Can People with Chronic Neck Pain Recognize Their Own Digital Pain Drawing?

Background: Although the reliability of pain drawings (PDs) has been confirmed in people with chronic pain, there is a lack of evidence about the validity of the PD, that is, does the PD accurately represent the pain experience of the patient? Objectives: We investigate whether people with chronic neck pain (CNP) can recognize their own PD to support the validity of the PD in reporting the experience of pain. Moreover, we examined the association between their ability to recognize their own PD with their levels of pain intensity and disability and extent of psychosocial and somatic features. Study Design: Experimental. Setting: University Laboratory. Methods: Individuals with CNP completed their PD on a digital body chart, which was then automatically modified with specific dimensions using a novel software, providing an objective range of distortion and eliminating errors, which could potentially occur in manually controlled visual-subjective based methods. Following a 10-minute break listening to music, a series of 20 PDs were presented to each patient in a random order, with only 2 being their original PD. For each PD, the patients rated its likeliness to their own original PD on a scale from 0 to 100, with 100 representing “this is my pain.” Results: Overall, the patients rated their original PD with a median score of 92% similarity, followed by 91.8% and 89.5% similarity when presented with a PD scaled down to 75% and scaled up by 150% of the original size, respectively; these scores were not significantly different to the ratings given for their original PD. The PD with horizontal translation by 40 pixels (8%) and vertical translation by 70 pixels (12.8%) were rated as the most dissimilar to their original PD; these scores were significantly different to their original PD scores. The Spearman correlation coefficient revealed a significant negative association between their ability to recognize their original PD and their Modified Somatic Perceptions Questionnaire scores. Limitations: The patients in the study presented with relatively mild CNP, and the results may not be generalized to those with more severe symptoms. Conclusions: People with CNP are generally able to identify their own PD but that their ability to recognize their original PD is negatively correlated with the extent of somatic awareness

To methylate or not to methylate? Study of Mercury Speciation along\ud the Venetian Littoral System (Q-ALiVe project)

The biogeochemical cycle of mercury (Hg) is affected not only by the physical, chemical and hydrological characteristics of the environment, but also by changes in productivity and biodiversity. In waters the complexes of Hg are related to the salinity and to the load of dissolved organic carbon (DOC) in the dissolved and in the particulate phases. Surface and bottom seawater were sampled along the Venetian coast at ten sites with different characteristics. Samples were analyzed employing hyphenated techniques and LOD (limit of detection) and LOQ (limit of quantification) were quantified. Although for some samples both the species were under the LOQ, the presence of methyl mercury (CH3Hg+) and ionic mercury (Hg2+) at the same time in surface and in bottom waters were observed. Variability in CH3Hg+ concentrations may be due to changes in the phytoplankton communities, which in turn may be affected by nutrient loads from the catchment area and port mouths of the Venice Lagoon. Thus, monitoring these nutrient loads may be essential for the health of the Venetian littoral system, since they may affect blooms, methylation and hyper-bioaccumulation along the trophic web, with effects on the environment and on human health

Held to ransom - CMV treatment in South Africa

Cytomegalovirus is a multi-systemic infection reactivated in the immunocompromised. Diagnosis and treatment are prohibitively costly in sub-Saharan Africa, and efforts need to be made for their price reduction to support the expanding highly active antiretroviral treatment programme in the region

Two-stage hepatectomy with radioembolization for bilateral colorectal liver metastases: A case report

BACKGROUND Two-stage hepatectomy (TSH) is a well-established surgical technique, used to treat bilateral colorectal liver metastases (CRLM) with a small future liver remnant (FLR). However, in classical TSH, drop-out is reported to be around 25%- 40%, due to insufficient FLR increase or progression of disease. Trans-arterial radioembolization (TARE) has been described to control locally tumor growth of liver malignancies such as hepatocellular carcinoma, but it has been also reported to induce a certain degree of contralateral liver hypertrophy, even if at a lower rate compared to portal vein embolization or ligation. CASE SUMMARY Herein we report the case of a 75-year-old female patient, where TSH and TARE were combined to treat bilateral CRLM. According to computed tomography (CT)-scan, the patient had a hepatic lesion in segment VI-VII and two other confluent lesions in segment II-III. Therefore, one-stage posterior right sectionectomy plus left lateral sectionectomy (LLS) was planned. The liver volumetry estimated a FLR of 38% (segments I-IV-V-VIII). However, due to a more than initially planned, extended right resection, simultaneous LLS was not performed and the patient underwent selective TARE to segments II-III after the first surgery. The CT-scan performed after TARE showed a reduction of the treated lesion and a FLR increase of 55%. Carcinoembryonic antigen and CA 19.9 decreased significantly. Nearly three months later after the first surgery, LLS was performed and the patient was discharged without any postoperative complications. CONCLUSION According to this specific experience, TARE was used to induce liver hypertrophy and simultaneously control cancer progression in TSH settings for bilateral CRLM

Families_Share: digital and social innovation for work–life balance

Purpose: The European H2020 Families_Share project aims at offering a grass-root approach and a co-designed platform supporting families for sharing time and tasks related to childcare, parenting, after-school and leisure activities and other household tasks. To achieve this objective, the Families_Share project has been built on current practices which are already leveraging on mutual help and support among families, such as Time Banks, Social Streets and self-organizing networks of parents active at the neighbourhood level and seek to harness the potential of ICT networks and mobile technologies to increase the effectiveness of participatory innovation. The aim of this paper is to present and discuss the Families_Share methodology and platform, as well as the results obtained by several partecipating communities in different European countries. Design/methodology/approach: This paper discusses how the Families Share approach (CAPS project, Horizon 2020) is bringing the sharing economy to childcare. Families Share developed a co-caring approach and a co-designed digital welfare platform to support parents with sharing time and tasks related to childcare, after-school and leisure activities. Families Share conducted two iterative pilot experiments and related socio-economic evaluations in six European cities. More than 3,000 citizens were engaged in the co-design process through their local community organizations and more than 1,700 parents and children actively experimented with the approach by organizing collaborative childcare activities. The authors discuss the challenges and solutions of co-designing a socio-technical approach aimed at facilitating socially innovative childcare models, and how the Families Share approach, based on technology-supported co-production of childcare, may provide a new sustainable welfare model for municipalities and companies with respect to life––work balance. Findings: The authors discuss the challenges and solutions of co-designing a technological tool aimed at facilitating socially innovative childcare models, and how the Families Share approach may provide a new sustainable welfare model for municipalities and companies with respect to work–life balance. Originality/value: As a main difference with state-of-the-art proposals, Families_Share is aimed to provide support to networks of parents in the organization of self-managed activities, this way being orthogonal with respect either to social-network functionalities or to supply and demand services. Furthermore, Families_Share has been based on a participative approach for both the ICT platform and the overall structure

Muscle Fiber Conduction Velocity Correlates With the Age at Onset in Mild FSHD Cases

A majority of patients with facioscapulohumeral muscular dystrophy (FSHD) report severe fatigue. The aim of this study was to explore whether fatigability during a performance task is related to the main clinical features of the disease in mildly affected patients. A total of 19 individuals with a molecular genetic-based diagnosis of FSHD (median D4Z4 deletion length of 27 kb) performed two isometric flexions of the dominant biceps brachii at 20% of their maximal voluntary contraction (MVC) for 2 min, and then at 60% MVC until exhaustion. Fatigability indices (average rectified value, mean frequency, conduction velocity, and fractal dimension) were extracted from the surface electromyogram (sEMG) signal, and their correlations with age, age at onset, disease duration, D4Z4 contraction length, perceived fatigability, and clinical disability score were analyzed. The conduction velocity during the low level contraction showed a significant negative correlation with the age at onset (p < 0.05). This finding suggest the assessment of conduction velocity at low isometric contraction intensities, as a potential useful tool to highlight differences in muscle involvement in FSHD patients

