Guided Tours Across a Collection of Historical Digital Images

We propose the use of short lectures, called narratives, embedded in a digital archive as a personalization method to support and guide users within a collection of historical material. The effectiveness of the approach has been evaluated with two groups of users. An analysis of the results has been conducted enabling the presentation of preliminary results

Coupling solid and fluid stresses with brain tumour growth and white matter tract deformations in a neuroimaging-informed model

Brain tumours are among the deadliest types of cancer, since they display a strong ability to invade the surrounding tissues and an extensive resistance to common therapeutic treatments. It is therefore important to reproduce the heterogeneity of brain microstructure through mathematical and computational models, that can provide powerful instruments to investigate cancer progression. However, only a few models include a proper mechanical and constitutive description of brain tissue, which instead may be relevant to predict the progression of the pathology and to analyse the reorganization of healthy tissues occurring during tumour growth and, possibly, after surgical resection. Motivated by the need to enrich the description of brain cancer growth through mechanics, in this paper we present a mathematical multiphase model that explicitly includes brain hyperelasticity. We find that our mechanical description allows to evaluate the impact of the growing tumour mass on the surrounding healthy tissue, quantifying the displacements, deformations, and stresses induced by its proliferation. At the same time, the knowledge of the mechanical variables may be used to model the stress-induced inhibition of growth, as well as to properly modify the preferential directions of white matter tracts as a consequence of deformations caused by the tumour. Finally, the simulations of our model are implemented in a personalized framework, which allows to incorporate the realistic brain geometry, the patient-specific diffusion and permeability tensors reconstructed from imaging data and to modify them as a consequence of the mechanical deformation due to cancer growth

Undergraduate nurses attitudes towards organ donation: a cross-sectional survey in a north Italian university.

BACKGROUND: Although research reveals that there are many complex factors influencing the low organ donation rate in addition to nurses, literature suggests that nurses and doctors' active engagement and support have a significant impact on donation rates. Donation rates can be influenced by a variety of factors, including health professionals' attitudes, knowledge, confidence, participation, and training. OBJECTIVES: To investigate the attitudes of undergraduate nursing students at the University of Brescia in the Campus of Cremona regarding organ and tissue donation. MATERIALS AND METHODS: A cross-sectional survey was conducted by administering the Organ Donation Attitudes Scale (ODAS). RESULTS: ODAS showed that most students know someone who has donated an organ during their lifetime or after death, and over half know someone who has received an organ transplant. However, 63.3% of students indicated that they had not received specific training, and attitudes ranged from 45 to 71 with a median score of 61. Bivariate correlation analysis revealed that received academic training does not correlate with students' attitudes (p=.37). Knowing someone who has received a transplant correlates with having expressed willingness to donate (p=.047), and academic training correlates with perceived knowledge about the donation process (p=.0001). CONCLUSIONS: The study found mainly positive attitudes toward organ and tissue donation among nursing undergraduate students from the Cremona campus. Further research involving nursing universities is needed to raise awareness of organ donation among the public and healthcare workers.INTRODUZIONE: Nonostante la ricerca mostri una certa complessità nelle ragioni che spieghino il basso tasso di donazione di organi nella popolazione, diversi studi in letteratura suggeriscono che la partecipazione attiva di infermieri e medici abbia una forte influenza sui tassi di donazione. In particolare, le attitudini, le conoscenze, la fiducia, l'impegno e la formazione dei professionisti della salute risultano essere fattori influenti. OBIETTIVI: Indagare le attitudini degli studenti infermieri universitari dell'Università di Brescia riguardo la donazione di organi e tessuti. MATERIALI E METODI: È stata condotta un'indagine trasversale mediante la somministrazione della Organ Donation Attitudes Scale (ODAS). RISULTATI: L'ODAS ha mostrato che la maggior parte degli studenti conosce qualcuno che ha donato un organo durante la propria vita o dopo la morte e oltre la metà conosce qualcuno che ha ricevuto un trapianto di organo. Tuttavia, il 63,3% degli studenti ha indicato di non aver ricevuto una formazione specifica. Gli scores totali variano da 45 a 71 con un punteggio mediano di 61. L'analisi di correlazione rivela come la formazione accademica non correla con le attitudini (p=0,37). Sapere che qualcuno ha ricevuto un trapianto correla con la disponibilità ad esprimere la volontà donativa (p=0,047) e la formazione accademica correla con la conoscenza percepita del processo di donazione (p=0,0001). CONCLUSIONI: Lo studio ha riscontrato prevalentemente attitudini positive verso la donazione di organi e tessuti tra gli studenti infermieri universitari del campus di Cremona. Ulteriori ricerche coinvolgendo le università di infermieristica sono necessarie per sensibilizzare il pubblico e gli operatori sanitari

Stroke Gait Rehabilitation: A Comparison of End-Effector, Overground Exoskeleton, and Conventional Gait Training

Gait recovery is one of the main goals of post-stroke rehabilitation and Robot-Assisted Gait Training (RAGT) has shown positive outcomes. However, there is a lack of studies in the literature comparing the effects of different devices. This paper aims to study the effects, in terms of clinical and gait outcomes, of treadmill-based and overground RAGT, compared to conventional gait training in stroke subjects. The results showed a significant improvement of clinical outcomes in both robotic treatments and in conventional therapy. The performance of locomotor tasks was clinically significant in the robotic groups only. The spatio-temporal gait parameters did not reveal any significant difference. Results suggest future multicentre studies on a larger number of subjects

