Intra-individual cortical networks in Anorexia Nervosa: Evidence from a longitudinal dataset.

OBJECTIVE: This work investigates cortical thickness (CT) and gyrification patterns in Anorexia Nervosa (AN) before and after short-term weight restoration using graph theory tools. METHODS: 38 female adolescents with AN underwent structural magnetic resonance imaging scans at baseline and after - on average - 3.5 months following short-term weight restoration while 53 age-matched healthy controls (HCs) were scanned once. Graph measures were compared between groups and longitudinally within the AN group. Associations with clinical measures such as age of onset, duration of illness, BMI standard deviation score (BMI-SDS), and longitudinal weight changes were tested via stepwise regression. RESULTS: Cortical thickness graphs of patients with acute AN displayed lower modularity and small-world index (SWI) than HCs. Modularity recovered after weight gain. Reduced global efficiency and SWI were observed in patients at baseline compared to HCs based on gyrification networks. Significant associations between local clustering of CT at admission and BMI-SDS, and clustering/global efficiency of gyrification and duration of illness emerged. CONCLUSIONS: Our results indicate a shift towards less organised CT networks in patients with acute AN. After weight recovery, the disarrangement seems to be partially reduced. However, longer-term follow-ups are needed to determine whether cortical organizational patterns fully return to normal.

Point-of-care pancreatic stone protein measurement in critically ill COVID-19 patients.

INTRODUCTION: Pancreatic stone protein (PSP) is a novel biomarker that is reported to be increased in pneumonia and acute conditions. The primary aim of this study was to prospectively study plasma levels of PSP in a COVID-19 intensive care unit (ICU) population to determine how well PSP performed as a marker of mortality in comparison to other plasma biomarkers, such as C reactive protein (CRP) and procalcitonin (PCT). METHODS: We collected clinical data and blood samples from COVID-19 ICU patients at the time of admission (T0), 72 h later (T1), five days later (T2), and finally, seven days later. The PSP plasma level was measured with a point-of-care system; PCT and CRP levels were measured simultaneously with laboratory tests. The inclusion criteria were being a critical COVID-19 ICU patient requiring ventilatory mechanical assistance. RESULTS: We enrolled 21 patients and evaluated 80 blood samples; we found an increase in PSP plasma levels according to mixed model analysis over time (p < 0.001), with higher levels found in the nonsurvivor population (p < 0.001). Plasma PSP levels achieved a statistically significant result in terms of the AUROC, with a value higher than 0.7 at T0, T1, T2, and T3. The overall AUROC of PSP was 0.8271 (CI (0.73-0.93), p < 0.001). These results were not observed for CRP and PCT. CONCLUSION: These first results suggest the potential advantages of monitoring PSP plasma levels through point-of-care technology, which could be useful in the absence of a specific COVID-19 biomarker. Additional data are needed to confirm these results.

Cortical complexity estimation using fractal dimension: A systematic review of the literature on clinical and nonclinical samples.

Fractal geometry has recently been proposed as a useful tool for characterizing the complexity of the brain cortex, which is likely to derive from the recurrence of sulci-gyri convolution patterns. The index used to describe the cortical complexity is called fractal dimensional (FD) and was employed by different research exploring the neurobiological correlates of distinct pathological and nonpathological conditions. This review aims to describe the literature on the application of this index, summarize the heterogeneities between studies and inform future research on this topic. Sixty-two studies were included in the systematic review. The main research lines concern neurodevelopment, aging and the neurobiology of specific psychiatric and neurological disorders. Overall, the included papers indicate that cortical complexity is likely to reduce during aging and in various pathological processes affecting the brain. Nevertheless, the high heterogeneity between studies strongly prevents the possibility of drawing conclusions. Further research considering this index besides other morphological values is needed to better clarify the role of FD in characterizing the cortical structure.

Stroke prevention and therapy awareness in a large sample of high school students: results of an educational campaign in the Northern-Western Italy.

