Handover checklist: testing a standardization process in an Italian hospital

Objectives: This study aimed to standardize and rationalize the handover, a critical and essential moment in common health care practices, through the realization of an efficient and standardized checklist, which could be used daily to ensure complete, thorough and effective handover. The principal purpose of the implementation of the handover is to reduce errors due to superficial and insufficient communication. Methods: The "operative group" defined the phases to the realization of the delineated aims: at first, the direct observation and the consequent realization of a handover checklist model and then, the experimental phases (trials). The handover checklist model was used for a month and it was daily and duly completed by the doctors who took part in the trial. To prove the success of the study, three questionnaires were distributed on different occasions. Results: Analyzing the answers to the questionnaires, the importance of the handover has come to light and that for the most part, the doctors consider it an essential and irreplaceable moment in daily health care work. Moreover, it became obvious that the use of the handover checklist guaranteed a considerable improvement in the traditional handover in terms of security, completeness, care continuity and clarity. The handover checklist was completely appreciated by the majority of the participant doctors who agree with the definitive introduction of it in their unit. Conclusions: Our study indicated the consistency of the handover checklist as an instrument to implement the handover and, indirectly, to improve the quality of the care

DRD1 and DRD2 Receptor Polymorphisms: Genetic Neuromodulation of the Dopaminergic System as a Risk Factor for ASD, ADHD and ASD/ADHD Overlap

The dopaminergic system (DS) is one of the most important neuromodulator systems involved in complex functions that are compromised in both autism spectrum disorder (ASD) and attention deficit/hyperactivity disorder (ADHD), conditions that frequently occur in overlap. This evidence suggests that both disorders might have common neurobiological pathways involving the DS. Therefore, the aim of this study was to examine the DRD1 and DRD2 dopamine receptor single nucleotide polymorphisms (SNPs) as potential risk factors for ASD, ADHD, and ASD/ADHD overlap. Genetic data were obtained from four groups: 75 ASD patients, 75 ADHD patients, 30 patients with ASD/ADHD overlap, and 75 healthy controls. All participants were between 2 and 17 years old. We compared the genotypic and allelic frequency of 18 SNPs among all of the study groups. Moreover, in the case of statistically significant differences, odds ratios (OR) were obtained to evaluate if the presence of SNPs might be a risk factor of developing a specific clinical phenotype. This study found that DRD1 and DRD2 receptors SNPs might be considered as potential risk factors for ASD and ADHD. However, only DRD2-12 (rs7131465) was significantly associated with a higher risk for the ASD/ADHD overlap. These data support the hypothesis of the genetic neuromodulation of the DS in the neurobiology of these conditions

A development cooperation Erasmus Mundus partnership for capacity building in earthquake mitigation science and higher education

Successful practices have shown that a community’s capacity to manage and reduce its seismic risk relies on capitalization on policies, on technology and research results. An important role is played by education, than contribute to strengthening technical curricula of future practitioners and researchers through university and higher education programs. EUNICE is a European Commission funded higher education partnership for international development cooperation with the objective to build capacity of individuals who will operate at institutions located in seismic prone Asian Countries. The project involves five European Universities, eight Asian universities and four associations and NGOs active in advanced research on seismic mitigation, disaster risk management and international development. The project consists of a comprehensive mobility scheme open to nationals from Afghanistan, Bangladesh, China, Nepal, Pakistan, Thailand, Bhutan, India, Indonesia, Malaysia, Maldives, North Korea, Philippines, and Sri Lanka who plan to enroll in school or conduct research at one of five European partner universities in Italy, Greece and Portugal. During the 2010-14 time span a total number of 104 mobilities are being involved in scientific activities at the undergraduate, masters, PhD, postdoctoral and academic-staff exchange levels. Researchers, future policymakers and practitioners build up their curricula over a range of disciplines in the fields of earthquake engineering, seismology, disaster risk management and urban planning

EU-NICE, Eurasian University Network for International Cooperation in Earthquakes

Despite the remarkable scientific advancements of earthquake engineering and seismology in many countries, seismic risk is still growing at a high rate in the world’s most vulnerable communities. Successful practices have shown that a community’s capacity to manage and reduce its seismic risk relies on capitalization on policies, on technology and research results. An important role is played by education, than contribute to strengthening technical curricula of future practitioners and researchers through university and higher education programmes. In recent years an increasing number of initiatives have been launched in this field at the international and global cooperation level. Cooperative international academic research and training is key to reducing the gap between advanced and more vulnerable regions. EU-NICE is a European Commission funded higher education partnership for international development cooperation with the objective to build capacity of individuals who will operate at institutions located in seismic prone Asian Countries. The project involves five European Universities, eight Asian universities and four associations and NGOs active in advanced research on seismic mitigation, disaster risk management and international development. The project consists of a comprehensive mobility scheme open to nationals from Afghanistan, Bangladesh, China, Nepal, Pakistan, Thailand, Bhutan, India, Indonesia, Malaysia, Maldives, North Korea, Philippines, and Sri Lanka who plan to enrol in school or conduct research at one of five European partner universities in Italy, Greece and Portugal. During the 2010-14 time span a total number of 104 mobilities are being involved in scientific activities at the undergraduate, masters, PhD, postdoctoral and academic-staff exchange levels. This high number of mobilities and activities is selected and designed so as to produce an overall increase of knowledge that can result in an impact on earthquake mitigation. Researchers, future policymakers and practitioners build up their curricula over a range of disciplines in the fields of engineering, seismology, disaster risk management and urban planning. Specific educational and research activities focus on earthquake risk mitigation related topics such as: anti-seismic structural design, structural engineering, advanced computer structural collapse analysis, seismology, experimental laboratory studies, international and development issues in disaster risk management, social-economical impact studies, international relations and conflict resolution

