An automated method for characterization of evoked single-trial local field potentials recorded from rat barrel cortex under mechanical whisker stimulation

Rodents explore their surroundings through whisking by localizing objects and detecting textures very precisely. During such tactile exploration, whisker deflection is first mechanically transduced by receptors and then information encoded throughout the somatosensory pathway ending in the somatosensory ‘barrel’ cortex. In the barrel cortex, tactile information from a single whisker is segregated and processed in a cortical column corresponding to the deflected whisker. Local Field Potentials (LFPs) generated by whisker deflection in the barrel cortex present typical signatures in terms of shape and amplitude that are related to the activation of the local neuronal populations. Therefore, rigorous analysis of such responses may reveal important features about the function of underlying neuronal microcircuits. In this context, software methods for characterizing single-trial LFPs are needed that are also suitable for online extraction of LFP features and for brain–machine interfacing applications. In this work, we present an automated and efficient method to analyze evoked LFP responses in the rat barrel cortex through automatic removal of stimulation artifacts, detection of single events and characterization of their relevant parameters. Evoked single-trial LFPs recorded under two different anesthetics are examined to demonstrate the feasibility, accuracy and applicability of the method

SURGERY IN PATIENTS WITH TESTICULAR MALIGNANT GERM CELL TUMORS: COMPLIANCE TO SURGICAL GUIDELINES AND RESULTS IN THE ITALIAN COOPERATIVE STUDY

Purpose: Surgery represents a main and often the only treatment in patients with testicular Malignant Germ Cell Tumors (MGCT). We analyzed the compliance to surgical guidelines and the results in a series of patients with testicular MGCT -/+ retroperitoneal node involvement, without distant metastases. Method: 42 patients, observed in 15 Centers were enrolled in the Italian Cooperative Study on MGCT (January2004–December2010). 14/42 were younger than 2 y. of age, 28/42 between 13–18 y. Treatment was delivered according to COG-Staging-System: St.I patients (complete excision with inguinal orchifunicolectomy+decrease of markers, +hemiscrotectomy if scrotal involvement) did not receive further treatment; St.II patients (scrotal involvement after hemiscrotectomy and/or retroperitoneal node (RPN) enlargement:2 cm) had RPN Dissection if residuals were suspected after PEBx3or4. Results: St.I: 26 patients. 3/26 had a scrotal approach due to suspected testicular torsion: 1/3 underwent hemiscrotectomy, 2 did not receive further therapy after decrease of alphaFP, due to patient’s or physician’s decision respectively. 3/26 were successfully treated for RPN relapse, occurred at 3,6,9 months after adequate surgery (2 adolescents, 1 infant). St.II: in 4 patients CTwas delivered due to slight enlargement of RPN (+persistent alphaFP in 1). St.III: 12 patients received CT and RPND (bilateral in 1). Histology was negative in 11/12. All patients are alive without disease, 39 in 1stCR, 3 in 2ndCR (f.u 9–86 m.:med.48). 1 St.1 patient suffered from postoperative scrotal hematoma. Among patients younger than 2 y, 10/14 had a pure YST, 12/14 had St.I disease; among those between 13–18 y, 27/28 had a mixed histology, 14/28 were St.II or St.III. In 3 adolescents a testicular prosthesis was positioned during primary operation. Conclusion: Outcome was excellent. Regional relapses, observed only in St.I patients, were cured. Surgical guidelines were followed in 40/42 cases. Scrotal approach did not worsen the outcome of patients who did not receive further treatment

SURGERY IN MALIGNANT GERM CELL TUMORS OF CHILDHOOD. RESULTS OF THE SECOND ITALIAN COOPERATIVE STUDY TCG 98

Analysis of treatment and results of the patientsenrolled in the Italian TCG-98 Study, still open and comparison of data with those of the previous Studt TCG-9

Poor youths and ‘pacification’:dilemmas between discourse and practice from the perspective of young people about policing in Rio de Janeiro’s favelas

This article explores the social representations of youngsters from favelas in Rio de Janeiro on police practices in the context of the implementation of ‘Pacifying Police Units’. Drawing from fieldwork, participant observation and interviews, the authors analyse the narratives and practices which influence relations between young people and the police in the Complexo do Alemão area of the city. The interviewees expressed a demand for further public security and social services. Young people noted some progress in police practices, although these changes appear to be unstable. The permanence of violent practices and prejudice by the police was verified in youngsters’ narratives. Any change in this scenario should be based on the replacement of the war logic of ‘pacification’ for another logic, that of participation.2030-01-0

