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1.
Ann Ist Super Sanita ; 60(1): 72-76, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38920261

RESUMEN

BACKGROUND: At the beginning of 2020, worldwide public debate focused on the fight against the climate crisis. Many challenges are ahead of us, from health emergencies, with the pandemics underway, to the exhaustion of natural resources, to major climate change. DISCUSSION: Many cities face health threats related to urban and land use planning, while infectious diseases thrive in overcrowded cities: living in unhealthy environments killed 12,6 million people in 2012 and air pollution killed 7 million people in 2016. Urbanization is one of the major global trends of the 21st century and has a significant impact on health. Over 55% of the world's population lives in urban areas, a percentage that is expected to increase to 68% by 2050. CONCLUSIONS: Developing new and more sustainable ways of living, moving, utilizing resources, and accessing services including healthcare and education, is crucial to preserve our future and the future of the next generations.


Asunto(s)
COVID-19 , Ciudades , Cambio Climático , Humanos , COVID-19/epidemiología , COVID-19/prevención & control , Urbanización , Salud Urbana , Pandemias
3.
Chemosphere ; 359: 142246, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38710414

RESUMEN

The knowledge and assessment of mixtures of chemical pollutants in the aquatic environment is a complex issue that is often challenging to address. In this review, we focused on the use of zebrafish (Danio rerio), a vertebrate widely used in biomedical research, as a model for detecting the effects of chemical mixtures with a focus on behaviour. Our aim was to summarize the current status of the ecotoxicological research in this sector. Specifically, we limited our research to the period between January 2012 and September 2023, including only those works aimed at detecting neurotoxicity through behavioural endpoints, utilizing zebrafish at one or more developmental stages, from egg to adult. Additionally, we gathered the findings for every group of chemicals involved and summarised data from all the works we included. At the end of the screening process 101 papers were considered eligible for inclusion. Results show a growing interest in zebrafish at all life stages for this kind of research in the last decade. Also, a wide variety of different assays, involving different senses, was used in the works we surveyed, with exposures ranging from acute to chronic. In conclusion, the results of this study show the versatility of zebrafish as a model for the detection of mixture toxicity although, for what concerns behavioural analysis, the lack of standardisation of methods and endpoints might still be limiting.


Asunto(s)
Conducta Animal , Síndromes de Neurotoxicidad , Contaminantes Químicos del Agua , Pez Cebra , Animales , Contaminantes Químicos del Agua/toxicidad , Conducta Animal/efectos de los fármacos , Síndromes de Neurotoxicidad/etiología , Pruebas de Toxicidad/métodos , Ecotoxicología/métodos
4.
BMC Med Imaging ; 24(1): 104, 2024 May 03.
Artículo en Inglés | MEDLINE | ID: mdl-38702613

RESUMEN

BACKGROUND: The role of isocitrate dehydrogenase (IDH) mutation status for glioma stratification and prognosis is established. While structural magnetic resonance image (MRI) is a promising biomarker, it may not be sufficient for non-invasive characterisation of IDH mutation status. We investigated the diagnostic value of combined diffusion tensor imaging (DTI) and structural MRI enhanced by a deep radiomics approach based on convolutional neural networks (CNNs) and support vector machine (SVM), to determine the IDH mutation status in Central Nervous System World Health Organization (CNS WHO) grade 2-4 gliomas. METHODS: This retrospective study analyzed the DTI-derived fractional anisotropy (FA) and mean diffusivity (MD) images and structural images including fluid attenuated inversion recovery (FLAIR), non-enhanced T1-, and T2-weighted images of 206 treatment-naïve gliomas, including 146 IDH mutant and 60 IDH-wildtype ones. The lesions were manually segmented by experienced neuroradiologists and the masks were applied to the FA and MD maps. Deep radiomics features were extracted from each subject by applying a pre-trained CNN and statistical description. An SVM classifier was applied to predict IDH status using imaging features in combination with demographic data. RESULTS: We comparatively assessed the CNN-SVM classifier performance in predicting IDH mutation status using standalone and combined structural and DTI-based imaging features. Combined imaging features surpassed stand-alone modalities for the prediction of IDH mutation status [area under the curve (AUC) = 0.846; sensitivity = 0.925; and specificity = 0.567]. Importantly, optimal model performance was noted following the addition of demographic data (patients' age) to structural and DTI imaging features [area under the curve (AUC) = 0.847; sensitivity = 0.911; and specificity = 0.617]. CONCLUSIONS: Imaging features derived from DTI-based FA and MD maps combined with structural MRI, have superior diagnostic value to that provided by standalone structural or DTI sequences. In combination with demographic information, this CNN-SVM model offers a further enhanced non-invasive prediction of IDH mutation status in gliomas.


