Introduction to the special issue on myelin plasticity in the central nervous system

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141426/1/dneu22575_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/141426/2/dneu22575.pd

Effectiveness and efficiency of European Regional Development Fund on separate waste collection: evidence from Italian regions by a stochastic frontier approach

Abstract The purpose of the present paper is to analyze the results of the impact of European Regional Development Fund (ERDF) in Convergence regions over the 2007–2013 on separate collection rate of Italian regions. The aim is twofold: propose a groundbreaking analysis that allows us to control both for the effectiveness of the Regulation (EC) No. 1080/2006, by a Difference in differences equation (DID), and the Regions' efficiency in the separate collection process, by a stochastic frontier analysis (SFA). Specifically, the SFA allows us to model the DID equation in order to take account the regions' efficiency in the separate collection process in terms of institutional quality. In particular, we use a panel with two dimensions: temporal—9 yearly observations from 2004 to 2012; and cross-sectional—20 regions. The estimates suggest that ERDF have not contributed to reducing the structural divide in Italy and its managerial slack has triggered in the failure of the convergence objective. Policy implications are discussed

Portuguese-Brazilian evidence-based guideline on the management of hyperglycemia in type 2 diabetes mellitus

Background: In current management of type 2 diabetes (T2DM), cardiovascular and renal prevention have become important targets to be achieved. In this context, a joint panel of four endocrinology societies from Brazil and Portugal was established to develop an evidence-based guideline for treatment of hyperglycemia in T2DM. Methods: MEDLINE (via PubMed) was searched for randomized clinical trials, meta-analyses, and observational studies related to diabetes treatment. When there was insufficient high-quality evidence, expert opinion was sought. Updated positions on treatment of T2DM patients with heart failure (HF), atherosclerotic CV disease (ASCVD), chronic kidney disease (CKD), and patients with no vascular complications were developed. The degree of recommendation and the level of evidence were determined using predefined criteria. Results and conclusions: In non-pregnant adults, the recommended HbA1c target is below 7%. Higher levels are recommended in frail older adults and patients at higher risk of hypoglycemia. Lifestyle modification is recommended at all phases of treatment. Metformin is the first choice when HbA1c is 6.5–7.5%. When HbA1c is 7.5–9.0%, dual therapy with metformin plus an SGLT2i and/or GLP-1RA (first-line antidiabetic agents, AD1) is recommended due to cardiovascular and renal benefits. If an AD1 is unaffordable, other antidiabetic drugs (AD) may be used. Triple or quadruple therapy should be considered when HbA1c remains above target. In patients with clinical or subclinical atherosclerosis, the combination of one AD1 plus metformin is the recommended first-line therapy to reduce cardiovascular events and improve blood glucose control. In stable heart failure with low ejection fraction ( 30 mL/min/1.73 m2, metformin plus an SGLT-2i is recommended to reduce cardiovascular mortality and heart failure hospitalizations and improve blood glucose control. In patients with diabetes-associated chronic kidney disease (CKD) (eGFR 30–60 mL/min/1.73 m2 or eGFR 30–90 mL/min/1.73 m2 with albuminuria > 30 mg/g), the combination of metformin and an SGLT2i is recommended to attenuate loss of renal function, reduce albuminuria and improve blood glucose control. In patients with severe renal failure, insulin-based therapy is recommended to improve blood glucose control. Alternatively, GLP-1RA, DPP4i, gliclazide MR and pioglitazone may be considered to reduce albuminuria. In conclusion, the current evidence supports individualizing anti-hyperglycemic treatment for T2DM

Società in house providing e fallimento: un difficile equilibrio fra pubblico e privato.

La tesi in oggetto si propone di tracciare i contorni del dibattito con cui, in tempi recenti, la giurisprudenza e la dottrina si sono interrogate circa la sorte che debba essere riconosciuta alle c.d. “società in house providing” ai fini fallimentari. Nel primo capitolo dell’elaborato vengono delineate la caratteristiche fondamentali delle società in house, al fine di meglio comprendere che cosa le rende così diverse dalle “normali” società di capitali e contemporaneamente così “vicine” alla nozione di ente pubblico, tanto da chiedersi se sia possibile la loro esclusione dal fallimento. Nel secondo capitolo vengono illustrati i criteri, adottati dalla giurisprudenza e dalla dottrina, utilizzati per tentare di collocare questo particolare modello societario nella sfera pubblica o nella sfera privata, al fine di individuare – sulla base della “reale” natura – la disciplina concretamente applicabile. Il terzo capitolo si esplica nello studio della prassi giurisprudenziale relativa al tema affrontato, attraverso l’analisi delle pronunce dei tribunali fallimentari italiani, suddivise in base al modus operandi adottato. Il quarto capitolo individua quali sono gli interessi tutelati rispettivamente dall’orientamento contrario all’assoggettamento al fallimento delle società in house e da quello favorevole

Un passo… indietro nella storia delle donne medico in Italia:

The first woman to graduate in Medicine and Surgery from the University of Rome is Edvige Benigni, in 1890, followed by Marcellina Corio and the famous Maria Montessori. This article explores the case of this pioneer: however, the documents collected show that Edvige Benigni was not a woman, as believed up to now, but a man, thus leaving the primacy to Marcellina Corio.La prima donna laureata in Medicina e Chirurgia presso l’Università di Roma risulta essere Edvige Benigni, nel 1890, seguita da Marcellina Corio e dalla celebre Maria Montessori. Il presente articolo approfondisce il caso di questa “pioniera”: i documenti reperiti, tuttavia, dimostrano che Edvige Benigni non era una donna, come si è ritenuto fino a oggi, bensì un uomo, lasciando così il primato a Marcellina Corio