International survey on the management of esophageal atresia

IntroductionBecause many aspects of the management of esophageal atresia (EA) are still controversial, we evaluated the practice patterns of this condition across Europe. MethodsA survey was completed by 178 delegates (from 45 [27 European] countries; 88% senior respondents) at the EUPSA-BAPS 2012. ResultsApproximately 66% of respondents work in centers where more than five EA repairs are performed per year. Preoperatively, 81% of respondents request an echocardiogram, and only 43% of respondents routinely perform preoperative bronchoscopy. Approximately 94% of respondents prefer an open approach, which is extrapleural in 71% of respondents. There were no differences in use of thoracoscopy between Europeans (10%) and non-Europeans (11%, p=nonsignificant). Approximately 60% of respondents measure the gap intraoperatively. A transanastomotic tube (90%) and chest drain (69%) are left in situ. Elective paralysis is adopted by 56% of respondents mainly for anastomosis tension (65%). About 72% of respondents routinely request a contrast study on postoperative day 7 (2-14). Approximately 54% of respondents use parenteral nutrition, 40% of respondents start transanastomotic feeds on postoperative day 1, and 89% of respondents start oral feeds after postoperative day 5. Pure EA: 46% of respondents work in centers that repair two or more than two pure EA a year. About 60% of respondents opt for delayed primary anastomosis at 3 months (1-12 months) with gastrostomy formation without esophagostomy. Anastomosis is achieved with open approach by 85% of respondents. About 47% of respondents attempt elongation of esophageal ends via Foker technique (43%) or with serial dilations with bougies (41%). Approximately 67% of respondents always attempt an anastomosis. Gastric interposition is the commonest esophageal substitution. ConclusionMany aspects of EA management are lacking consensus. Minimally invasive repair is still sporadic. We recommend establishment of an EA registry

Effectiveness of dolutegravir-based regimens as either first-line or switch antiretroviral therapy: data from the Icona cohort

Introduction: Concerns about dolutegravir (DTG) tolerability in the real-life setting have recently arisen. We aimed to estimate the risk of treatment discontinuation and virological failure of DTG-based regimens from a large cohort of HIV-infected individuals. Methods: We performed a multicentre, observational study including all antiretroviral therapy (ART)-naïve and virologically suppressed treatment-experienced (TE) patients from the Icona (Italian Cohort Naïve Antiretrovirals) cohort who started, for the first time, a DTG-based regimen from January 2015 to December 2017. We estimated the cumulative risk of DTG discontinuation regardless of the reason and for toxicity, and of virological failure using Kaplan–Meier curves. We used Cox regression model to investigate predictors of DTG discontinuation. Results: About 1679 individuals (932 ART-naïve, 747 TE) were included. The one- and two-year probabilities (95% CI) of DTG discontinuation were 6.7% (4.9 to 8.4) and 11.5% (8.7 to 14.3) for ART-naïve and 6.6% (4.6 to 8.6) and 7.6% (5.4 to 9.8) for TE subjects. In both ART-naïve and TE patients, discontinuations of DTG were mainly driven by toxicity with an estimated risk (95% CI) of 4.0% (2.6 to 5.4) and 2.5% (1.3 to 3.6) by one year and 5.6% (3.8 to 7.5) and 4.0% (2.4 to 5.6) by two years respectively. Neuropsychiatric events were the main reason for stopping DTG in both ART-naïve (2.1%) and TE (1.7%) patients. In ART-naïve, a concomitant AIDS diagnosis predicted the risk of discontinuing DTG for any reason (adjusted relative hazard (aRH) = 3.38, p = 0.001), whereas starting DTG in combination with abacavir (ABC) was associated with a higher risk of discontinuing because of toxicity (aRH = 3.30, p = 0.009). TE patients starting a DTG-based dual therapy compared to a triple therapy had a lower risk of discontinuation for any reason (adjusted hazard ratio (aHR) = 2.50, p = 0.037 for ABC-based triple-therapies, aHR = 3.56, p = 0.012 for tenofovir-based) and for toxicity (aHR = 5.26, p = 0.030 for ABC-based, aHR = 6.60, p = 0.024 for tenofovir-based). The one- and two-year probabilities (95% CI) of virological failure were 1.2% (0.3 to 2.0) and 4.6% (2.7 to 6.5) in the ART naïve group and 2.2% (1.0 to 3.3) and 2.9% (1.5 to 4.3) in the TE group. Conclusions: In this large cohort, DTG showed excellent efficacy and optimal tolerability both as first-line and switching ART. The low risk of treatment-limiting toxicities in ART-naïve as well as in treated individuals reassures on the use of DTG in everyday clinical practice