Asunto(s)
Neoplasias Encefálicas , Imagen de Difusión Tensora , Glioma , Isocitrato Deshidrogenasa , Mutación , Humanos , Isocitrato Deshidrogenasa/genética , Glioma/diagnóstico por imagen , Glioma/genética , Glioma/patología , Imagen de Difusión Tensora/métodos , Estudios Retrospectivos , Masculino , Femenino , Persona de Mediana Edad , Neoplasias Encefálicas/diagnóstico por imagen , Neoplasias Encefálicas/genética , Adulto , Anciano , Clasificación del Tumor , Máquina de Vectores de Soporte , Imagen por Resonancia Magnética/métodos , Redes Neurales de la Computación , Radiómica
5.
Hum Brain Mapp ; 45(2): e26578, 2024 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-38339907

RESUMEN

Fibre tract delineation from diffusion magnetic resonance imaging (MRI) is a valuable clinical tool for neurosurgical planning and navigation, as well as in research neuroimaging pipelines. Several popular methods are used for this task, each with different strengths and weaknesses making them more or less suited to different contexts. For neurosurgical imaging, priorities include ease of use, computational efficiency, robustness to pathology and ability to generalise to new tracts of interest. Many existing methods use streamline tractography, which may require expert neuroimaging operators for setting parameters and delineating anatomical regions of interest, or suffer from as a lack of generalisability to clinical scans involving deforming tumours and other pathologies. More recently, data-driven approaches including deep-learning segmentation models and streamline clustering methods have improved reproducibility and automation, although they can require large amounts of training data and/or computationally intensive image processing at the point of application. We describe an atlas-based direct tract mapping technique called 'tractfinder', utilising tract-specific location and orientation priors. Our aim was to develop a clinically practical method avoiding streamline tractography at the point of application while utilising prior anatomical knowledge derived from only 10-20 training samples. Requiring few training samples allows emphasis to be placed on producing high quality, neuro-anatomically accurate training data, and enables rapid adaptation to new tracts of interest. Avoiding streamline tractography at the point of application reduces computational time, false positives and vulnerabilities to pathology such as tumour deformations or oedema. Carefully filtered training streamlines and track orientation distribution mapping are used to construct tract specific orientation and spatial probability atlases in standard space. Atlases are then transformed to target subject space using affine registration and compared with the subject's voxel-wise fibre orientation distribution data using a mathematical measure of distribution overlap, resulting in a map of the tract's likely spatial distribution. This work includes extensive performance evaluation and comparison with benchmark techniques, including streamline tractography and the deep-learning method TractSeg, in two publicly available healthy diffusion MRI datasets (from TractoInferno and the Human Connectome Project) in addition to a clinical dataset comprising paediatric and adult brain tumour scans. Tract segmentation results display high agreement with established techniques while requiring less than 3 min on average when applied to a new subject. Results also display higher robustness than compared methods when faced with clinical scans featuring brain tumours and resections. As well as describing and evaluating a novel proposed tract delineation technique, this work continues the discussion on the challenges surrounding the white matter segmentation task, including issues of anatomical definitions and the use of quantitative segmentation comparison metrics.


Asunto(s)
Sustancia Blanca , Adulto , Humanos , Niño , Sustancia Blanca/diagnóstico por imagen , Imagen de Difusión Tensora/métodos , Reproducibilidad de los Resultados , Imagen de Difusión por Resonancia Magnética/métodos , Neuroimagen , Procesamiento de Imagen Asistido por Computador/métodos , Encéfalo/diagnóstico por imagen
6.
Magn Reson Med ; 91(4): 1354-1367, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38073061

RESUMEN

PURPOSE: Amide proton transfer-weighted (APTw) MRI at 3T provides a unique contrast for brain tumor imaging. However, APTw imaging suffers from hyperintensities in liquid compartments such as cystic or necrotic structures and provides a distorted APTw signal intensity. Recently, it has been shown that heuristically motivated fluid suppression can remove such artifacts and significantly improve the readability of APTw imaging. THEORY AND METHODS: In this work, we show that the fluid suppression can actually be understood by the known concept of spillover dilution, which itself can be derived from the Bloch-McConnell equations in comparison to the heuristic approach. Therefore, we derive a novel post-processing formula that efficiently removes fluid artifact, and explains previous approaches. We demonstrate the utility of this APTw assessment in silico, in vitro, and in vivo in brain tumor patients acquired at MR scanners from different vendors. RESULTS: Our results show a reduction of the CEST signals from fluid environments while keeping the APTw-CEST signal intensity almost unchanged for semi-solid tissue structures such as the contralateral normal appearing white matter. This further allows us to use the same color bar settings as for conventional APTw imaging. CONCLUSION: Fluid suppression has considerable value in improving the readability of APTw maps in the neuro-oncological field. In this work, we derive a novel post-processing formula from the underlying Bloch-McConnell equations that efficiently removes fluid artifact, and explains previous approaches which justify the derivation of this metric from a theoretical point of view, to reassure the scientific and medical field about its use.


Asunto(s)
Neoplasias Encefálicas , Sustancia Blanca , Humanos , Protones , Amidas , Imagen por Resonancia Magnética/métodos , Neoplasias Encefálicas/diagnóstico por imagen , Neoplasias Encefálicas/patología , Sustancia Blanca/patología
7.
One Health ; 17: 100613, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-37588423

RESUMEN

Introduction: As the COVID-19 pandemic has demonstrated, the complexity of factors involved in the emergence of health threats requires a holistic One Health (OH) approach to enhance the effectiveness of prevention, preparedness, and response (PPR) strategies. Therefore, we conducted a scoping review to explore how the OH approach has been adopted in the context of PPR strategies to health threats, and the challenges and benefits deriving from its integration. Methods: We defined the research questions and a strategy to guide the peer-reviewed and grey literature search to identify relevant articles and documents (identification). We assessed them for eligibility according to predefined criteria (screening) and finally included the ones that answered the research questions (inclusion). We performed a descriptive and thematic analysis of the results. Results: A total of 138 records were included in the review (57 from the peer-reviewed literature and 81 from the grey literature). The OH approach was mainly adopted in prevention strategies, particularly within the governance area. Human and animal health were the most integrated disciplines in the OH approach, while environmental and social sciences were the less integrated. The most targeted threats were antimicrobial resistance and zoonoses, with the African region being the most represented. Conducive factors for the adoption of OH PPR strategies were identified in resolutions and guidance emanating from international organisations. Discussion: The global governance of OH should utilise conducive factors, such as international resolutions and guidance, to enhance the adoption of multisectoral and multi-actor PPR strategies, that focus on national and international priorities and neglected threats, such as environmental hazards and pandemic risk. Integrated frameworks and metrics for the implementation and evaluation of OH PPR strategies need to be consolidated to contribute to the growing body of evidence supporting the adoption of the OH approach.

8.
Netw Neurosci ; 7(2): 478-495, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37397890

RESUMEN

Beyond the established effects of subthalamic nucleus deep brain stimulation (STN-DBS) in reducing motor symptoms in Parkinson's disease, recent evidence has highlighted the effect on non-motor symptoms. However, the impact of STN-DBS on disseminated networks remains unclear. This study aimed to perform a quantitative evaluation of network-specific modulation induced by STN-DBS using Leading Eigenvector Dynamics Analysis (LEiDA). We calculated the occupancy of resting-state networks (RSNs) in functional MRI data from 10 patients with Parkinson's disease implanted with STN-DBS and statistically compared between ON and OFF conditions. STN-DBS was found to specifically modulate the occupancy of networks overlapping with limbic RSNs. STN-DBS significantly increased the occupancy of an orbitofrontal limbic subsystem with respect to both DBS OFF (p = 0.0057) and 49 age-matched healthy controls (p = 0.0033). Occupancy of a diffuse limbic RSN was increased with STN-DBS OFF when compared with healthy controls (p = 0.021), but not when STN-DBS was ON, which indicates rebalancing of this network. These results highlight the modulatory effect of STN-DBS on components of the limbic system, particularly within the orbitofrontal cortex, a structure associated with reward processing. These results reinforce the value of quantitative biomarkers of RSN activity in evaluating the disseminated impact of brain stimulation techniques and the personalization of therapeutic strategies.

9.
Anim Cogn ; 26(5): 1661-1673, 2023 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-37458893

RESUMEN

Nonlinear phenomena (NLP) in animal vocalizations arise from irregularities in the oscillation of the vocal folds. Various non-mutually exclusive hypotheses have been put forward to explain the occurrence of NLP, from adaptive to physiological ones. Non-human primates often display NLP in their vocalizations, yet the communicative role of these features, if any, is still unclear. We here investigate the occurrence of NLP in the song of a singing primate, the indri (Indri indri), testing for the effect of sex, age, season, and duration of the vocal display on their emission. Our results show that NLP occurrence in indri depends on phonation, i.e., the cumulative duration of all the units emitted by an individual, and that NLP have higher probability to be emitted in the later stages of the song, probably due to the fatigue indris may experience while singing. Furthermore, NLP happen earlier in the vocal display of adult females than in that of the adult males, and this is probably due to the fact that fatigue occurs earlier in the former because of a greater contribution within the song. Our findings suggest, therefore, that indris may be subjected to physiological constraints during the singing process which may impair the production of harmonic sounds. However, indris may still benefit from emitting NLP by strengthening the loudness of their signals for better advertising their presence to the neighboring conspecific groups.


Asunto(s)
Indriidae , Canto , Masculino , Femenino , Animales , Indriidae/fisiología , Vocalización Animal/fisiología , Sonido , Comunicación
10.
Eur Radiol ; 33(9): 6081-6093, 2023 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-37410110

RESUMEN

OBJECTIVES: Lateralisation of some language pathways has been reported in the literature using diffusion tractography, which is more feasible than functional magnetic resonance imaging (fMRI) in challenging patients. Our retrospective study investigates whether a correlation exists between threshold-independent fMRI language lateralisation and structural lateralisation using tractography in healthy controls and brain tumour patients. METHODS: Fifteen healthy subjects and 61 patients underwent language fMRI and diffusion-weighted MRI. A regional fMRI laterality index (LI) was calculated. Tracts dissected were the arcuate fasciculus (long direct and short indirect tracts), uncinate fasciculus, inferior longitudinal fasciculus, inferior fronto-occipital fasciculus and frontal aslant tract. An asymmetry index (AI) for each tract was calculated using tract volume analysed with single tensor (ST) and spherical deconvolution (SD) models, as well as hindrance modulated orientational anisotropy (HMOA) for SD tracts. Linear regression assessed the correlation between LI and AI. RESULTS: In all subjects, there was no significant correlation between LI and AI for any of the dissected tracts. Significant correlations were only found when handedness for controls and tumour volume for patients were included as covariates. In handedness subgroups, the average AI of some tracts showed the same laterality as LI, and some the opposite. Discordant results were observed for ST- and SD-based AIs. CONCLUSIONS: Our results do not support using tractography in the assessment of language lateralisation. The discordant results between ST and SD indicate that either the structural lateralisation of dissected tracts is less robust than functional lateralisation, or tractography is not sensitive methodology. Other diffusion analysis approaches should be developed. CLINICAL RELEVANCE STATEMENT: Although diffusion tractography may be more feasible than fMRI in challenging tumour patients and where sedation or anaesthesia is required, our results do not currently recommend replacing fMRI with tractography using volume or HMOA in the assessment of language lateralisation. KEY POINTS: • No correlation found between fMRI and tractography in language lateralisation. • Discordance between asymmetry indices of different tractography models and metrics. • Tractography not currently recommended in language lateralisation assessment.


Asunto(s)
Imagen por Resonancia Magnética , Sustancia Blanca , Humanos , Estudios Retrospectivos , Imagen por Resonancia Magnética/métodos , Sustancia Blanca/diagnóstico por imagen , Sustancia Blanca/patología , Imagen de Difusión por Resonancia Magnética , Lenguaje , Vías Nerviosas
11.
Sci Total Environ ; 898: 165564, 2023 Nov 10.
Artículo en Inglés | MEDLINE | ID: mdl-37467998

RESUMEN

Given the widespread presence of plastics, especially in micro- and nanoscale sizes, in freshwater systems, it is crucial to identify a suitable model organism for assessing the potential toxic and teratogenic effects of exposure to plastic particles. Until now, the early life stage of freshwater organisms and the regeneration capacity in relation to plastic particles exposure is a still poorly investigated topic. In this study, we examine the teratogenic effect on diatom Cocconeis placentula and cnidarian Hydra vulgaris under controlled exposure conditions of poly(styrene-co-methyl methacrylate) (P(S-co-MMA)) particles. Significant effects were observed at the lowest concentrations (0.1 µg/L). A significant increase in the teratological frequency in C. placentula and a significant decrease in the regeneration rate in H. vulgaris were found at the lowest concentration. The delay in hydra regeneration impaired the feeding capacity and tentacles reactivity at 96 h of exposure. No effects on diatom growth were observed upon exposure to P(S-co-MMA) particles (0.1, 1, 100, 10,000 µg/L) for 28 days and these findings agree with other studies investigating algal growth. The application of the Teratogenic Risk Index, modified for diatoms, highlighted a moderate risk for the lowest concentration evaluating C. placentula and low risk at the lowest and the highest concentrations considering H. vulgaris. This study suggests the importance of testing organisms belonging to different trophic levels as diverse teratogenic effects can be found and the need to evaluate environmentally relevant concentrations of plastic particles.


