Reproducibility and Accuracy of the Radiofrequency Echographic Multi-Spectrometry for Femoral Mineral Density Estimation and Discriminative Power of the Femoral Fragility Score in Patients with Primary and Disuse-Related Osteoporosis

We aimed to investigate the reproducibility and accuracy of Radiofrequency Echographic Multi-Spectrometry (REMS) for femoral BMD estimation and the reproducibility and discriminative power of the REMS-derived femoral fragility score. 175 patients with primary and disuse-related osteoporosis were recruited: one femoral Dual-energy X-ray Absorptiometry (DXA) scan and two femoral REMS scans were acquired. No significant test—retest differences were observed for all REMS-derived variables. The diagnostic concordance between DXA and REMS was 63% (Cohen’s kappa = 0.31) in patients with primary osteoporosis and 13% (Cohen’s kappa: −0.04) in patients with disuse-related osteoporosis. No significant difference was observed between REMS and DXA for either femoral neck BMD (mean difference between REMS and DXA: −0.015 g/cm(2)) or total femur BMD (mean difference: −0.004 g/cm(2)) in patients with primary osteoporosis. Significant differences between the two techniques were observed in patients with disuse-related osteoporosis (femoral neck BMD difference: 0.136 g/cm(2); total femur BMD difference: 0.236 g/cm(2)). Statistically significant differences in the fragility score were obtained between the fractured and non-fractured patients for both populations. In conclusion, REMS showed excellent test-retest reproducibility, but the diagnostic concordance between DXA and REMS was between minimal and poor. Further studies are required to improve the REMS—derived estimation of femoral BMD

Effectiveness of a home-based telerehabilitation system in patients after total hip arthroplasty: study protocol of a randomized controlled trial

Background: The demand for total hip arthroplasty (THA) is quickly rising given the escalating global incidence of hip osteoarthritis, and it is widely accepted that the post-surgery rehabilitation is key to optimize outcomes. The overall objective of this study is to evaluate the effectiveness of a new telerehabilitation solution, ReHub, for the physical function and clinical outcome improvement following THA. The specific aims of this manuscript are to describe the study design, protocol, content of interventions, and primary and secondary outcomes and to discuss the clinical rehabilitation impact of the expected experimental results. Methods/design: This prospective, randomized, controlled, parallel-group trial will include 56 patients who had undergone primary THA. Patients are randomized to a control group (standard rehabilitation during the 2-week stay in the rehabilitation clinic followed by 3 weeks of unsupervised home-based rehabilitation) or an experimental group (standard rehabilitation during the 2-week stay in the rehabilitation clinic followed by 3 weeks of home-based ReHub-assisted telerehabilitation). The primary outcome is physical performance assessed through the Timed Up-and-Go (TUG) test. Secondary outcomes include independence level, pain intensity, hip disability, hip range of motion, muscle strength, and patient's perception of clinical improvement. Discussion: Proving the clinical and cost-effectiveness of a home-based telerehabilitation program for physical and muscle function following THA could support its systematic incorporation in post-surgical rehabilitation protocols, which should be tailored to the individual and collective needs

A complex network approach reveals pivotal sub-structure of genes linked to Schizophrenia

Research on brain disorders with a strong genetic component and complex heritability, like schizophrenia and autism, has promoted the development of brain transcriptomics. This research field deals with the deep understanding of how gene-gene interactions impact on risk for heritable brain disorders. With this perspective, we developed a novel data-driven strategy for characterizing genetic modules, i.e., clusters, also called community, of strongly interacting genes. The aim is to uncover a pivotal module of genes by gaining biological insight upon them. Our approach combined network topological properties, to highlight the presence of a pivotal community, matchted with information theory, to assess the informativeness of partitions. Shannon entropy of the complex networks based on average betweenness of the nodes is adopted for this purpose. We analyzed the publicly available BrainCloud dataset, containing post-mortem gene expression data and we focused on the Dopamine Receptor D2, encoded by the DRD2 gene. To parse the DRD2 community into sub-structure, we applied and compared four different community detection algorithms. A pivotal DRD2 module emerged for all procedures applied and it represented a considerable reduction, compared with the beginning network size. Dice index 80% for the detected community confirmed the stability of the results, in a wide range of tested parameters. The detected community was also the most informative, as it represented an optimization of the Shannon entropy. Lastly, we verified that the DRD2 was strongly connected to its neighborhood, stronger than any other randomly selected community and more than the Weighted Gene Coexpression Network Analysis (WGCNA) module, commonly considered the standard approach for these studies

Evaluation of liquefaction potential in an intermountain Quaternary lacustrine basin (Fucino basin, central Italy)

