Is neuregulin 1 involved in determining cerebral volumes in schizophrenia? Preliminary results showing a decrease in superior temporal gyrus volume.

BACKGROUND/AIMS: Reduced left superior temporal gyrus (STG) volume is one of the most replicated imaging findings in schizophrenia. However, it remains unclear whether genes play any role in our understanding of such structural alteration. It has been proposed that Neuregulin 1 (NRG1) might be a promising gene involved in schizophrenia, because of its role in neurodevelopment and neuroplasticity. In this study, the association between NRG1 and STG anatomy in patients with schizophrenia was explored for the first time. METHODS: We investigated a 1-year treated prevalence cohort of patients with schizophrenia in contact with the South Verona Community-Based Mental Health Service. A blood sample was collected for DNA extraction and brain structure was assessed with an MRI scan. A total of 27 subjects with schizophrenia underwent both assessments and were included in the study. RESULTS: We investigated the association between the polymorphism SNP8NRG222662 (rs4623364) of NRG1 and volume of the STG. We found that patients homozygous for the C allele had reduced left STG gray and white matter volumes in comparison to those homozygous for the G allele (p < 0.01 and p < 0.001, respectively). CONCLUSIONS: This exploratory study suggests that NRG1 may be involved in determining STG size in schizophrenia, and may play a role in the neurogenetic basis of the language disturbances seen in this disorder. However, due to our small sample size, the results should be regarded as preliminary and replicated in a larger sample.

Cost analysis of equipment failure of a radiology department and possible choices about maintenance.

PURPOSE: Our aim was to evaluate the economic impact of equipment failures in a radiology department with a view to guiding maintenance policy decisions. MATERIAL AND METHODS: We assessed the negative economic impact caused by the interruption of activity of a radiodiagnostics section due to equipment failure, taking into account: the effects occurring during the first day of equipment down-time (assuming that the equipment failure occurs in the middle of the shift) and the effects during the following days until the repair of the failure; the effects occurring in the short- and long-term. To exemplify the negative impact of inactivity due to equipment failure, we chose three radiology sections with different levels of technological and operational complexity (chest radiology, gastrointestinal radiology and remote-controlled diagnostics). For each, we evaluated the loss of contribution margin and the idle capacity costs (short- and long-term impact). RESULTS: The negative economic effects were: for thoracic radiology, 496,77 Euro in the first day, and 30,99 Euro from the second day onwards; for gastrointestinal radiology, 526,40 Euro for the first day, and 730,39 Euro from the second day onwards; for remote-controlled diagnostics, 786,25 Euro for the first day, and 927,67 Euro from the second days onwards. DISCUSSION: Our results indicate that the level of idle capacity costs (mainly equipment and staff) increases with the complexity of the equipment, whereas the contribution margin appears to fluctuate, because the charges are state-imposed and do not vary with the complexity of equipment. Moreover, our analysis shows that if the workload of a broken machine can easily be assigned to an additional shift using another machine, losses are considerably reduced from the second day onwards. Once the negative economic impact of equipment failures has been evaluated, the second step is to choose the best kind of maintenance. CONCLUSIONS: A sound calculation of the economic impact of equipment failures is very useful for guiding the head of department and the hospital manager in deciding whether to purchase maintenance services (or a long-term guarantee) from the equipment manufacturer, to set up an auxiliary centre for maintenance and repair, or to purchase a third-party maintenance contract.