Asunto(s)
Cnidarios , Hydra , Contaminantes Químicos del Agua , Animales , Contaminantes Químicos del Agua/toxicidad , Organismos Acuáticos , Agua Dulce , Plásticos/toxicidad
12.
Eur Radiol ; 33(11): 8067-8076, 2023 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-37328641

RESUMEN

OBJECTIVES: Surgical planning of vestibular schwannoma surgery would benefit greatly from a robust method of delineating the facial-vestibulocochlear nerve complex with respect to the tumour. This study aimed to optimise a multi-shell readout-segmented diffusion-weighted imaging (rs-DWI) protocol and develop a novel post-processing pipeline to delineate the facial-vestibulocochlear complex within the skull base region, evaluating its accuracy intraoperatively using neuronavigation and tracked electrophysiological recordings. METHODS: In a prospective study of five healthy volunteers and five patients who underwent vestibular schwannoma surgery, rs-DWI was performed and colour tissue maps (CTM) and probabilistic tractography of the cranial nerves were generated. In patients, the average symmetric surface distance (ASSD) and 95% Hausdorff distance (HD-95) were calculated with reference to the neuroradiologist-approved facial nerve segmentation. The accuracy of patient results was assessed intraoperatively using neuronavigation and tracked electrophysiological recordings. RESULTS: Using CTM alone, the facial-vestibulocochlear complex of healthy volunteer subjects was visualised on 9/10 sides. CTM were generated in all 5 patients with vestibular schwannoma enabling the facial nerve to be accurately identified preoperatively. The mean ASSD between the annotators' two segmentations was 1.11 mm (SD 0.40) and the mean HD-95 was 4.62 mm (SD 1.78). The median distance from the nerve segmentation to a positive stimulation point was 1.21 mm (IQR 0.81-3.27 mm) and 2.03 mm (IQR 0.99-3.84 mm) for the two annotators, respectively. CONCLUSIONS: rs-DWI may be used to acquire dMRI data of the cranial nerves within the posterior fossa. CLINICAL RELEVANCE STATEMENT: Readout-segmented diffusion-weighted imaging and colour tissue mapping provide 1-2 mm spatially accurate imaging of the facial-vestibulocochlear nerve complex, enabling accurate preoperative localisation of the facial nerve. This study evaluated the technique in 5 healthy volunteers and 5 patients with vestibular schwannoma. KEY POINTS: • Readout-segmented diffusion-weighted imaging (rs-DWI) with colour tissue mapping (CTM) visualised the facial-vestibulocochlear nerve complex on 9/10 sides in 5 healthy volunteer subjects. • Using rs-DWI and CTM, the facial nerve was visualised in all 5 patients with vestibular schwannoma and within 1.21-2.03 mm of the nerve's true intraoperative location. • Reproducible results were obtained on different scanners.


Asunto(s)
Neuroma Acústico , Humanos , Neuroma Acústico/diagnóstico por imagen , Neuroma Acústico/cirugía , Neuroma Acústico/patología , Estudios Prospectivos , Imagen de Difusión Tensora/métodos , Imagen de Difusión por Resonancia Magnética , Nervio Facial/diagnóstico por imagen , Nervio Facial/patología , Nervio Vestibulococlear/patología
13.
Front Allergy ; 4: 1079945, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37089704