BACKGROUND: People often ignore the usefulness of stroke prevention, the typical onset symptoms, and the efficacy of the new therapies. In order to attempt to correct this situation, we performed a wide educational campaign addressed to students of high schools in Liguria and Piedmont Italian regions. METHOD: The campaign consisted in two phases: (1) compilation of a simple questionnaire on stroke, followed by a scientific lecture on the disease, distribution of didactic materials, and final open discussion; (2) re-filling and sending by participants of the same questionnaire for the statistical evaluation of the improvement of stroke awareness. RESULTS: The global initial percentage of wrong answers (number of subjects 2,264) was 33.4%: (A) stroke general knowledge 23.5%, (B) stroke risk factors 37.6%, (C) stroke early symptoms 34.1%). At the end of the campaign, the total percentage of wrong answers (number of subjects 1883) attained the 11.4%.: (A) stroke general knowledge 3.7%, (B) stroke risk factors 11.7%, (C) stroke early symptoms 12.5%). All these differences were strongly significant. DISCUSSION AND CONCLUSION: We demonstrated that our educational campaign obtained an important improvement of stroke awareness in our sample. Girl students, Lyceum students, and less young students attained significant better knowledge improvement. We hope that the enhanced awareness might induce a more frequent diffusion of prevention strategies, an increased capacity of recognizing onset stroke symptoms with shortening of patients' presentation in the emergency room of the hospitals when they can undergo reperfusion treatments.

Brain networks in eating disorders: a systematic review of graph theory studies.

PURPOSE: Recent evidence from neuroimaging research has shown that eating disorders (EDs) are characterized by alterations in interconnected neural systems, whose characteristics can be usefully described by connectomics tools. The present paper aimed to review the neuroimaging literature in EDs employing connectomic tools, and, specifically, graph theory analysis. METHODS: A systematic review of the literature was conducted to identify studies employing graph theory analysis on patients with eating disorders published before the 22nd of June 2020. RESULTS: Twelve studies were included in the systematic review. Ten of them address anorexia nervosa (AN) (AN = 199; acute AN = 85, weight recovered AN with acute diagnosis = 24; fully recovered AN = 90). The remaining two articles address patients with bulimia nervosa (BN) (BN = 48). Global and regional unbalance in segregation and integration properties were described in both disorders. DISCUSSION: The literature concerning the use of connectomics tools in EDs evidenced the presence of alterations in the topological characteristics of brain networks at a global and at a regional level. Changes in local characteristics involve areas that have been demonstrated to be crucial in the neurobiology and pathophysiology of EDs. Regional imbalances in network properties seem to reflect on global patterns. LEVEL OF EVIDENCE: Level I, systematic review.

Conflicts of interest and Scientific Societies.

The purpose of this paper is to bring attention to the complex issue of conflicts of interest (COIs) from the point of view of Scientific Societies and their responsibility in managing secondary interests possibly undermining their activities such as improvement of professional quality, research promotion, and development of guidelines. The first publication on the issue of COIs dates back to more than a century, but only in the last decades the related ethical and legal problems have received public and professional attention. The growing role of industry in biomedical research, the significant decrease in public contributions to health, care, training, and research, and the involvement of physicians in industry-funded research have obliged to study how to identify and manage COIs. The Bioethics and Palliative Care Study Group of the Italian Neurological Society addressed the issue with a specific focus on Scientific Societies that, in our opinion, should also set an example for individual practice, raising awareness among their associates on COIs and implementing strategies for their identification and management. The paper is focused on the nature of the COI, why and how it could be managed, which policies can be implemented, and which kind of action should be considered by Scientific Societies. We emphasize the role of Scientific Societies in fostering knowledge and awareness of conflicts of interest through training and continuing education.

Treatment Options for Hepatitis A and E: A Non-Systematic Review.

Hepatitis A and hepatitis E are relatively common causes of liver disease. Both viruses are mainly transmitted through the faecal-oral route and, consequently, most outbreaks occur in countries with poor sanitation. An important role of the immune response as the driver of liver injury is also shared by the two pathogens. For both the hepatitis A (HAV) and hepatitis E (HEV) viruses, the clinical manifestations of infection mainly consist of an acute disease with mild liver injury, which results in clinical and laboratory alterations that are self-limiting in most cases. However, severe acute disease or chronic, long-lasting manifestations may occur in vulnerable patients, such as pregnant women, immunocompromised individuals or those with pre-existing liver disease. Specifically, HAV infection rarely results in fulminant hepatitis, prolonged cholestasis, relapsing hepatitis and possibly autoimmune hepatitis triggered by the viral infection. Less common manifestations of HEV include extrahepatic disease, acute liver failure and chronic HEV infection with persistent viraemia. In this paper, we conduct a non-systematic review of the available literature to provide a comprehensive understanding of the state of the art. Treatment mainly consists of supportive measures, while the available evidence for aetiological treatment and additional agents in severe disease is limited in quantity and quality. However, several therapeutic approaches have been attempted: for HAV infection, corticosteroid therapy has shown outcome improvement, and molecules, such as AZD 1480, zinc chloride and heme oxygenase-1, have demonstrated a reduction in viral replication in vitro. As for HEV infection, therapeutic options mainly rely on the use of ribavirin, and some studies utilising pegylated interferon-alpha have shown conflicting results. While a vaccine for HAV is already available and has led to a significant reduction in the prevalence of the disease, several vaccines for HEV are currently being developed, with some already available in China, showing promising results.