Mature and Immature Teratoma: A Report From the Second Italian Pediatric Study

Background. Teratomas demonstrate a benign clinical behavior, however they may recur with malignant components or as teratoma, and in a small group of patients prognosis could be fatal. After the ®rst Italian study, we collected cases of teratoma, alongside the protocol for malignant germ cell tumors. Procedure. Patients with teratoma were collected from 2004 to 2014. Teratomas were classi®ed according to the WHO classi®cations, as mature and immature. Patients with pathological aFP and/or bHCG, and those with a malignant germ cell component were not included. Results. The study enrolled 219 patients (150 mature, 69 immature teratomas) with a median age at diagnosis of 42 months. The primary sites involved were: 118 gonadal and 101 extragonadal teratomas. Two females with ovarian teratoma had a positive family history. Complete and incomplete surgeries were performed in 85% and 9% of cases. Seventeen events occurred: six females had a second metachronous tumor (5 contralateral ovarian teratoma, 1 adrenal neuroblastoma) and 11 teratomas relapsed/progressed (3 mature, 8 immature teratomas). Two patients died, one of progressive immature teratoma and one of surgical complications. At a median follow up of 68 months, the event-free, relapse-free, and overall survival rates were 90.6%, 94.3%, 98.6%, respectively. Conclusions. Teratomas show a good prognosis, especially the mature ones: surgery and follow-up remain the standard approach. Incomplete surgery in immature teratoma is the group at greatest risk of relapse. Bilateral ovarian tumors are a possibility, and the rare family predisposition to ovarian mature teratoma warrants further analyses

The development of stochastic based transport models to predict the advection and diffusion of bed-load sediment

Many morphological and environmental problems in rivers are associated with the transport of sediment, in particular with the movement of material along the stream bed. The complex nature of turbulent flow and the variability inherent within granular beds, along with the mutual influence one plays on the other, can only be described using the concepts of probability. It follows that the intermittent motion of bed-load particles can be termed by random variables. The stochasticity of key variables has been recently identified as a source of diffusion, i.e. suggesting that a plume of bed-load grains tends to spread while moving in the main flow direction. In this study the application of a Lagrangian analysis to existing high-frequency measurements of moving natural gravel particles contained in a tracking database helped to identify and scale the diffusive regimes related to different stages of grains' motion. Lagrangian tracking data allowed for an in-depth, study of the stochasticity of the particle step length, i.e. the single longitudinal distance computed by a grain from the entrainment to the deposition. The information on the distributed step lengths is then incorporated into a modified version of the Exner mass balance equation which has been developed to model the experimental advective and diffusive transport observed in long duration flume experiments with graded bed deposits comprised of natural sand and crashed marble gravel that have been previously reported. The modelling results indicate that the relative size of bed roughness, together with the thickness of the mixing surficial layer of the bed, play a major role in dictating the pattern of behaviour of particle motion. As the time-dependent burial depth of grains influences the vertical mixing and therefore the downstream diffusion of particles, concentrating the research only on the surficial motion of particles appears restrictive. In order to attain an insight view of the bed and to overcome the previous experimental limitations in terms of the description of the particle step distribution, a non-intrusive technique has been implemented in an annular flume to track the time history of tracing grains subject to intermittent motion in a bed made of transparent glass beads. In the light of the new information on particle transport, a more general Exner-based model incorporates the idea that tracer particles arriving at position x at time t started their random hops r at many different times. Its application to the latest sediment tracer concentration data has proven to be promising in that convincing detailed descriptions of the observed advective and diffusive behaviour of bed-load transport were obtained