RESUMEN

Introduction: We previously demonstrated functionally significant structural plasticity within the central olfactory networks, in association with improved olfaction after surgical treatment of chronic rhinosinusitis (CRS). In order to confirm and expand on these findings, the primary aim of this study was to determine whether these same regions undergo functionally significant structural plasticity following functional septorhinoplasty (fSRP), in patients with non-CRS olfactory dysfunction (OD) of mixed cause. fSRP has previously been shown to improve olfactory function, and the secondary aim of this study was to provide initial insights into the mechanism by which fSRP affects olfaction. Methods: We performed a pilot prospective, multimodal neuroimaging study in 20 participants undergoing fSRP, including patients with non-CRS OD of mixed cause, as well as normosmic surgical controls. Participants underwent psychophysical olfactory testing, assessment of nasal airway, structural and functional neuroimaging. This was performed pre- and postoperatively in patients, and preoperatively in controls. Results: There was a statistically and clinically significant improvement in mean psychophysical olfactory scores after surgery. This was associated with structural and functional plasticity within areas of the central olfactory network (anterior cingulate, orbitofrontal cortex, insula, temporal pole). Improved psychophysical scores were significantly correlated with change in bilateral measures of nasal airflow, not measures of airflow symmetry, suggesting that improved overall airflow was more important than correction of septal deviation. Conclusion: This work highlights the importance of these neuroanatomical regions as potential structural correlates of olfactory function and dysfunction. Our results also provide initial insight into the mechanistic effects of fSRP on olfaction. Further work could investigate the utility of these regions as personalised biomarkers of OD, as well as the role of fSRP in treating OD.

14.
J Magn Reson Imaging ; 57(6): 1676-1695, 2023 06.
Artículo en Inglés | MEDLINE | ID: mdl-36912262

RESUMEN

Preoperative clinical MRI protocols for gliomas, brain tumors with dismal outcomes due to their infiltrative properties, still rely on conventional structural MRI, which does not deliver information on tumor genotype and is limited in the delineation of diffuse gliomas. The GliMR COST action wants to raise awareness about the state of the art of advanced MRI techniques in gliomas and their possible clinical translation. This review describes current methods, limits, and applications of advanced MRI for the preoperative assessment of glioma, summarizing the level of clinical validation of different techniques. In this second part, we review magnetic resonance spectroscopy (MRS), chemical exchange saturation transfer (CEST), susceptibility-weighted imaging (SWI), MRI-PET, MR elastography (MRE), and MR-based radiomics applications. The first part of this review addresses dynamic susceptibility contrast (DSC) and dynamic contrast-enhanced (DCE) MRI, arterial spin labeling (ASL), diffusion-weighted MRI, vessel imaging, and magnetic resonance fingerprinting (MRF). EVIDENCE LEVEL: 3. TECHNICAL EFFICACY: Stage 2.


Asunto(s)
Neoplasias Encefálicas , Glioma , Imagen por Resonancia Magnética , Humanos , Neoplasias Encefálicas/diagnóstico por imagen , Neoplasias Encefálicas/cirugía , Neoplasias Encefálicas/patología , Medios de Contraste , Glioma/diagnóstico por imagen , Glioma/cirugía , Glioma/patología , Imagen por Resonancia Magnética/métodos , Espectroscopía de Resonancia Magnética/métodos , Periodo Preoperatorio
15.
Ann Ist Super Sanita ; 59(1): 51-55, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36974705

RESUMEN

BACKGROUND: The Health Impact Assessment (HIA) is a procedure with the aim to protect the populations exposed to the impacts deriving from the establishment or upgrading of large industrial enterprises, i.e. large combustion plants (>300 MWth). In Italy a guideline for the HIA procedure has been published in compliance with the 2014/52/EU Directive on the Environmental Impact Assessment (EIA) requirements. Italian HIA procedure. An ecotoxicological approach has been included for the first time in the HIA procedure with the aim to detect toxic effects caused by unknown not-monitored contaminants or mixtures in the ecosystem components affected by the potential emissions, discharges and releases of large industrial enterprises. Ecotoxicology plays an important bridge role between environment and human health in the scoping and monitoring step of the HIA procedure with a key function of early warning system and screening. The aim of this paper is to present the Italian experience in the first three years of the application of the new approach, proposing recommendations on specific case studies. Conclusion and future perspective. 80% of enterprises, that applied HIA, have delivered a robust, integrated and detailed documentation in relation to the ecotoxicological assessment, this positive feedback will generate environmental and human health benefits to the areas where the plants are established.