Non-linear relationships of cerebrospinal fluid biomarker levels with cognitive function: an observational study

INTRODUCTION: Levels of cerebrospinal fluid (CSF) β-amyloid (Aβ) and Tau proteins change in Alzheimer's disease (AD). We tested if the relationships of these biomarkers with cognitive impairment are linear or non-linear. METHODS: We assessed cognitive function and assayed CSF Aβ and Tau biomarkers in 95 non-demented volunteers and 97 AD patients. We then tested non-linearities in their inter-relations. RESULTS: CSF biomarkers related to cognitive function in the non-demented range of cognition, but these relations were weak or absent in the patient range; Aβ1-40's relationship was biphasic. CONCLUSIONS: Major biomarker changes precede clinical AD and index cognitive impairment in AD poorly, if at all

Vascular endothelial growth factor and tryptase changes after chemoembolization in hepatocarcinoma patients

AIM: To evaluate vascular endothelial growth factor (VEGF) and tryptase in hepatocellular cancer (HCC) before and after trans-arterial chemoembolization (TACE). METHODS: VEGF and tryptase serum concentrations were assessed from 71 unresectable HCC patients before and after hepatic TACE performed by binding DC-Beads® to doxorubicin. VEGF levels were examined for each serum sample using the Quantikine Human VEGF-enzyme-linked immuno-absorbent assay (ELISA), whereas tryptase serum concentrations were assessed for each serum sample by means of fluoro-enzyme immunoassay (FEIA) using the Uni-CAP100 tool. Differences between serum VEGF and tryptase values before and after TACE were evaluated using Student t test. Person's correlation was used to assess the degree of association between the two variables. RESULTS: VEGF levels and serum tryptase in HCC patients before TACE had a mean value and standard deviation (SD) of 114.31 ± 79.58 pg/mL and 8.13 ± 3.61 μg/L, respectively. The mean levels and SD of VEGF levels and serum tryptase in HCC patients after TACE were 238.14 ± 109.41 pg/mL and 4.02 ± 3.03 μg/L. The changes between the mean values of concentration of VEGF and tryptase before treatment and after treatment was statistically significant (P < 0.000231 and P < 0.00124, by Wilcoxon-Mann-Whitney respectively). A significant correlation between VEGF levels before and after TACE and between tryptase levels before and after TACE was demonstrated (r = 0.68, P = 0.003; r = 0.84, P = 0.000 respectively). CONCLUSION: Our pilot results suggest that the higher serum VEGF levels and the lower tryptase levels following TACE may be potential biomarkers changing in response to therapy

NGN2 mmRNA-Based Transcriptional Programming in Microfluidic Guides hiPSCs Toward Neural Fate With Multiple Identities

Recent advancements in cell engineering have succeeded in manipulating cell identity with the targeted overexpression of specific cell fate determining transcription factors in a process named transcriptional programming. Neurogenin2 (NGN2) is sufficient to instruct pluripotent stem cells (PSCs) to acquire a neuronal identity when delivered with an integrating system, which arises some safety concerns for clinical applications. A non-integrating system based on modified messenger RNA (mmRNA) delivery method, represents a valuable alternative to lentiviral-based approaches. The ability of NGN2 mmRNA to instruct PSC fate change has not been thoroughly investigated yet. Here we aimed at understanding whether the use of an NGN2 mmRNA-based approach combined with a miniaturized system, which allows a higher transfection efficiency in a cost-effective system, is able to drive human induced PSCs (hiPSCs) toward the neuronal lineage. We show that NGN2 mRNA alone is able to induce cell fate conversion. Surprisingly, the outcome cell population accounts for multiple phenotypes along the neural development trajectory. We found that this mixed population is mainly constituted by neural stem cells (45% \ub1 18 PAX6 positive cells) and neurons (38% \ub1 8 \u3b2IIITUBULIN positive cells) only when NGN2 is delivered as mmRNA. On the other hand, when the delivery system is lentiviral-based, both providing a constant expression of NGN2 or only a transient pulse, the outcome differentiated population is formed by a clear majority of neurons (88% \ub1 1 \u3b2IIITUBULIN positive cells). Altogether, our data confirm the ability of NGN2 to induce neuralization in hiPSCs and opens a new point of view in respect to the delivery system method when it comes to transcriptional programming applications