White matter changes in corticobasal degeneration syndrome and correlation with limb apraxia

BACKGROUND: Data on white matter changes in corticobasal degeneration syndrome (CBDS) are not yet available, whereas cortical gray matter loss is a feature of this condition. The structural abnormalities related to a key feature of CBDS (limb apraxia) are unknown. OBJECTIVES: To measure selective structural changes in early CBDS using diffusion tensor imaging and voxel-based morphometry and to evaluate the structural correlates of limb apraxia. DESIGN: Patient and control group comparison. SETTING: Referral center for dementia and movement disorders. PARTICIPANTS: Twenty patients with CBDS and 21 matched control subjects. INTERVENTIONS: Clinical and standardized neuropsychological evaluations, including assessment of limb apraxia. MAIN OUTCOME MEASURES: Gray and white matter changes in early CBDS. RESULTS: Diffusion tensor imaging revealed decreases in fractional anisotropy in the long frontoparietal connecting tracts, the intraparietal associative fibers, and the corpus callosum. Fractional anisotropy was also reduced in the sensorimotor projections of the cortical hand areas. Voxel-based morphometry showed a prevalent gray matter reduction in the left hemisphere (in the inferior frontal and premotor cortices, parietal operculum, superotemporal gyrus, and hippocampus). The pulvinar, bilaterally, and the right cerebellar cortex also showed atrophy. Limb apraxia correlated with parietal atrophy and with fractional anisotropy reductions in the parietofrontal associative fibers (P < .01). The limb-kinetic component of apraxia correlated with reduction of hand sensorimotor connecting fibers. CONCLUSIONS: The present integrative approach to in vivo structural anatomy combines hodologic imaging, describing patterns of white matter connections between cortical areas, with neuropsychological data. This provides new evidence of gray matter and fiber tract abnormalities in early-phase disease and contributes to clarifying the neural basis of apraxia in CBDS

Impact on monthly migraine days of discontinuing anti-CGRP antibodies after one year of treatment - a real-life cohort study.

OBJECTIVE This study aims to analyse the effect of the discontinuation of anti-calcitonin gene-related peptide antibodies on monthly migraine days after 12 treatment months. BACKGROUND Anti-calcitonin gene-related peptide antibodies have been a game changer in migraine prophylaxis. However, high treatment costs warrant reducing treatment duration to the essential minimum. METHODS We collected data of patients with migraine who had received anti-calcitonin gene-related peptide antibodies and had received treatment for 12 months. RESULTS We included 52 patients. The average number of monthly migraine days was 16 ± 7 days at baseline, 6 ± 6 in the third, and 5 ± 4 in the 12th treatment month. After treatment interruption, the number of monthly migraine days was 6 ± 4 days in the first month, 9 ± 4 days in the second, and 11 ± 5 days in the third month. Most patients (88.9%) restarted treatment. CONCLUSION Only little of the therapeutic effect of anti-calcitonin gene-related peptide antibodies outlasts their pharmacological effect. After treatment interruption, migraine frequency rose in most patients, and prophylaxis was required again in most cases.Limiting treatment to benefitting patients and confirming the need for prophylaxis periodically is reasonable. However, our data does not support the need for prescheduled treatment discontinuation after 12 months and a fixed duration of the treatment interruption of 3 months

Headache: Prevalence and relationship with office or ambulatory blood pressure in a general population sample (the Vobarno Study).

The association of headache and arterial hypertension is still controversial, although headache is usually considered a symptom of hypertension. The aim of this study is to evaluate the prevalence of headache in a general population sample and the relationship with arterial hypertension, as diagnosed by office measurements and ambulatory monitoring of blood pressure (BP).In the randomized sample of the Vobarno population, 301 subjects (126 males, 175 females, age range 35-50 years) underwent a structured standardized headache questionnaire, office and 24-h ambulatory BP monitoring.Prevalence of lifetime headache and of migraine was greater in females than in males. Office and 24-h BP values did not differ between subjects without headache and subjects with headache. No differences in headache prevalence (58% vs 55%), migraine prevalence (32% vs 28%) and use of analgesic drugs in the presence of headache (82% vs 78%) were observed between hypertensive patients (93.5% newly diagnosed, 6.5% treated) and normotensive subjects.In a general population sample, hypertension (diagnosed by office and/or 24-h BP) is not associated with headache

A case of vocal cord dysfunction in the emergency department

We describe the case of a 78-year-old woman admitted to our emergency department for an acute onset of severe dyspnoea with inspiratory wheezing-like sounds. She denied fever, cough, voice change and pain. She referred a similar but less severe episode occurred spontaneously one year before, with complete resolution in few minutes without sequelae. On examination upper airway obstruction was firstly excluded. She was initially treated as having asthma, without response. Parenteral high dose corticosteroids and antihistamines provided no benefit. Point-of-care-ultrasound resulted normal. Flexible laryngoscopy during the episode showed paradoxical vocal cord movement with adduction during both inspiration and expiration. This demonstrated that her dyspnoea was from Vocal Cord Dysfunction (VCD). VCD completely solved after administration of intravenous benzodiazepines