Effects of 12 Weeks of Essential Amino Acids (EAA)-Based Multi-Ingredient Nutritional Supplementation on Muscle Mass, Muscle Strength, Muscle Power and Fatigue in Healthy Elderly Subjects: A Randomized Controlled Double-Blind Study

Objective: To counteract muscle mass, muscle strength and power loss during aging, and to study age-related change of neuromuscular manifestation of fatigue in relation to nutritional supplementation. Design: randomized controlled double-blind study. Setting: Twice-daily consumption for 12 weeks of an Essential Amino Acids (EAA)-based multi-ingredient nutritional supplement containing EAA, creatine, vitamin D and Muscle Restore Complex®. Participants: 38 healthy elderly subjects (8 male, 30 female; age: 68.91±4.60 years; body weight: 69.40±15.58 kg; height: 1.60±0.09 m) were randomized and allocated in supplement (SUPP) or placebo (PLA) group. Mean Measurements: Vitamin D blood level; Appendicular Lean Mass (ALM); Visceral Adipose Tissue (VAT); Maximal Voluntary Contraction (MVC) and Peak Power (PP); myoelectric descriptors of fatigue: Fractal Dimension and Conduction Velocity initial values (FD iv, CV iv), their rates of change (FD slopes, CV slopes) and the Time to perform the Task (TtT). Mean Results: Significant changes were found in SUPP compared to baseline: Vitamin D (+8.73 ng/ml; p<0.001); ALM (+0.34 kg; p<0.001); VAT (-76.25 g; p<0.001); MVC (+0.52 kg; p<0.001); PP (+4.82 W; p<0.001). Between group analysis (SUPP Vs. PLA) showed improvements: vitamin D blood levels (+11,72 ng/ml; p<0.001); Legs FFM (+443.7 g; p<0.05); ALM (+0.53 kg; p<0.05); MVC (+1.38 kg; p<0.05); PP (+9.87 W; p<0.05). No statistical changes were found for FD iv, CV iv, FD and CV slopes and TtT, either compared to baseline or between groups. Significant correlations between mean differences in SUPP group were also found. Conclusion: The study demonstrates that in healthy elderly subjects an EAA-based multi-ingredient nutritional supplementation of 12 weeks is not effective to change myoelectric manifestation of fatigue and TtT failure but can positively affect muscle mass, muscle strength, muscle power and VAT, counterbalancing more than one year of age-related loss of muscle mass and strength

Liver transplantation for hepatocellular carcinoma: further considerations on selection criteria

The selection criteria in liver transplantation for HCC are a matter of debate. We reviewed our series, comparing two periods: before and after 1996, when we started to apply the Milan criteria. The study population was composed of patients with a preoperative diagnosis of HCC, confirmed by the pathological report and with a survival of &gt; 1 year. Preoperative staging as revealed by radiological imagining was distinguished from postoperative data, including the variable of tumor volume. After 1996 tumor recurrences significantly decreased (6 out of 15 cases, 40% vs. 3 out of 48, 6.3%, P &lt; .005) and 5-year patient survival improved (42% vs. 83%, P &lt; .005). Not meeting the Milan criteria was significantly related to higher recurrence rate (37.5% vs. 12.7%, P &lt; .05) and to lower 5-year patient survival (38% vs. 78%, P &lt; .005%) in the preoperative analysis, but not in the postoperative one. The alfa-fetoprotein level of more than 30 ng/dL and the preoperative tumor volume of more than 28 cm3 predicted HCC recurrences in the univariate and mutivariate analysis (P &lt; .005 and P &lt; .05, respectively). The ROC curve showed a linear correlation between preoperative tumor volume and HCC recurrence. Milan criteria significantly reduced tumor recurrences after liver transplantation, improving long-term survival. In conclusion, the efficacy of tumor selection criteria must be analyzed with the use of preoperative data, to avoid bias of the postoperative evaluation. Tumor volume and alfa-fetoprotein level may improve the selection of patients. Copyright © 2004 by the American Association for the Study of Liver Diseases