Asunto(s)
Ecosistema , Ecotoxicología , Humanos , Ambiente , Italia , Evaluación del Impacto en la Salud/métodos
16.
J Magn Reson Imaging ; 57(6): 1655-1675, 2023 06.
Artículo en Inglés | MEDLINE | ID: mdl-36866773

RESUMEN

Preoperative clinical magnetic resonance imaging (MRI) protocols for gliomas, brain tumors with dismal outcomes due to their infiltrative properties, still rely on conventional structural MRI, which does not deliver information on tumor genotype and is limited in the delineation of diffuse gliomas. The GliMR COST action wants to raise awareness about the state of the art of advanced MRI techniques in gliomas and their possible clinical translation or lack thereof. This review describes current methods, limits, and applications of advanced MRI for the preoperative assessment of glioma, summarizing the level of clinical validation of different techniques. In this first part, we discuss dynamic susceptibility contrast and dynamic contrast-enhanced MRI, arterial spin labeling, diffusion-weighted MRI, vessel imaging, and magnetic resonance fingerprinting. The second part of this review addresses magnetic resonance spectroscopy, chemical exchange saturation transfer, susceptibility-weighted imaging, MRI-PET, MR elastography, and MR-based radiomics applications. Evidence Level: 3 Technical Efficacy: Stage 2.


Asunto(s)
Neoplasias Encefálicas , Glioma , Humanos , Imagen por Resonancia Magnética/métodos , Glioma/diagnóstico por imagen , Glioma/cirugía , Glioma/patología , Neoplasias Encefálicas/diagnóstico por imagen , Neoplasias Encefálicas/cirugía , Neoplasias Encefálicas/patología , Espectroscopía de Resonancia Magnética/métodos , Imagen de Difusión por Resonancia Magnética
17.
J Glob Antimicrob Resist ; 32: 104-107, 2023 03.
Artículo en Inglés | MEDLINE | ID: mdl-36764658

RESUMEN

OBJECTIVES: Around the globe, escalation in rare opportunistic microbial infections is alarming as they are heading steadily towards 'superbug' status. In aquatic ecosystems, plastic fosters multidrug-resistant pathogenic bacteria and plays a significant role in trafficking antibiotic-resistant genes. In this study, we focused on a multidrug-resistant bacterial strain isolated from microbial communities found on plastic substrates of a volcanic lake in central Italy. METHODS: Extended-spectrum beta-lactamase-producing strains were isolated from both raw water and plastic substrates for a comparative investigation using microbiological and molecular methods, and antibiotic susceptibility profiling was performed against a panel of ten antibiotics. RESULTS: Molecular identification and Basic Local Alignment Search Tool analysis confirmed an almost identical sequencing pattern of two isolated strains and their homology with Morganella morganii. Antibiotic susceptibility tests revealed their resistance to almost all tested antibiotics. Class 1 integron-associated gene (intI1) and seven antibiotic resistance genes were detected in both strains, confirming their superbug status. CONCLUSION: To our knowledge, this is the first study on the characterization of extended-spectrum beta-lactamase-producing M. morganii isolated from the biofilm of plastic substrates, depicting the potential toxicity of plastic in harbouring and dispersing virulent, multidrug-resistant, opportunistic human pathogens.


Asunto(s)
Infecciones por Enterobacteriaceae , Morganella morganii , Humanos , Morganella morganii/genética , Ecosistema , Infecciones por Enterobacteriaceae/microbiología , Antibacterianos/farmacología , Farmacorresistencia Bacteriana Múltiple/genética , beta-Lactamasas/genética , beta-Lactamasas/metabolismo
18.
J Neurosurg ; 139(3): 873-880, 2023 09 01.
Artículo en Inglés | MEDLINE | ID: mdl-36708535

RESUMEN

OBJECTIVE: Despite the disabling deficits of motor apraxia and sensory ataxia resulting from intraoperative injury of the superior thalamocortical tracts (TCTs), region-specific electrophysiological localization is currently lacking. Herein, the authors describe a novel TCT mapping paradigm. METHODS: Three patients, 1 asleep and 2 awake, underwent glioma resection affecting primarily the somatosensory cortex and underlying TCT. Stimulation was performed at the median, ulnar, and posterior tibial nerves. Parameters comprised single anodal pulses (duration 200-500 µsec, 2.1-4.7 Hz) with a current ranging from 10 to 25 mA. Recordings were captured with a bipolar stimulation probe, avoiding the classic collision technique. Positive localization sites were used to tractographically reconstruct the TCT in the third case. RESULTS: Employing one electrophysiological paradigm, the TCT was localized subcortically in all 3 cases by using a bipolar probe, peak range of 19.6-29.2 msec, trough of 23.3-34.8 msec, stimulation range of 10-25 mA. In the last case, tractographic reconstruction of the TCT validated a highly accurate TCT localization within a specific region of the posterior limb of the internal capsule. CONCLUSIONS: The authors describe the first electrophysiological technique for intraoperative localization and protection of the TCT in both asleep and awake craniotomies with tractographic validation, while avoiding the collision paradigm. None of the above paradigms have been previously reported. More data are required to further validate this technique.


