Central vein sign differentiates Multiple Sclerosis from central nervous system inflammatory vasculopathies.

In multiple sclerosis (MS), magnetic resonance imaging (MRI) is a sensitive tool for detecting white matter lesions, but its diagnostic specificity is still suboptimal; ambiguous cases are frequent in clinical practice. Detection of perivenular lesions in the brain (the "central vein sign") improves the pathological specificity of MS diagnosis, but comprehensive evaluation of this MRI biomarker in MS-mimicking inflammatory and/or autoimmune diseases, such as central nervous system (CNS) inflammatory vasculopathies, is lacking. In a multicenter study, we assessed the frequency of perivenular lesions in MS versus systemic autoimmune diseases with CNS involvement and primary angiitis of the CNS (PACNS). In 31 patients with inflammatory CNS vasculopathies and 52 with relapsing-remitting MS, 3-dimensional T2*-weighted and T2-fluid-attenuated inversion recovery images were obtained during a single MRI acquisition after gadolinium injection. For each lesion, the central vein sign was evaluated according to consensus guidelines. For each patient, lesion count, volume, and brain location, as well as fulfillment of dissemination in space MRI criteria, were assessed. MS showed higher frequency of perivenular lesions (median = 88%) than did inflammatory CNS vasculopathies (14%), without overlap between groups or differences between 3T and 1.5T MRI. Among inflammatory vasculopathies, Behçet disease showed the highest median frequency of perivenular lesions (34%), followed by PACNS (14%), antiphospholipid syndromes (12%), Sjögren syndrome (11%), and systemic lupus erythematosus (0%). When a threshold of 50% perivenular lesions was applied, central vein sign discriminated MS from inflammatory vasculopathies with a diagnostic accuracy of 100%. The central vein sign differentiates inflammatory CNS vasculopathies from MS at standard clinical magnetic field strengths. Ann Neurol 2018;83:283-294

Fostering a Growth Mind-set: Integrating Research on Teaching and Learning and the Practice of Teaching

Centers for teaching and learning have a crucial role to play in helping facuity learn about and apply research on learning. The approach we have developed integrates discussion of recent research with specific recom mendations of teaching modifications that can be adapted for different disciplines and courses. Preliminary evaluation suggests the effectiveness of this approach in fostering a growth mind-set about teaching--a mind-set that helps faculty develop, implement, and assess effective teaching modifications, thereby transforming facuity into scholars of teaching and learning and further developing a collaborative, innovative culture that integrates research on teaching and learning with the practice of teaching

Psychometric validation of the Internet Disorder Scale–short form in an Italian adult sample

Research examining online addictions has conceptualized generalized internet addiction as an "umbrella" term comprising the addictive use of various online activities such as gambling, gaming, pornograpgy consumption shopping, and social media use. This has led to the development of many different psychometric instruments to assess specific forms of online addiction as well as ones that assess disordered internet use more generally. One such scale is the nine-item short-form Internet Disorder Scale (IDS9-SF) based on the DSM-5 criteria for internet gaming disorder. Although the IDS9-SF has been validated in a number of languages, it has not been validated into Italian. Therefore, the present study validated the IDS9-SF utilizing an Italian-speaking sample (N = 1477). Data were initially collected from 963 participants and the sample was equally split to carry out exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) on the Italian IDS9-SF. Results showed that two items were problematic (i.e., in terms of asymmetry and kurtosis) so a slightly modified Italian IDS9-SF was developed (modifying the two items). Data were then collected from a further 514 participants to test the modified Italian IDS9-SF. The second sample was again equally split, and EFA and CFA were carried out. The modified Italian IDS9-SF was found to be a psychometrically robust measure for assessing the risk of internet disorder among Italian adults

Effect of disease-modifying treatments on antibody-mediated response to anti- COVID19 vaccination in people with multiple sclerosis

