Telemedicine Network in Pediatric Cardiology: The Case of Tuscany Region in Italy

Four years ago, a telemedicine project in diagnosis and care of congenital cardiac malformations was developed in Tuscany interconnecting the Heart Hospital of Gabriele Monasterio Tuscany Foundation (FTGM) in Massa with main clinical centers around the region. Both live and store-and-forward tele-echocardiography were implemented, while the FTGM medical record system was applied for collaborative reporting. Mobile medical-grade carts, equipped with videoconferencing and computer units, were installed at main neonatology/pediatric centers throughout the Tuscany region. Today, 13 hospitals are connected to the network, while the MEYER Pediatric University Hospital (MEYER) in Firenze has recently adhered to the project, as HUB center jointly with FTGM, so enabling H24 telemedicine service in pediatric cardiology throughout the region. So far, more than 200 patients were diagnosed and followed by telemedicine

Massage accelerates brain development and the maturation of visual function

Environmental enrichment (EE) was shown recently to accelerate brain development in rodents. Increased levels of maternal care, and particularly tactile stimulation through licking and grooming, may represent a key component in the early phases of EE. We hypothesized that enriching the environment in terms of body massage may thus accelerate brain development in infants. We explored the effects of body massage in preterm infants and found that massage accelerates the maturation of electroencephalographic activity and of visual function, in particular visual acuity. In massaged infants, we found higher levels of blood IGF-1. Massage accelerated the maturation of visual function also in rat pups and increased the level of IGF-1 in the cortex. Antagonizing IGF-1 action by means of systemic injections of the IGF-1 antagonist JB1 blocked the effects of massage in rat pups. These results demonstrate that massage has an influence on brain development and in particular on visual development and suggest that its effects are mediated by specific endogenous factors such as IGF-1

Histological Characteristics, Fatty Acid Composition of Lipid Fractions, and Cholesterol Content of Semimembranosus and Triceps Brachii Muscles in Maremmana and Limousine Bovine Breeds

This study examined the histological properties of Semimembranosus and Triceps brachii muscle in two different bovine breeds, Maremmana (an autochthonous breed from Tuscany, Italy) and Limousine. The animals were grazed in two adjoining pastures, received the same feed supplementation and were weighed monthly. The experimental period lasted from weaning (six months old) to slaughter (19 months old). Muscle samples were collected immediately after slaughter, before carcass cooling. Regarding the histological properties, the number of fibres (TNF), mean sarcolemma perimeter (MSP), cross section area (CSA), and total sarcolemma perimeter (TSP) were determined. Samples were also analysed for proximate composition, fatty acid profile of total lipids, phospholipids and neutral lipids and for total cholesterol content. Breed was a significant variation factor for the performance parameter and histological muscle fibre properties. Interestingly, despite that Maremmana being a less extensively genetically improved breed than Limousine, it showed higher weight at slaughter (+18%) and daily weight gain (+19%). Maremmana also showed smaller muscle fibres than Limousine and, consequently, the TSP was higher. This difference affected the lipid fraction distribution (Limousine was higher in phospholipids and lower in neutral lipids than Maremmana) and, consequently, the fatty acid composition of total lipids (Limousine was high in polyunsaturated fatty acids, while Maremmana was high in monounsaturated fatty acids). The results of this experiment highlight the importance of environmental and management conditions on the full expression of genotypic potentia

Painting a global picture of basal ganglia network: from past to present!

Since the 70s it has been thought that basal ganglia integrated sensorimotor, associative and limbic inputs and then projected this information through the thalamus to the motor cortex, supplementary motor area and frontal cortex, thus playing a relevant role in planning movement. Recent literature on basal ganglia networks is going beyond the classical “dogma” of dorsal striatum as the main station for cortical inputs in basal ganglia loops and several neurophysiological studies have suggested a more segregated organization of these neural circuits. In the classical view, various tract-tracing methods combined with immunohistochemistry and in situ hybridization demonstrated that the cortical information flows through the basal ganglia via a dual-network model, based on the “direct” and “indirect” routes. However, in addition to these two major projection systems, a glutamatergic hyper-direct pathway between cerebral cortex and subthalamic nucleus has been demonstrated first in monkeys and then in humans. Furthermore, we have recently shown a i) cortico-pallidal connection; ii) a cerebello-pallidal connection; iii) a cerebello nigral connection [1, 2]. Herein, we extensively examined basal ganglia network of fifteen healthy subjects by using probabilistic constrained spherical deconvolution tractography on magnetic resonance diffusion weighted imaging data and we also performed weighted connectivity analysis for each of the subcortical nuclei. In addition, we demonstrated for the first time tractographic evidences of the existence of a direct cortico-nigral pathway in humans. We found that substantia nigra is connected with cerebral cortex as a whole, with the most representative connections involving prefrontal cortex, precentral and postcentral gyri and superior parietal lobule. These findings would strength the hypothesis that the cortico-basal ganglia network consists of several, parallel, segregated, and functionally distinct, but homologous loop, and may be relevant for the comprehension of the pathophysiology of several basal ganglia disorders

Topo-pathological re-wiring in brain structural connectomes of de novo Parkinson’s Disease patients

Although several studies in the last decades have challenged our understanding of Parkinson’s Disease (PD) pathophysiology, an important gap at a network and system level still remains to be filled in order to understand the fundamental changes in high-order motor and non-motor circuits underlying PD symptoms. The wide spectrum of both motor and non-motor symptoms suggests that Parkinson’s Disease may reflect extended alterations of the global brain network, thus justifying the onset of this heterogeneous symptomatology. Such hypothesis would be suitable with the idea of an “associationist” brain, which goes beyond the classic cortical “localizationist” theory. According to the former, the brain might consist of several, segregated and parallel distributed networks around critical and participating cortical epicenters. To the best of our knowledge, only few studies attempted to improve our understanding on structural MRI networks in PD. With the aim of detecting altered topological rewiring of brain networks in early stage de novo PD patients, we reconstructed tractography-based brain structural connectomes [1] in a pilot population of 10 PD patients and 13 controls. Topological features of structural connectomes were computed and compared between the healthy controls group and the group with PD at different level of cut-off. Significant group differences were showed at certain cut-off in the structural connectivity from the measurement of the Local Community Paradigm-correlation (LCPcorr), Characteristic Path Length, Betweenness Centrality and Edge Betweenness Centrality. Increased value of LCPcorr in the pathological group reflects a topological (and not spatial) network local community re-organization of structural interactions between common neighbors nodes [2]. As a result, the PD group has an increased correlation between the number of common neighbors and the number of their internal-interactions across all the structural local communities in the networks. On the other hand, decreased values in Characteristic Path Length, Betweenness Centrality and Edge Betweenness Centrality suggest also a global topological network re-wiring. Taken together these findings strongly indicate altered topological rewiring in de novo PD brain connectome and could shed new light on the pathophysiology of the disease and in the definition of network-based markers for a more quantitative and precise diagnosis

Laser Induced Breakdown Spectroscopy for Elemental Analysis in Environmental, Cultural Heritage and Space Applications: A Review of Methods and Results

Analytical applications of Laser Induced Breakdown Spectroscopy (LIBS), namely optical emission spectroscopy of laser-induced plasmas, have been constantly growing thanks to its intrinsic conceptual simplicity and versatility. Qualitative and quantitative analysis can be performed by LIBS both by drawing calibration lines and by using calibration-free methods and some of its features, so as fast multi-elemental response, micro-destructiveness, instrumentation portability, have rendered it particularly suitable for analytical applications in the field of environmental science, space exploration and cultural heritage. This review reports and discusses LIBS achievements in these areas and results obtained for soils and aqueous samples, meteorites and terrestrial samples simulating extraterrestrial planets, and cultural heritage samples, including buildings and objects of various kinds

Increased Expression and Activity of Matrix Metalloproteinases Characterize Embolic Cardiac Myxomas

Tumor embolism occurs in 30 to 50% of all cases of cardiac myxoma, but the causes are still uncertain. Matrix metalloproteinases (MMPs) are proteolytic enzymes that degrade the extracellular matrix (ECM) and play a crucial role in plaque instability and aortic aneurysm development, in addition to cancer and heart failure. To determine whether MMP activity contributes to tumor embolism, we examined 27 left atrium-sided myxomas, 10 of which showed clinical signs of peripheral embolism. Immunohistochemistry (in all cases) and Western blotting, and in situ and in-gel zymography (in four embolic and six nonembolic consecutive tumors) demonstrated higher expression and activity of MT1-MMP, pro-MMP-2, and pro-MMP-9 in embolic myxomas, whereas pro-MMP-1, MMP-3, and TIMP-1 levels were similar to those of nonembolic tumors. Reverse transcriptase-polymerase chain reaction demonstrated that increased MMP activity was due, at least in part, to increased transcription and that TIMP-2 transcripts increased in embolic myxomas. In vitro, embolic tumor cells retained higher MT1-MMP and pro-MMP-2 levels in basal conditions and after stimulation with interleukin-1β and interleukin-6. Increased MMP synthesis and release correlated with enhanced ECM degradation products containing glycosaminoglycan chains in embolic myxoma tissue. Our results strongly suggest that MMP overexpression may contribute to an excessive degradation of tumor ECM and increase the risk of embolism in cardiac myxomas