Asunto(s)
Neoplasias Encefálicas , Glioma , Humanos , Neoplasias Encefálicas/diagnóstico por imagen , Neoplasias Encefálicas/cirugía , Vigilia , Mapeo Encefálico/métodos , Glioma/cirugía , Craneotomía/métodos
19.
Environ Toxicol Chem ; 42(5): 966-977, 2023 05.
Artículo en Inglés | MEDLINE | ID: mdl-36541332

RESUMEN

Human activities severely affect aquatic ecosystems: the lockdown restrictions due to SARS-CoV-2 (COVID-19) have proved that reducing anthropogenic activities can positively influence the environment and mitigate atmospheric pollution. In addition, studies on aquatic ecosystems have highlighted the decrease in suspended matter and pollutant concentrations associated with reduced marine transport and industrial activities. We evaluated the effects of the reduction of anthropogenic activities in highly impacted water ecosystems. Three of the sampling sites were on the Tiber River's lower stretch close to the urban area of Rome (Italy), and the other two were transitional waters located in the southern Latium region coastal area. These sampling sites have been studied by our research group for at least 20 years. The present study involved analysis of chemical and physicochemical parameters, biological communities, and land use. Microbiological fecal indicators and Salmonella spp. were also analyzed. There were two sampling campaigns, the first one in May 2020 (ID II) at the end of lockdown measures, and the second one a year later, in June 2021 (ID III). The data were compared with our old data, collected from 2002 to 2015 (ID I), to evaluate the potential effects of the restrictive measures. Biotic communities were dominated by pollution-tolerant taxa, indicating eutrophication and organic pollution. Furthermore, the high concentrations of microbiological indicators was mainly due to sewage from the urban area. The results of the research indicated no significant changes from past years (ID I) to 2020 (ID II) and 2021 (ID III). In conclusion, the restrictions adopted in Italy during the pandemic period were not sufficient to mitigate the heavy pressure of urbanization and agriculture that have long affected the studied aquatic ecosystems. Environ Toxicol Chem 2023;42:966-977. © 2022 The Authors. Environmental Toxicology and Chemistry published by Wiley Periodicals LLC on behalf of SETAC.


Asunto(s)
COVID-19 , Ecosistema , Humanos , Pandemias , SARS-CoV-2 , Control de Enfermedades Transmisibles , Monitoreo del Ambiente
20.
Nutr Rev ; 81(2): 153-167, 2023 01 10.
Artículo en Inglés | MEDLINE | ID: mdl-35950956

RESUMEN

CONTEXT: Strenuous exercise may lead to negative acute physiological effects that can impair athletic performance. Some recent studies suggest that probiotic supplementation can curtail these effects by reducing the permeability of the intestinal barrier, yet results are inconsistent. OBJECTIVE: The aim of this systematic review is to assess the effects of probiotic supplementation on athletic performance. DATA SOURCES: The PubMed/MEDLINE, Cochrane, and Scopus databases were searched for articles that assessed the effects of probiotic supplementation on athletic performance. DATA EXTRACTION THIS SYSTEMATIC REVIEW IS REPORTED ACCORDING TO: PRISMA guidelines. Risk of bias was assessed through the Cochrane RoB 2.0 tool. Seventeen randomized clinical trials assessing athletic performance as the primary outcome were included. In total, 496 individuals (73% male) comprising athletes, recreationally trained individuals, and untrained healthy individuals aged 18 to 40 years were investigated. DATA ANALYSIS: Three studies showed an increase or an attenuation of aerobic performance (decline in time to exhaustion on the treadmill) after supplementation with probiotics, while 3 found an increase in strength. However, most studies (n = 11) showed no effect of probiotic consumption on aerobic performance (n = 9) or muscular strength (n = 2). The most frequently used strain was Lactobacillus acidophilus, used in 2 studies that observed positive results on performance. Studies that used Lactobacillus plantarum TK10 and Lactobacillus plantarum PS128 also demonstrated positive effects on aerobic performance and strength, but they had high risk of bias, which implies low confidence about the actual effect of treatment. CONCLUSION: There is not enough evidence to support the hypothesis that probiotics can improve performance in resistance and aerobic exercises. Further well-controlled studies are warranted.


Asunto(s)
Rendimiento Atlético , Probióticos , Humanos , Masculino , Femenino , Probióticos/uso terapéutico , Ejercicio Físico , Rendimiento Atlético/fisiología , Atletas , Fuerza Muscular
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