In this study, we analyse the susceptibility to liquefaction of the Pozzone site, which is located on the northern side of the Fucino lacustrine basin in central Italy. In 1915, this region was struck by a M 7.0 earthquake, which produced widespread coseismic surface effects that were interpreted to be liquefaction-related. However, the interpretation of these phenomena at the Pozzone site is not straightforward. Furthermore, the site is characterized by an abundance of fine-grained sediments, which are not typically found in liquefiable soils. Therefore, in this study, we perform a number of detailed stratigraphic and geotechnical investigations (including continuous-coring borehole, CPTu, SDMT, SPT, and geotechnical laboratory tests) to better interpret these 1915 phenomena and to evaluate the liquefaction potential of a lacustrine environment dominated by fine-grained sedimentation. The upper 18.5 m of the stratigraphic succession comprises fine-grained sediments, including four strata of coarser sediments formed by interbedded layers of sand, silty sand and sandy silt. These strata, which are interpreted to represent the frontal lobes of an alluvial fan system within a lacustrine succession, are highly susceptible to liquefaction. We also find evidence of paleo-liquefaction, dated between 12.1–10.8 and 9.43–9.13 kyrs ago, occurring at depths of 2.1–2.3 m. These data, along with the aforementioned geotechnical analyses, indicate that this site would indeed be liquefiable in a 1915-like earthquake. Although we found a broad agreement among CPTu, DMT and shear wave velocity ‘‘simplified procedures’’ in detecting the liquefaction potential of the Pozzone soil, our results suggest that the use and comparison of different in situ techniques are highly recommended for reliable estimates of the cyclic liquefaction resistance in lacustrine sites characterized by high content of fine-grained soils. In geologic environments similar to the one analysed in this work, where it is difficult to detect liquefiable layers, one can identify sites that are susceptible to liquefaction only by using detailed stratigraphic reconstructions, in situ characterization, and laboratory analyses. This has implications for basic (Level 1) seismic microzonation mapping, which typically relies on the use of empirical evaluations based on geologic maps and pre-existing sub-surface data (i.e., age and type of deposits, prevailing grain size, with particular attention paid to clean sands, and depth of the water table).Published91-1115T. Sismologia, geofisica e geologia per l'ingegneria sismicaJCR Journa

West Nile Virus lineage 2 overwintering in Italy

In January 2022, West Nile virus (WNV) lineage 2 (L2) was detected in an adult female goshawk rescued near Perugia in the region of Umbria (Italy). The animal showed neurological symptoms and died 15 days after its recovery in a wildlife rescue center. This was the second case of WNV infection recorded in birds in the Umbria region during the cold season, when mosquitoes, the main WNV vectors, are usually not active. According to the National Surveillance Plan, the Umbria region is included amongst the WNV low-risk areas. The necropsy evidenced generalized pallor of the mucous membranes, mild splenomegaly, and cerebral edema. WNV L2 was detected in the brain, heart, kidney, and spleen homogenate using specific RT-PCR. Subsequently, the extracted viral RNA was sequenced. A Bayesian phylogenetic analysis performed through a maximum-likelihood tree showed that the genome sequence clustered with the Italian strains within the European WNV strains among the central-southern European WNV L2 clade. These results, on the one hand, confirmed that the WNV L2 strains circulating in Italy are genetically stable and, on the other hand, evidenced a continuous WNV circulation in Italy throughout the year. In this report case, a bird-to-bird WNV transmission was suggested to support the virus overwintering. The potential transmission through the oral route in a predatory bird may explain the relatively rapid spread of WNV, as well as other flaviviruses characterized by similar transmission patterns. However, rodent-to-bird transmission or mosquito-to-bird transmission cannot be excluded, and further research is needed to better understand WNV transmission routes during the winter season in Ital

Ticks from migratory birds as possible route to spread Crimean-Congo Hemorrhagic fever virus : preliminary data about species composition from three Italian islands

Migratory birds have been known to be passive carriers of arthropod vectors of various pathogens. A study to assess the potential role of migratory birds, which are tick-carriers, as a possible route to spread the Crimean-Congo Hemorrhagic Fever Virus (CCHFV) into Europe was initiated in 2017 by the Italian Ministry of Health. Ticks were collected from birds during seasonal bird ringing activities in Mediterranean islands known to be stop-over sites for migratory birds from Africa or from East Europe and Turkey.peer-reviewe

Gravitational collapse in an expanding background and the role of substructure II: Excess power at small scales and its effect of collapse of structures at larger scales

We study the interplay of clumping at small scales with the collapse and relaxation of perturbations at larger scales using N-Body simulations. We quantify the effect of collapsed haloes on perturbations at larger scales using two point correlation function, moments of counts in cells and mass function. The purpose of the study is twofold and the primary aim is to quantify the role played by collapsed low mass haloes in the evolution of perturbations at large scales, this is in view of the strong effect seen when the large scale perturbation is highly symmetric. Another reason for this study is to ask whether features or a cutoff in the initial power spectrum can be detected using measures of clustering at scales that are already non-linear. The final aim is to understand the effect of ignoring perturbations at scales smaller than the resolution of N-Body simulations. We find that these effects are ignorable if the scale of non-linearity is larger than the average inter-particle separation in simulations. Features in in the initial power spectrum can be detected easily if the scale of these features is in the linear regime, detecting such features becomes difficult as the relevant scales become non-linear. We find no effect of features in initial power spectra at small scales on the evolved power spectra at large scales. We may conclude that in general, the effect on evolution of perturbations at large scales of clumping on small scales is very small and may be ignored in most situations.Comment: Accepted for publication in MNRA

Cluster-like headache and idiopathic intracranial hypertension: a case report.