BACKGROUND: Few data are available so far on the antibody-mediated immune response to anti-SARS-Cov2 vaccination in people with multiple sclerosis (pwMS) treated with disease-modifying treatments (DMTs), therefore this issue was explored in a real-life cohort of pwMS. MATERIALS AND METHODS: Retrospective monocentric study on anti-spike protein antibody response in pwMS who had received vaccination for Sars-Cov2. Adverse events following vaccination were also recorded. RESULTS: One hundred and twenty pwMS were included: 83 females (69%); median age at vaccination 42 years (range 21–73); 112/120 patients (93%) were receiving DMTs at vaccination. Anti-spike protein IgG antibodies were detectable in 102/120 (85%) cases overall, being the proportion lower in pwMS receiving anti-CD20 antibodies (14/31, 45%) compared to non-depletive treatments (77/78, 99%), p < 0.0001. Median anti-spike titre was lower in anti-CD20 antibodies and fingolimod-treated pwMS compared to those receiving other DMTs, and it correlated with anti-CD20 treatment duration (R − 0.93, p < 0.0001) and with age at vaccination in pwMS not receiving depletive treatments (R − 0.25, p = 0.028). Baseline CD19+ cell count (where available) was higher in the responder group than in non-responders, p < 0.0001. Two symptomatic COVID-19 infections were diagnosed over a median follow-up of 5 months (range 2–7); adverse events were aligned with the published literature. CONCLUSION: Antibody response to anti-COVID-19 vaccines was detected in most of the pwMS analysed, but frequency of responders was reduced in those receiving CD20 depleting therapies compared to other DMTs-treated pwMS. Investigations on cell-mediated immune response are needed to assess whether a protective immune response is elicited also in non-antibody responders

Developing Scholarly Teachers Through an SoTL Faculty Fellowship

The increasing interest in incorporating evidenced based teaching in higher education has created a pronounced need for faculty to learn the theory and practice of the Scholarship of Teaching and Learning (SoTL). This article describes a program designed to prepare faculty to (a) draw on existing SoTL studies when designing and implementing evidenced based teaching methods, (b) design SoTL studies to test the effectiveness of those methods, and (c) integrate their new knowledge of SoTL into the practice of “scholarly teaching.” This program has proven to be a successful model for incorporating evidenced based teaching into undergraduate science, technology, engineering, and mathematics (STEM) courses at our university

CSF/serum matrix metallopeptidase-9 ratio discriminates neuro Behcet from multiple sclerosis

In neuro Behcet disease with multiple sclerosis-like features, diagnosis could be challenging. Here, we studied the cerebrospinal fluid and serum inflammatory profile of 11 neuro Behcet and 21 relapsing-remitting multiple sclerosis patients. Between the soluble factors analyzed (MMP9, TNF, IL6, CXCL13, CXCL10, CXCL8, IFN, IL10, IL17, IL23, and others) we found MMP9 increased in neuro Behcet serum compared to multiple sclerosis and decreased in cerebrospinal fluid. Furthermore, neuro Behcet analysis of circulating natural killer CD56(DIM) subset suggests their potential involvement in increased MMP9 production. We believe that these findings may have a translational utility in clinical practice

The Use of Social Media and Digital Devices Among Italian Neurologists

Background: Digital devices and online social networks are changing clinical practice. In this study, we explored attitudes, awareness, opinions, and experiences of neurologists toward social media and digital devices. Methods: Each member of the Italian Society of Neurology (SIN) participated in an online survey (January to May 2018) to collect information on their attitude toward digital health. Results: Four hundred and five neurologists participated in the study. At work, 95% of responders use the personal computer, 87% the smartphone, and 43.5% the tablet. These devices are used to obtain health information (91%), maintain contact with colleagues (71%), provide clinical information (59%), and receive updates (67%). Most participants (56%) use social media to communicate with patients, although 65% are against a friendship with them on social media. Most participants interact with patients on social media outside working hours (65.2%) and think that social media have improved (38.0%) or greatly improved (25.4%) the relationship with patients. Most responders (66.7%) have no wearable devices available in clinical practice. Conclusion: Italian neurologists have different practices and views regarding the doctor–patient relationship in social media. The availability of digital devices in daily practice is limited. The use of social networks and digital devices will increasingly permeate into everyday life, bringing a new dimension to health care. The danger is that advancement will not go hand in hand with a legal and cultural adaptation, thus creating ambiguity and risks for clinicians and patients. Neurologists will need to be able to face the opportunities and challenges of this new scenario