Assessment of Domestic Well-Being: From Perception to Measurement

Nowadays, there are plenty of sensing devices that enable the measurement of physiological, environmental, and behavioral parameters of people 24 hours a day, seven days a week and provide huge quantities of different data. Data and signals coming from sensing devices, installed in indoor or outdoor environments or often worn by the users, generate heterogeneous and complex structured datasets, most of the time not uniformly structured. The artificial intelligence (AI) algorithms applied to these sets of data have demonstrated capabilities to infer indices related to a subject's status and well-being [1]. Well-being is a key parameter in the World Health Organization (WHO) definition of health, considering its physical, mental, and social spheres. Quantitatively assessing a subject's well-being is of paramount importance if we want to assess the whole status of a person, which is particularly useful in the case of ageing people living alone. Assessment allows for continuous remote monitoring to improve people's quality of life (QoL) according to their perceptions, needs, and preferences. Technology undoubtedly plays a pivotal role in this regard, providing us new tools to support the objective evaluation of a subject's status, including her/his perception of the living environment. Its potential is huge, also in terms of support to the healthcare system and ageing people; however, there are several engineering challenges to consider, especially in terms of sensors integrability, connectivity, and metrological performance, in order to obtain reliable and accurate measurement systems

Histone modifications affect timing of oligodendrocyte progenitor differentiation in the developing rat brain

Timely differentiation of progenitor cells is critical for development. In this study we asked whether global epigenetic mechanisms regulate timing of progenitor cell differentiation into myelin-forming oligodendrocytes in vivo. Histone deacetylation was essential during a specific temporal window of development and was dependent on the enzymatic activity of histone deacetylases, whose expression was detected in the developing corpus callosum. During the first 10 postnatal days, administration of valproic acid (VPA), the specific inhibitor for histone deacetylase activity, resulted in significant hypomyelination with delayed expression of late differentiation markers and retained expression of progenitor markers. Differentiation resumed in VPA-injected rats if a recovery period was allowed. Administration of VPA after myelination onset had no effect on myelin gene expression and was consistent with changes of nucleosomal histones from reversible deacetylation to more stable methylation and chromatin compaction. Together, these data identify global modifications of nucleosomal histones critical for timing of oligodendrocyte differentiation and myelination in the developing corpus callosum

Laparoscopic bilateral hand-assisted nephrectomy: end-stage renal disease from tuberculosis, an unusual indication for nephrectomy before transplantation.

The purpose of the study was to sterilize renal tuberculous foci in a pretransplantation patient with a laparoscopic hand-assisted approach and to verify the feasibility of bilateral nephrectomy for this indication. This case report is the first description of hand-assisted laparoscopic bilateral nephrectomy for this pathologic condition. The 33-year-old patient had end-stage renal disease from renal tuberculosis. A commercially available hand-assistance device was used through a midline 8-cm supraumbilical incision and with four ports. The procedure was successfully completed. The total operative time was 3 hours and 40 minutes. Estimated blood loss was 250 mL. The postoperative course was uneventful, and clinical follow-up at 3 weeks revealed a successful outcome. Hand-assisted bilateral laparoscopic nephrectomy in patients with chronic renal failure from tuberculosis represents a viable option because it is feasible and effective. The hand-assisted approach increases the safety of the procedure while retaining all the advantages of minimally invasive surgery

Laparoscopic lymph node biopsy for lymphoma with a novel use of indocyanine green fluorescence in a 66-year-old male patient

Introduction: Indocyanine green (ICG) near-infrared fluorescence is primarily employed in detecting Intraoperative sentinel lymph node (SLN) mapping or to evaluate the extent of radical lymphadenectomy mainly in colo-rectal and gastric cancer. To date there are no reports indicating the use of this dye to detect pathologic lymphatic tissue when a lymph node biopsy for suspected lymphoproliferative disease is performed. Presentation of case: A 66-year-old male patient was admitted to the hospital for severe pain of left renal colic type. A computed tomography (CT) scan and a positron emission tomography (PET) showed a left hydroureteronephrosis due to ureter compression by paraortic solid tissue of lymphomatous aspect with a standardized uptake value (SUV) of 15. Multiple lymphadenopathies on paracaval, para-aortic and common iliac sites were present as well. Discussion: A laparoscopic lymph node biopsy (LLB) was planned for diagnostic purposes. After induction of anesthesia a ICG solution was injected Intradermally at both inguinal regions. At laparoscopy a complete visualization of the pathologic lymphnodes was achieved, enabling incisional biopsies of the lymphomatous mass. Histopathological examination showed an extranodal localization of an aggressive B-cell non-Hodgkin lymphoma. Conclusion: ICG-fluorescence seems to offer a simple and safe method for pathologic lymph node detection. LLB in the suspicion of intra abdominal lymphoma can largely take advantage by this novel opportunity not yet tested to date. More studies with large case series are needed to confirm the efficacy of ICG-fluorescence for detecting pathologic lymph nodes