Recurrent Painful Ophthalmoplegic Neuropathy: A case report with atypical features and a review of the literature

Introduction: Recurrent Painful Ophthalmoplegic Neuropathy, previously known as Ophthalmoplegic Migraine, is a poorly characterized disorder mainly because there are few cases described. We report a new case of Recurrent Painful Ophthalmoplegic Neuropathy and a review of the literature to contribute to increasing the knowledge of the clinical features of this disorder. Case report and review of literature: A 45-year-old woman presented with adult-onset recurrent attacks of abducens and oculomotor palsy associated with diplopia followed by headache. Most notably, pain always presented many days after oculomotor impairment, a feature never described in the literature. A diagnosis of possible Recurrent Painful Ophthalmoplegic Neuropathy was made after excluding other possible mimicking disorders. Symptoms usually resolved gradually with corticosteroid therapy, albeit without a clear-cut benefit.Clinical data collected from 1989 to 2022 showed that adult onset in Recurrent Painful Ophthalmoplegic Neuropathy is not uncommon. While III cranial nerve palsy is typical, VI and IV nerve palsy have also been described. Pathophysiology and diagnosis: Several hypotheses have been proposed, including nerve compression, ischemia or inflammation/demyelination, but none has been completely accepted.Diagnosis remains of exclusion; magnetic resonance imaging and blood exams are key in differential diagnosis. Conclusions: Our case gives us the possibility to expand the clinical features of Recurrent Painful Ophthalmoplegic Neuropathy, also contributing to updating the pathophysiological hypotheses

Clinical and pathology characterization of small nerve fiber neuro(no)pathy in cerebellar ataxia with neuropathy and vestibular areflexia syndrome

Background and purpose; Biallelic mutation/expansion of the gene RFC1 has been described in association with a spectrum of manifestations ranging from isolated sensory neuro(no)pathy to a complex presentation as cerebellar ataxia with neuropathy and vestibular areflexia syndrome (CANVAS). Our aim was to define the frequency and characteristics of small fiber neuropathy (SFN) in RFC1 disease at different stages.Methods: RFC1 cases were screened for SFN using the Neuropathic Pain Symptom Inventory and Composite Autonomic Symptom Score 31 questionnaires. Clinical data were retrospectively collected. If available, lower limb skin biopsy samples were evaluated for somatic epidermal and autonomic subepidermal structure innervation and compared to healthy controls (HCs).Results: Forty patients, median age at onset 54 years (interquartile range [IQR] 49-61) and disease duration 10 years (IQR 6-16), were enrolled. Mild-to-moderate positive symptoms (median Neuropathic Pain Symptom Inventory score 12.1/50, IQR 5.5-22.3) and relevant autonomic disturbances (median Composite Autonomic Symptom Score 31 37.0/100, IQR 17.7-44.3) were frequently reported and showed scarce correlation with disease duration. A non-length-dependent impairment in nociception was evident in both clinical and paraclinical investigations. An extreme somatic denervation was observed in all patients at both proximal (fibers/mm, RFC1 cases 0.0 vs. HCs 20.5, p < 0.0001) and distal sites (fibers/mm, RFC1 cases 0.0 vs. HCs 13.1, p < 0.0001); instead only a slight decrease was observed in cholinergic and adrenergic innervation of autonomic structures.Conclusions: RFC1 disease is characterized by a severe and widespread somatic SFN. Skin denervation may potentially represent the earliest feature and drive towards the suspicion of this disorder

Voluntary work and cultural capital: an exploratory analysis for Italian regional data

This paper addresses the relationship between voluntary work and cultural capital, providing a conceptual framework by moving from a cultural economics standpoint to a relational goods theory approach. The two main hypotheses relate to a positive relationship between cultural capital and voluntary work and a significant relationship between relational cultural goods and voluntary work. We corroborate these assumptions empirically by applying a two-stage least squares regression to Italian data at the regional level. The data are drawn from official sources and cover 20 Italian regions over the span of 2005–2013. The results show that volunteering is stimulated by cultural participation in more niche cultural goods and is shared by individuals with some knowledge and human and artistic sensitivity. Moreover, the consumption of specific cultural goods with a strong relational component, such as museums, exhibitions and theatre, has a significant impact on volunteer activity

Are mobile and fixed broadband substitutes or complements? New empirical evidence from Italy and implications for the digital divide policies

The literature on broadband policies has been focusing on the possible role of mobile broadband as a means for addressing geographical digital divide in areas with no or inadequate fixed broadband infrastructure coverage. Broadband plans designed by most of the industrialized countries take the substitutability between fixed and mobile technologies for granted, with restrictions essentially relating only to bandwidth performance. We explore the determinants of individuals' private access (away from work) to the Internet with the smartphone through a mobile broadband connection, focusing on the role played by Internet uses and taking into account the availability of a fixed broadband connection at home. The results of our econometric exercise, carried out on microdata referred to Italian individuals, provide original and interesting evidence: a complementarity effect between mobile and fixed broadband is found for browsing, video streaming, gaming and cloud services; a substitution effect emerges for social networking and music streaming. Such increasing complexity of individuals’ broadband usage patterns should be acknowledged in the way broadband coverage is mapped and policies designed, adopting a more ecosystem-oriented approach which integrates supply- and demand-side features. A first step in this direction is the inclusion of some, so far neglected, key-attributes of the demand (data traffic allowance, latency, ease of interconnection with Internet capable devices) among the relevant dimensions of policy design

Are mobile and fixed broadband substitutes or complements? New empirical evidence from Italy and implications for the digital divide policies

The literature on broadband policies has been focusing on the possible role of mobile broadband as a means for addressing geographical digital divide in areas with no or inadequate fixed broadband infrastructure coverage. Broadband plans designed by most of the industrialized countries take the substitutability between fixed and mobile technologies for granted, with restrictions essentially relating only to bandwidth performance. We explore the determinants of individuals' private access (away from work) to the Internet with the smartphone through a mobile broadband connection, focusing on the role played by Internet uses and taking into account the availability of a fixed broadband connection at home. The results of our econometric exercise, carried out on microdata referred to Italian individuals, provide original and interesting evidence: a complementarity effect between mobile and fixed broadband is found for browsing, video streaming, gaming and cloud services; a substitution effect emerges for social networking and music streaming. Such increasing complexity of individuals’ broadband usage patterns should be acknowledged in the way broadband coverage is mapped and policies designed, adopting a more ecosystem-oriented approach which integrates supply- and demand-side features. A first step in this direction is the inclusion of some, so far neglected, key-attributes of the demand (data traffic allowance, latency, ease of interconnection with Internet capable devices) among the relevant dimensions of policy design

SERIOUS GAMES, FOOD EDUCATION AND HEALTHY HABITS AT SCHOOL: A PEDAGOGICAL PERSPECTIVE

The increasing use of technologies in educational setting is progressively modifying time, space and learning environments, determining not only different way of access knowledge, but also the didactic methodologies, way of learning and academic outcomes. In this context, in accordance with to the stimulating challenges, the customize experiences, and the practice-based approach, the Serious Games (SG) and Gamification represent important tools to facilitate learnings and to develop soft skills, emotional intelligence, and divergent thinking. Recent findings have assessed the effectiveness of digital gaming elements on nutritional knowledge in children and adolescents for improving correct eating behaviours and reducing the prevalence of overweight and obesity. The present paper aims to describe use of SG and Gamification for promoting healthy eating habits in children and adolescents, highlighting the pedagogical and methodological implications.