Cluster headache (CH) is a well-defined primary headache syndrome, but cases of symptomatic headache with clinical features of CH have been previously reported. Idiopathic Intracranial Hypertension (IIH) is a secondary headache disorder characterized by headache and visual symptoms, without clinical, radiological or laboratory evidence of intracranial pathology. Both papilloedema and IIH-related headache are typically bilateral, however asymmetrical or even unilateral localizations are described in literature. We report the case of a previously headache-free woman who presented cluster-like headache and asymmetrical papilloedema related to IIH. In our opinion the asymmetrical presentation supports, in this case, the hypothesis of cavernous sinus involvement in the IIH-related cluster-like headache pathogenesis

Sistema Integrato Multicentrico di Indicatori. Rapporto 2005. Provincia di Pescara

The SIMI (Integrated System of Indicators multicenter) Project contributes to the development of an integrated management of informative data streams related to drug addicted persons. This report analyzes the phenomenon of addiction on the territory of Pescara province through a description of the network services that provide care and rehabilitation of those addicted. Besides the characteristics of users of local services for addictions, has been developed the analysis of the subjects reported to the prefectures for use of illegal drugs and any action taken. Standard methods of estimation were also applied to quantify the proportion of users of substances that do not relate to services and to identify certain characteristics.Il Progetto SIMI (Sistema Integrato Multicentrico di Indicatori) intende contribuire allo sviluppo di una gestione integrata e sinergica dei flussi informativi relativi ai consumatori di sostanze stupefacenti afferenti alle diverse amministrazioni dello Stato. In linea con quanto proposto dall\u27Osservatorio europeo di Lisbona, per la descrizione e analisi del fenomeno connesso all\u27uso/abuso di sostanze, risulta di fondamentale importanza la possibilit? di ottenere informazioni esaustive e comparabili sulle persone che usano e/o abusano di sostanze psicotrope. Il presente rapporto analizza il fenomeno delle dipendenze sul territorio della provincia di Pescara attraverso la descrizione della rete dei servizi preposti alla cura e riabilitazione dei soggetti tossicodipendenti. Accanto alle caratteristiche degli utenti dei servizi territoriali per le dipendenze, ? stata sviluppata l\u27analisi dei soggetti segnalati alle Prefetture per uso di sostanze illegali e degli eventuali provvedimenti adottati. Sono state inoltre applicate metodologie standard di stima per quantificare la quota parte di utilizzatori di sostanze che non afferiscono ai servizi e per identificarne alcune caratteristiche

Bibliometric Network Analysis on Rapid-Onset Opioids for Breakthrough Cancer Pain Treatment

Background and Objectives. Proper breakthrough cancer pain (BTcP) management is of pivotal importance. Although rapid-acting, oral and nasal transmucosal, fentanyl formulations (rapid-onset opioids, ROOs) are licensed for BTcP treatment, not all guidelines recommend their use. Presumably, some research gaps need to be bridged to produce solid evidence. We present a bibliometric network analysis on ROOs for BTcP treatment.Methods. Documents were retrieved from the Web of Science (WOS) online database. The string was "rapid onset opioids" or "transmucosal fentanyl" and "breakthrough cancer pain". Year of publication, journal metrics (impact factor and quartile), title, document type, topic, and clinical setting (in-patients, outpatients, and palliative care) were extracted. The software tool VOSviewer (version 1.6.17) was used to analyze the semantic network analyzes, bibliographic coupling, journals analysis, and research networks.Results. 502 articles were found in WOS. A declining trend in published articles from 2014 to 2021 was observed. Approximately 50% of documents regard top quartile (Q1) journals. Most articles focused on ROOs efficacy, but abuse and misuse issues are poorly addressed. With respect to article type, we calculated 132 clinical investigations. The semantic network analysis found interconnections between the terms "breakthrough cancer pain," "opioids," and "cancers." The top co-cited article was published in 2000 and addressed pain assessment. The largest number of partnerships regarded the United States, Italy, and England.Conclusion. In this research area, most articles are published in top-ranked journals. Nevertheless, paramount topics should be better addressed, and the implementation of research networks is needed. (C) 2022 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved