Seismic Hazard Mapping inside the Project SIGMA

The Project SIGMA (Sistema Integrato di sensori in ambiente cloud per la Gestione Multirischio Avanzata) arises from the fields of Information and Communications Technologies (ICT) and advanced applications for the control, monitoring and management of high-risk processes of natural and social origin. SIGMA is a multilevel architecture whose main aim is the acquisition, integration and processing of heterogeneous data from different sources (seismic, volcanic, meteorologic, hydric, pluvial, car traffic, marine traffic, and so on) to manage and elaborate risk mitigation strategies which are important for the emergency management planning. Within the several experimental activities included in the project, there is the designing and realization of a prototype of application platform specialized to provide the operating procedures and software to the public administrations and the industrial companies, for constantly monitoring both the anthropic and natural phenomena in Sicily. In this framework, of course, the seismic risk analysis plays a very important role since Sicily is one of the Italian regions with high seismic risk. Seismic risk assessment may be approached in two different ways: i) as average seismic risk of the buildings and facilities in question during the period considered, combining the vulnerability of different building types and the seismic hazard for the site, which are then expressed in terms of the effects of the events derived from an earthquake catalogue that exceed a specified threshold during a given period; ii) as estimated damage of the buildings and the critical facilities using a scenario input described in terms of the source parameters of the hypocenter as location, magnitude, and so on. Here we deal with the hazard calculation through the code CRISIS (Ordaz, Aguilar and Arboleda) and with the code PROSCEN (PRObabilistic SCENario, [Rotondi and Zonno, 2010]) to obtain earthquake scenario to be used in the latter approach. Indeed, an earthquake scenario is a planning tool that helps decision makers to visualize the specific impact of an earthquake based on the scientific knowledge. An earthquake scenario creates a picture that the members of community can recognize and, at the same time, improves the communication between the scientific, emergency management and policy communities to seismic risk reduction

Sarcoglycans and gabaa receptors in rat central nervous system: an immunohistochemical study

Sarcoglycan subcomplex is a transmembrane glycoprotein system which connects extracellular matrix to cytoskeleton. Although this complex has been found in several non-muscular tissues, no data exist about a sarcoglycan subcomplex in brain. Only the presence of ε-sarcoglycan in brain has been described in detail because its mutation determines Myoclonus Dystonia Syndrome. Also ζ-, β- and δ-sarcoglycans have been found in brain but only at mRNA level and their distribution in brain is still unknown. Here, we have searched for the expression of all sarcoglycans in specific brain regions of rat as hippocampus, cerebral and cerebellar cortex. Since a correlation between dystrophin glycoprotein complex and γ-amino butyric acid A (GABAA) receptor was demonstrated, we have investigated also a possible colocalization between sarcoglycans and GABAA receptor. Results have shown that all sarcoglycans are expressed in neurons of all observed regions; these proteins show a spot-like pattern of fluorescence and are mainly localized at soma level. Moreover, each sarcoglycan colocalizes with GABAA receptor. The present study shows, for the first time, the expression of all sarcoglycans in brain; moreover, the prevalent localization of sarcoglycans at post-synaptic level and the colocalization of these glycoproteins with GABAA receptor suggests that sarcoglycans play a key role in central nervous system, regulating post-synaptic receptors assembly

Moving into the wide clinical spectrum of consciousness disorders: Pearls, perils and pitfalls

The last few years have been characterized by a growing interest of the medical and scientific world for the field of consciousness and its related disorders. Medically speaking, conscious- ness can be defined as the state of awareness of self and environment and the alertness to external stimulation, besides responsiveness to inner need. Transient loss of consciousness can be due to alterations in cerebral blood flow leading to fainting or syncope, migraine, metabolic dysfunctions, unexpected intracranial pressure increases, epileptic seizures, and sleep disorders. Chronic disorders of consciousness are a tragic success of high-technology treatment, in an attempt to maintain or reestablish brain function, which is to be considered as the main goal of therapeutics. Management of vegetative or a minimally conscious state individuals involves charily getting the right diagnosis with an evidence-based prognosis, also taking into account the medical, ethical, and legal key factors of the ideal treatment. This paper is aimed at exploring the wide spectrum of consciousness disorders and their clinical differential diagnosis, with particular regards to those with a negative impact on patient and their caregiver quality of life, including epilepsy, sleep disorders, and vegetative/minimally conscious state

A study of the olfactory tract with 3D rendering, f-MRI and CSD fiber tractography in healty and PD subjects

In this study we report an optimized single-shot diffusion-weighted echo planar imaging sequence that can visualize the olfactory tracts with CSD fiber tracking, 3D volume rendering and f-MRI. The olfactory tracts are localized in the olfactory grooves of the ethmoidal bone, running posteriorly through the olfactory sulci connecting to the inferior surfaces of the frontal lobes. Distally the tracts are enlarged into the olfactory bulbs and proximally they split into medial, intermediate and lateral striae and from here the axon projecting to the olfactory cortex, divided into five main areas: the anterior olfactory nucleus, which connects the two olfactory bulbs through a portion of the anterior commissure; the piriform cortex; parts of the amigdala, the olfactory tubercle and entorinal cortex; not all of these connections through the thalamus. Moreover, olfactory information is transmitted from the amygdala to the hypothalamus and from the entorinal area to the hippocampus.The olfactory tracts are difficult to depict with MRI diffusion-weighted imaging due to the high sensitivity to susceptibility artifacts at the base of the skull (Duprez and Rombaux, 2010). Ten subjects were examined; in five healthy subjects the olfactory tracts could be fiber tracked with the diffusion-weighted sequence, while in five anosmic PD patients, altered olfactory tracts were visualized. Furthermore, olfactory stimuli were applied during fMRI scanning to show the area BOLD activation to advance our understanding of olfactory dysfunction in PD patients compared to control. Olfactory function was established using the “Sniffin’ Sticks” test battery.This study of the olfactory tracts promise to visualize the anatomic organization and to facilitate the identification of different hyposmic and anosmic entities caused by neurodegenerative disorders or post-traumatic and congenital disfunctions

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

Hypericum perforatum treatment: effect on behaviour and neurogenesis in a chronic stress model in mice

<p>Abstract</p> <p>Background</p> <p>Extracts of <it>Hypericum perforatum </it>(St. John's wort) have been traditionally recommended for a wide range of medical conditions, in particular mild-to-moderate depression. The present study was designed to investigate the effect of Hypericum perforatum treatment in a mouse model of anxiety/depressive-like behavior, induced by chronic corticosterone administration.</p> <p>Methods</p> <p>CD1 mice were submitted to 7 weeks corticosterone administration and then behavioral tests as Open Field (OF), Novelty-Suppressed Feeding (NSF), Forced Swim Test (FST) were performed. Cell proliferation in hippocampal dentate gyrus (DG) was investigated by both 5-bromo-2'-deoxyuridine (BrdU) and doublecortin (DCX) immunohistochemistry techniques and stereological procedure was used to quantify labeled cells. Golgi-impregnation method was used to evaluate changes in dendritic spines in DG. Hypericum perforatum (30 mg/Kg) has been administered for 3 weeks and then neural development in the adult hippocampus and behavioral changes have been examined.</p> <p>Results</p> <p>The anxiety/depressive-like state due to chronic corticosterone treatment was reversed by exogenous administration of Hypericum perforatum; the proliferation of progenitor cells in mice hippocampus was significantly reduced under chronic corticosterone treatment, whereas a long term treatment with Hypericum perforatum prevented the corticosterone-induced decrease in hippocampal cell proliferation. Corticosterone-treated mice exhibited a reduced spine density that was ameliorated by Hypericum perforatum administration.</p> <p>Conclusion</p> <p>These results provide evidence of morphological adaptations occurring in mature hippocampal neurons that might underlie resilient responses to chronic stress and contribute to the therapeutic effects of chronic Hypericum perforatum treatment.</p

Acupuncture for the treatment of severe acute pain in Herpes Zoster: results of a nested, open-label, randomized trial in the VZV Pain Study

<p>Abstract</p> <p>Background</p> <p>Data on the potential efficacy of acupuncture (AC) in controlling intense or very intense pain in patients with Herpes Zoster (HZ) has not been so far adequately assessed in comparison with standard pharmacological treatment (ST) by a controlled trial design.</p> <p>Methods</p> <p>Within the VZV Pescara study, pain was assessed in HZ patients on a Visual Analogue Scale (VAS) and by the McGill Pain Questionnaire (MPQ) both at the beginning and at the end of treatment. Response rates, mean changes in pain intensity, differences in total pain burden with an area-under-the-curve (AUC) method over a 1-year follow-up and differences in the incidence of Post-Herpetic Neuralgia (PHN) were evaluated.</p> <p>Results</p> <p>One hundred and two patients were randomized to receive either AC (n = 52) or ST (n = 50) for 4 weeks. Groups were comparable regarding age, sex, pain intensity at presentation and missed antiviral prescription. Both interventions were largely effective. No significant differences were observed in response rates (81.6% vs 89.2%, p = 0.8), mean reduction of VAS (4.1 +/- 2.3 vs 4.9 +/- 1.9, p = 0.12) and MPQ scores (1.3 +/- 0.9 vs 1.3 +/- 0.9, p = 0.9), incidence of PHN after 3 months (48.4% vs 46.8%, p = 0.5), and mean AUC during follow-up (199 +/- 136 vs 173 +/- 141, p = 0.4). No serious treatment-related adverse event was observed in both groups.</p> <p>Conclusions</p> <p>This controlled and randomized trial provides the first evidence of a potential role of AC for the treatment of acute herpetic pain.</p> <p>Trial registration</p> <p>ChiCTR-TRC-10001146.</p

Is "option B+" also being adopted in pregnant women in high-income countries? Temporal trends from a national study in Italy

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Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries