvement without tumour shrinkage at short-term imaging follow-up.

BACKGROUND: This study investigates a possible relationship between the effects of gamma knife (GK) on meningioma somatostatin receptors (SRs) and the high rate of early neurological improvement without tumour reduction at short-term imaging follow-up. METHODS: From December 1997 to December 2002, somatostatin receptor scintigraphy (SRS) using an 111Indium-labelled somatostatin analogue, Octreotide, was performed both before and 7-12 months after radiosurgery in 20 patients with intracranial meningiomas. Semiquantitative data were calculated as an SRS index. FINDINGS: The pre-GK SRS index was always > 1, averaging 4.44 +/- 3.20. There were no statistically significant differences between the pre-GK average values of primary (4.80 +/- 3.65) and residual (3.75 +/- 1.93) meningiomas. At the first clinical/MRI follow-up, the neurological examination had improved in 15/20 (75%) and had not changed in 5/20 patients. A corresponding slight tumour shrinkage on high-resolution MRI was documented in 3/20 cases only. The post-GK average SRS index was lower than pre-GK values both in primary (3.87 +/- 3.19) and in adjuvant (2.52 +/- 1.14) treatments, but the differences were not significant. However, the subgroup of patients with early neurological improvement showed a higher pre-GK average SRS index (5.21 +/- 3.33) and a more substantial post-GK average SRS index decrease (3.86 +/- 3.00) than the patients whose clinical condition remained stable (2.10 +/- 0.59 and 1.99 +/- 0.55, respectively). The difference between the two subgroups of patients proved to be statistically significant (P < 0.05). CONCLUSIONS: Our preliminary findings suggest a possible relationship between a decrease in the concentration of SRs on meningioma cells at short-term functional imaging follow-up after radiosurgery and early neurological improvement.

[Risk management in health care systems: the new legislative orientations in medical civil responsibility]. / Risk management in sanità: i nuovi orientamenti legislativi sulla responsabilità civile in ambito medico.

The recent radical change in the relationships between physicians and patients has increased the frequency of malpractice. Consequently, on one hand, many physicians got used to avoiding any possible risk of denunciation by applying the so called "defensive medicine", while on the other hand, the insurance companies raised the prices of their premiums for policies concerning civil responsibility of health operators. In order to avoid this "vicious circle", some health structures created Units for the Risk Management related to malpractice, while others took advantage of the collaboration of Associations for Patients' Rights to create database about the most frequent medical mistakes. The need for a legislative change has been accepted by the Parliament which expects with the proposal n.108 (approved in spring 2002 by the Commission for Hygiene and Health of the Senate) to attribute the civil responsibility of the physicians to the hospitals (both private and public) for which they work, to constitute a Register of experts and to accelerate the legal disputes. The problem is complex and still to be solved, but it seems that time for a strong intervention in order to improve the situation has to come.

[Disseminated intravascular coagulation in chickenpox. Report of a case in a child]. / CID in corso di varicella. Descrizione di un caso in un bambino.

The case of a healthy and immunocompetent five-year-old boy, who developed a disseminated intravascular coagulation during chickenpox is described. Disseminated intravascular coagulation manifestations were extremely severe and included macroscopic hematuria, necrotic purpura and cerebrovascular thrombosis. The outcome in this patient was a complete recovery. Nevertheless, the possibility of a seriously complicated course of chickenpox even in low-risk children subgroups suggests that the Varicella-Zoster virus infection should not be underestimated. More accurate information about the impact of chickenpox and its complications on the population is needed, in order to provide a contribution for the debate about the costs associated with this disease and the potential benefits of both the early antiviral therapy and the vaccinal prophylaxis.