Accessible-to-All Cities. A Project of Networking Italian Experiences to Raise Awareness and Promote Universal Design.

In 2016 the Italian National Institute of Urban Planning (INU) launched the project Accessible-to-all Cities, aimed at fostering the creation of an inclusive environment for improving universal accessibility to places and services at both scales of the city and the territory, by networking accessibility good practices and stakeholders from all corners of the country. Since then, a community of public and private subjects gathered by INU has been established and growing, sharing experiences, problems and solutions. Through the organization of dozens of meetings, seminars, workshops, conference sessions and webinars, more than 200 experiences developed in Italy have been collected, including studies and research, public policies, projects and actions, both material and immaterial, concerning the overcoming of different kind of barriers: physical, sensory, perceptive, intellectual, cultural, social, economic, health and gender. On these bases, in 2019, the INU Accessible-to-all Cities Community launched an open web archive, an initiative that intends to contribute to increasing awareness and knowledge, as well as to facilitate the implementation and development of actions and policies, by leveraging the good practices widespread, but often little known, in Italy.

Novel insights into the relationship between cerebellum and dementia: A narrative review as a toolkit for clinicians.

The role of the cerebellum in neurodegenerative disorders that target cognitive functions has been a subject of increasing interest over the past years. However, a review focused on making clinicians more aware of the role of the cerebellum in dementia is still missing. This narrative review explores the possible factors explaining the involvement of the cerebellum in different kinds of dementia by providing more insights on how this structure can be relevant in clinical practice. It emerged that, despite overlapping in specific areas, structural cerebellar alterations in dementia show a certain degree of disease-specificity. Furthermore, the relevance of cerebellar changes in dementia is corroborated by correlations observed between their topography and cognitive symptomatology, as well as by its previously ignored involvement of the cerebellum in early stages of dementia. Despite needing further investigations, these findings could become a useful diagnostic aid for clinicians that should not be overlooked, in particular for those individuals who do not show distinct and manifest brain or neuropsychological alterations, but that still make clinicians suspect the presence of a neurocognitive disease.

The GIS-based SafeAirView software for the concentration assessment of radioactive pollutants after an accidental release.

The European Commission Joint Research Centre (JRC) in Ispra (Italy) has long been running nuclear installations for research purposes. The Nuclear Decommissioning and Facilities Management Unit (NDFM) is responsible for the surveillance of radioactivity levels in nuclear emergency conditions. The NDFM Unit has commissioned the implementation of a specifically developed decision support system, which can be used for quick emergency evaluation in the case of hypothetical accident and for emergency exercises. The requisites were to be a user-friendly software, able to quickly calculate and display values of air and ground radioactive contamination in the complex area around JRC, following an accidental release of radioactive substances from a JRC nuclear research installation. The developed software, named "SafeAirView", is an advanced implementation of GIS technology applied to an existing MS-DOS mode dispersion model, SAFE_AIR (Simulation of Air pollution From Emissions_Above Inhomogeneous Regions). SAFE_AIR is a numerical model which simulates transport, diffusion, and deposition of airborne pollutants emitted in the low atmosphere above complex orography at both local and regional scale, under non-stationary and inhomogeneous emission and meteorological conditions. SafeAirView makes use of user-friendly MS-Windows type interface which drives the dispersion model by a sequential and continuous input-output process, allowing a real time simulation. The GIS environment allows a direct interaction with the territory elements in which the simulation takes place, using data for the JRC Ispra region represented in geo-referenced cartography. Furthermore it offers the possibility to relate concentrations with population distribution and other geo-referenced maps, in a geographic view. Output concentration and deposition patterns can be plotted and/or exported. In spite of the selected specific databases, the SafeAirView software architecture is a general structure, therefore the decision support system could be easily modified to be applied in a region different from the JRC one. Beside the description of SafeAirView, the present paper presents a statistical evaluation of the software, which has considered three well known tracer experiments: Copenhagen, Indianapolis and Kincaid. The data sets related to these experiments are all included in the so called Model Validation Kit.