The assessment of hemineglect syndrome with cancellation tasks. A comparison between the bells test and the Apples test

Unilateral spatial neglect (USN) is a frequent consequence of acquired brain injury, especially following right hemisphere damage. Traditionally, unilateral spatial neglect is assessed with cancellation tests such as the Bells test. Recently, a new cancellation test, the Apples test, has been proposed. The present study aims at comparing the accuracy of these two tests in detecting hemispatial neglect, on a sample of 56 right hemisphere stroke patients with a diagnosis of USN. In order to evaluate the agreement between the Apples and Bells tests, Cohen's kappa and McNemar's test were used to assess differences between the two methods of evaluation. Poor agreement and statistically significant differences emerged between the Apples and Bells tests. Overall, the Apples test was significantly more sensitive than the Bells test in detecting USN. Based on these results, the use of the Apples test for peripersonal neglect assessment is therefore highly recommende

THE POGGIO ROSSO LOCALITY CALIBRATED TO THE END-PLIOCENE AND ITS SIGNIFICANCE FOR DATING THE LATE VILLAFRANCHIAN MAMMAL FAUNAS OF THE UPPER VALDARNO, CENTRAL ITALY

A rich deposit of mammals was discovered in September 1995 at Poggio Rosso, the hill-top of the Matassino clay pit, in the Upper Valdarno Basin, 30 m above another deposit whose local fauna was assembled 30 years earlier. This latter provided the Matassino Locality, assigned to the beginning of the late Villafranchian Mammal Neogene age on the basis of its affinity with the Olivola faunal unit, which was also taken to represent the earliest assemblage in the Pleistocene. The paleomagnetic record in the short section across the Matassino Locality revealed the Olduvai chron, which was imprinted also in the fossil-bearing stratum of Poggio Rosso, so constraining both their ages to the latest Pliocene. The Poggio Rosso fauna, yet to be paleontologically determined, and the other late Villafranchian faunas collected in the Upper Valdarno from the Montevarchi complex fit a similar time span. Therefore, their magnetostratigraphically calibrated ages provide the time constraints for the biochronological relationships between faunas which can be tuned to several tie points for numerically evaluating their diversification steps during the whole Olduvai chron and shortly out of it.

Cultura notarile e tradizione statutaria nel Casentino del Tre e Quattrocento. Un modello originale?

Uno studio della cultura notarile attraverso la testimonianza di alcuni statuti rurali del XIV, che rivela alcuni tratti testuali caratteristici di una ristretta area geografica

A multidirectional modified Physarum solver for discrete decision making

In this paper, a bio-inspired algorithm able to incrementally grow decision graphs in multiple directions is presented. The heuristic draws inspiration from the behaviour of the slime mould Physarum Polycephalum. In its main vegetative state, the plasmodium, this large single-celled amoeboid organism extends and optimizes a net of veins looking for food. The algorithm is here used to solve classical problems in operations research (symmetric Traveling Salesman and Vehicle Routing Problems). Simulations on selected test cases demonstrate that a multidirectional modied Physarum solver performs better than a unidirectional one. The ability to evaluate decisions from multiple directions enhances the performance of the solver in the construction and selection of optimal decision sequences

Back to the Future? Understanding Change in Food Habits of Farmers' Market Customers

farmers' markets, food habits, Italy, Agribusiness, Consumer/Household Economics, Demand and Price Analysis, Food Consumption/Nutrition/Food Safety, Health Economics and Policy,

Optimal multi-objective discrete decision making using a multidirectional modified Physarum solver

This paper will address a bio-inspired algorithm able to incrementally grow decision graphs in multiple directions for discrete multi-objective optimization. The algorithm takes inspiration from the slime mould Physarum Polycephalum, an amoeboid organism that in its plasmodium state extends and optimizes a net of veins looking for food. The algorithm is here used to solve multi-objective Traveling Salesman and Vehicle Routing Problems selected as representative examples of multi-objective discrete decision making problems. Simulations on selected test case showed that building decision sequences in two directions and adding a matching ability (multidirectional approach) is an advantageous choice if compared with the choice of building decision sequences in only one direction (unidirectional approach). The ability to evaluate decisions from multiple directions enhances the performance of the solver in the construction and selection of optimal decision sequences

Longitudinal prospective observational type study about determinants of renal resistive index variations in chronic renal failure patients treated with conventional medical and dietetic therapy

Objective: This longitudinal prospective observational type study was conceived with the aim to examine the impact on renal resistive index (RRI) of the variables that we can manipulate with therapeutic and or dietetic interventions in a chronic kidney disease population in order to known which of these variables was statistically related to changes in RRI and therefore could become the object of the greatest therapeutic effort. Material and methods: This study was undertaken between May 2016 to May 2017 in the outpatient nephrology and urology clinic of San Donato Hospital in Arezzo. The study population (84 patients: 47 males and 37 females) was randomly selected among the chronic kidney patients (with various degrees of renal impairment) affected by hypertension and or diabetes mellitus. After a comprehensive medical examination these patients were submitted to determination of serum creatinine, glycated hemoglobin, 24-hour urinary albumin excretion and finally renal Doppler ultrasonography. Then the patients were submitted to a full therapeutic and dietetic intervention to ameliorate the renal impairment by a wide range of actions and after on average a one-year interval were submitted again to a new medical examination and a second determination of serum creatinine, glycated hemoglobin, 24-hour urinary albumin excretion and a new renal Doppler ultrasonography too. Results: The comparison between basal and final data revealed a slight reduction in the mean of bilateral renal resistance indices (Delta RRI: -0.0182 ± 0.08), associated to a slight increase in the mean glomerular filtration rate (Delta GFR: 0.8738 ± 10.95 ml/min/1.73 m2), a reduction in mean body weight (Delta weight: -1.9548 ± 5.26 Kg) and mean BMI (Delta BMI: -0.7643 ± 2.10 Kg/m2) as well as a reduction in the mean systolic blood pressure (Delta systolic blood pressure: -8.8333 ± 25.19 mmHg). Statistical analysis showed statistically significant correlations (p < 0.05) between Delta RRI and Delta weight (p < 0.03), Delta BMI (p < 0.02) and Delta systolic blood pressure (p < 0.05). Conclusion: Despite the many limitations the our study clearly identifies the targets (yet widely known) to act on to prevent kidney alterations related to RRI and provides further evidence, if any, of the utility of RRI as a key parameter in monitoring patients with chronic renal failure and as a valuable tool to drive the clinical efforts to contrast the kidney disease

Using the Oxford cognitive screen to detect cognitive impairment in stroke patients. A comparison with the Mini-Mental State Examination

Background: The Oxford Cognitive Screen (OCS) was recently developed with the aim of describing the cognitive de cits after stroke. The scale consists of 10 tasks encom- passing ve cognitive domains: attention and executive function, language, memory, number processing, and praxis. OCS was devised to be inclusive and un-confounded by aphasia and neglect. As such, it may have a greater potential to be informative on stroke cognitive de cits of widely used instruments, such as the Mini-Mental State Examination (MMSE) or the Montreal Cognitive Assessment, which were originally devised for demented patients. Objective: The present study compared the OCS with the MMSE with regards to their ability to detect cognitive impairments post-stroke. We further aimed to examine perfor- mance on the OCS as a function of subtypes of cerebral infarction and clinical severity. Methods: 325 rst stroke patients were consecutively enrolled in the study over a 9-month period. The OCS and MMSE, as well as the Bamford classi cation and NIHSS, were given according to standard procedures. results: About a third of patients (35.3%) had a performance lower than the cutoff (&lt;22) on the MMSE, whereas 91.6% were impaired in at least one OCS domain, indicating higher incidences of impairment for the OCS. More than 80% of patients showed an impairment in two or more cognitive domains of the OCS. Using the MMSE as a standard of clinical practice, the comparative sensitivity of OCS was 100%. Out of the 208 patients with normal MMSE performance 180 showed impaired performance in at least one domain of the OCS. The discrepancy between OCS and MMSE was particularly strong for patients with milder strokes. As for subtypes of cerebral infarction, fewer patients demonstrated widespread impairments in the OCS in the Posterior Circulation Infarcts category than in the other categories. conclusion: Overall, the results showed a much higher incidence of cognitive impairment with the OCS than with the MMSE and demonstrated no false negatives for OCS vs MMSE. It is concluded that OCS is a sensitive screen tool for cognitive de cits after stroke. In particular, the OCS detects high incidences of stroke-specific cognitive impairments, not detected by the MMSE, demonstrating the importance of cognitive pro ling.Background: The Oxford Cognitive Screen (OCS) was recently developed with the aim of describing the cognitive deficits after stroke. The scale consists of 10 tasks encompassing five cognitive domains: attention and executive function, language, memory, number processing, and praxis. OCS was devised to be inclusive and un-confounded by aphasia and neglect. As such, it may have a greater potential to be informative on stroke cognitive deficits of widely used instruments, such as the Mini-Mental State Examination (MMSE) or the Montreal Cognitive Assessment, which were originally devised for demented patients. Objective: The present study compared the OCS with the MMSE with regards to their ability to detect cognitive impairments post-stroke. We further aimed to examine performance on the OCS as a function of subtypes of cerebral infarction and clinical severity. Methods: 325 first stroke patients were consecutively enrolled in the study over a 9-month period. The OCS and MMSE, as well as the Bamford classification and NIHSS, were given according to standard procedures. Results: About a third of patients (35.3%) had a performance lower than the cutoff(&lt; 22) on the MMSE, whereas 91.6% were impaired in at least one OCS domain, indicating higher incidences of impairment for the OCS. More than 80% of patients showed an impairment in two or more cognitive domains of the OCS. Using the MMSE as a standard of clinical practice, the comparative sensitivity of OCS was 100%. Out of the 208 patients with normal MMSE performance 180 showed impaired performance in at least one domain of the OCS. The discrepancy between OCS and MMSE was particularly strong for patients with milder strokes. As for subtypes of cerebral infarction, fewer patients demonstrated widespread impairments in the OCS in the Posterior Circulation Infarcts category than in the other categories. Conclusion: Overall, the results showed a much higher incidence of cognitive impairment with the OCS than with the MMSE and demonstrated no false negatives for OCS vs MMSE. It is concluded that OCS is a sensitive screen tool for cognitive deficits after stroke. In particular, the OCS detects high incidences of stroke-specific cognitive impairments, not detected by the MMSE, demonstrating the importance of cognitive profiling. © 2018 Mancuso, Demeyere, Abbruzzese, Damora, Varalta, Pirrotta, Antonucci, Matano, Caputo, Caruso, Pontiggia, Coccia, Ciancarelli, Zoccolotti and The Italian OCS Grou