Screening for developmental disorders in 3- and 4-year-old italian children: a preliminary study

BACKGROUND: The "Osserviamo" project, coordinated by the Municipality of Rome and the Department of Pediatrics and Child Neuropsychiatry of Sapienza University, aimed to validate an Italian version of the Ages and Stages Questionnaire-3 and to collect, for the first time in Italy, data on developmental disorders in a sample of 4,000 children aged 3 and 4 years. The present paper presents the preliminary results of the "Osserviamo" project. METHODS: 600 parents of children between 39 and 50 months of age (divided in two age stages: 42 and 48 months) were contacted from 15 kindergarden schools. RESULTS: 23.35% of the whole sample scored in the risk range of at least one developmental area of the Ages and Stages Questionnaire-3rd Edition (ASQ-3) and 7.78% scored in the clinical range. Specifically, 23.97% of the children in the 42-month age stage scored in the risk range and 5.79% scored in the clinical range. Males scored lower than females in the fine motor skills and personal-social development domains. Moreover, 22.79% of the children in the 48-month age stage scored in the risk range, while 9.55% scored in the clinical range. Males scored lower than females in fine motor skills. CONCLUSION: Italian validation of the ASQ-3 and recruitment of all 4,000 participants will allow these data on the distribution of developmental disorders to be extended to the general Italian pediatric population. One main limitation of the study is the lack of clinical confirmation of the data yielded by the screening programme, which the authors aim to obtain in later stages of the study

Evaluation of Linear and Nonlinear Site Effects for the MW 6.3, 2009 L’Aquila Earthquake

An effective strategy for the seismic risk mitigation needs the use of advanced seismological methodologies for a realistic estimate of the seismic hazard and, consequently, to reduce earthquake damage through a preventive evaluation of vulnerability and actions for structure safety. Prediction of earthquakes and their related effects (expressed in terms of ground shaking) can be performed either by a probabilistic approach or by using modelling tools based, on one hand, on the theoretical knowledge of the physics of the seismic source and of wave propagation and, on the other hand, on the rich database of geological, tectonic, historical information already available. Strong earthquakes are very rare phenomena and it is therefore statistically very difficult to assemble a representative database of recorded strong motion signals that could be analyzed to define ground motion parameters suitable for seismic hazard estimations. That is, the probabilistic estimation of the seismic hazard is a very gross approximation, and often a severe underestimation, of reality. A realistic and reliable estimate of the expected ground motion can be performed by using the Neo-Deterministic Seismic Hazard Analysis (NDSHA), an innovative modelling technique that takes into account source, propagation and local site effects (for a recent review see Panza et al., 2011). This is done using basic principles of physics about wave generation and propagation in complex media, and does not require to resort to convolutive approaches, that have been proven to be quite unreliable, mainly when dealing with complex geological structures, the most interesting from the practical point of view

Burning mouth syndrome (BMS) : evaluation of thyroid and taste

Background Burning mouth syndrome (BMS) is a chronic, intraoral burning sensation seen mainly in middle-aged and post-menopausal females, without identifiable oral lesions or abnormal laboratory findings, but often associated with psychogenic disorders such as depression. The latter can have a range of causes, including hormonal. Objective Since there may be connections between BMS, psychogenic changes, hormonal changes and taste abnormalities , we have examined aspects of taste and thyroid function.. Patients and methods We selected 50 patients with BMS (study group) and 50 healthy subjects (control group) and analysed their ability to taste bitter, acid and spicy substances and analysed their thyroid function and Undertook thyroid echography. Results Taste sensation was normal in all controls. However, 30 of the patients with BMS reported ageusia for bitter taste and 2 had ageusia for acid. The use of pepper sauce ( Tabasco®) (spicy substance) produced a strong burning to the tongue in 28 patients of the BMS group but only in 10 controls. No control patients showed abnormality of thyroid function or echograpic abnormality. Five patients in the BMS group had biochemical evidence of hypothyroidism, 4 patients had raised levels of thyroid autoantibodies and, of the 41 remaining BMS patients, most (34) had thyroid echographic changes indicative of nodularity. Conclusions Hypothyroidism may be responsible for a negative influence on taste and consequent increase in trigeminal sensorial sensation (tactile, thermal and painful sensation)

Components of Purity to Describe the Polarimetric State of a 3-D Field Within the Reverberating Chamber

Reverberating chambers (RCs) are electrically large microwave enclosures in which a random electromagnetic 3-D, i.e., nonplanar, field is generated. To characterize such 3-D fields, a proper polarimetric decomposition is requested. In this article, a new set of parameters, namely the components of purity (CP), first proposed to the electromagnetic compatibility community, is presented. The CP parameters, which stem for the so-called trivial decomposition, are able to classify any 3-D polarimetric field into two states: regular and nonregular. Such characterization is of practical relevance, e.g., for RC isotropy testing

On the Trade-Off Between Enhancement of the Spatial Resolution and Noise Amplification in Conical-Scanning Microwave Radiometers

The ability to enhance the spatial resolution of measurements collected by a conical-scanning microwave radiometer (MWR) is discussed in terms of noise amplification and improvement of the spatial resolution. Simulated (and actual) brightness temperature profiles are analyzed at variance of different intrinsic spatial resolutions and adjacent beams overlapping modeling a simplified 1-D measurement configuration (MC). The actual measurements refer to Special Sensor Microwave Imager (SSM/I) data collected using the 19.35 and the 37.00 GHz channels that match the simulated configurations. The reconstruction of the brightness profile at enhanced spatial resolution is performed using an iterative gradient method which allows a fine tuning of the level of regularization. Objective metrics are introduced to quantify the enhancement of the spatial resolution and noise amplification. Numerical experiments, performed using the simplified 1-D MC, show that the regularized deconvolution results in negligible advantages when dealing with low-overlapping/fine-spatial-resolution configurations. Regularization is a mandatory step when addressing the high-overlapping/low-spatial-resolution case and the spatial resolution can be enhanced up to 2.34 with a noise amplification equal to 1.56. A more stringent requirement on the noise amplification (up to 0.6) results in an improvement of the spatial resolution up to 1.64

Lacticaseibacillus rhamnosus GG Counteracts Rotavirus-Induced Ion Secretion and Enterocyte Damage by Inhibiting Oxidative Stress and Apoptosis Through Specific Effects of Living and Postbiotic Preparations

Background: Administration of Lacticaseibacillus rhamnosus GG (LGG) to children with gastroenteritis is recommended by universal guidelines. Rotavirus (RV) causes diarrhea through combined cytotoxic and enterotoxic effects. Aim of this study was to evaluate the mechanisms of efficacy of LGG in an in-vitro model of RV diarrhea in its viable form (LGG) and conditioned medium (mLGG). Methods: Ion secretion corresponding to the NSP4 enterotoxic effect, was evaluated by short circuit current (Isc) and the cytotoxic effect by transepithelial electrical resistance (TEER) in Ussing chambers, upon exposure to RV in Caco-2 enterocyte monolayers treated or not with living probiotic or its culture supernatant. Mechanisms of enterotoxic and cytotoxic damage were evaluated including oxidative stress measured by reactive oxygen species, apoptosis evaluated by DAPI and nuclear staining, NFkβ immunofluorescence. Results: RV induced Isc increase and TEER decrease, respectively indicating ion secretion and epithelial damage, the two established pathways of diarrhea. Both probiotic preparations reduced both diarrheal effects, but their potency was different. Live LGG was equally effective on both enterotoxic and cytotoxic effect whereas mLGG was highly effective on ion secretion and showed minimal protective effects on cytoskeleton, apoptosis and NFkβ. Conclusions: LGG counteracts RV-induced diarrhea by inhibiting both cytotoxic and enterotoxic pathogenic mechanisms. Namely, LGG inhibits chloride secretion by specific moieties secreted in the medium with a direct pharmacologic-like action. This is considered a postbiotic effect. Subsequently, live bacteria exert a probiotic effect protecting the enterocyte structure

An unsupervised behavioral modeling and alerting system based on passive sensing for elderly care

Artificial Intelligence in combination with the Internet of Medical Things enables remote healthcare services through networks of environmental and/or personal sensors. We present a remote healthcare service system which collects real-life data through an environmental sensor package, including binary motion, contact, pressure, and proximity sensors, installed at households of elderly people. Its aim is to keep the caregivers informed of subjects’ health-status progressive trajectory, and alert them of health-related anomalies to enable objective on-demand healthcare service delivery at scale. The system was deployed in 19 households inhabited by an elderly person with post-stroke condition in the Emilia–Romagna region in Italy, with maximal and median observation durations of 98 and 55 weeks. Among these households, 17 were multi-occupancy residences, while the other 2 housed elderly patients living alone. Subjects’ daily behavioral diaries were extracted and registered from raw sensor signals, using rule-based data pre-processing and unsupervised algorithms. Personal behavioral habits were identified and compared to typical patterns reported in behavioral science, as a quality-of-life indicator. We consider the activity patterns extracted across all users as a dictionary, and represent each patient’s behavior as a ‘Bag of Words’, based on which patients can be categorized into sub-groups for precision cohort treatment. Longitudinal trends of the behavioral progressive trajectory and sudden abnormalities of a patient were detected and reported to care providers. Due to the sparse sensor setting and the multi-occupancy living condition, the sleep profile was used as the main indicator in our system. Experimental results demonstrate the ability to report on subjects’ daily activity pattern in terms of sleep, outing, visiting, and health-status trajectories, as well as predicting/detecting 75% hospitalization sessions up to 11 days in advance. 65% of the alerts were confirmed to be semantically meaningful by the users. Furthermore, reduced social interaction (outing and visiting), and lower sleep quality could be observed during the COVID-19 lockdown period across the cohort

Glottic-SubGlottic adenoid cystic carcinoma. A case report and review of the literature

Background: Malignant tumours of minor salivary glands are uncommon, representing only 2-4% of all head and neck cancers. In the larynx, minor salivary gland tumours rarely occur and constitute less than 1% of laryngeal neoplasm. Most of the minor salivary gland tumours arise in the subglottis; however, they can also occur in the supraglottis, in the false vocal cords, aryepiglottic folds and caudal portion of the epiglottis. The most common type of malignant minor salivary gland tumour is adenoid cystic carcinoma. Methods: We present a unusual case of adenoid cystic carcinoma of glottic-subglottic region in a 61-year-old woman. Follow-up endoscopy and laryngeal magnetic resonance imaging (MRI) at three years after treatment showed no recurrence of the tumour. Results: The diagnosis of glottic-subglottic adenoid cystic carcinoma should be considered in patients who are characterized by dyspnea, cough and stridor, but do not respond to pharmacologic approach. Conclusions: Adenoid cystic carcinoma is usually a very slow growing cancer, invested by an apparently normal laryngeal mucosa, so that it can show no clear symptoms for a long time. For these reasons the increasing number of diagnostic mistakes or late diagnosis that may be fatal in some case

Association between Coagulation Profile and Clinical Outcome in Children with SARS-CoV-2 Infection or MIS-C: A Multicenter Cross-Sectional Study

Limited data on the coagulation profile in children affected by the SARS-CoV-2 infection are available. We aimed to evaluate the role of d-dimers as predictors of poor outcomes in a pediatric population affected by the SARS-CoV-2 infection or multisystem inflammatory syndrome (MIS-C). We performed a retrospective cross-sectional multicenter study. Data from four different centers were collected. Laboratory tests, when performed, were collected at the time of diagnosis, and 24, 48, 72, 96, 120 and beyond 120 h from diagnosis; blood counts with formula, an international normalized ratio (INR), activated partial thromboplastin time (aPTT), D-dimers and fibrinogen values were collected. Data regarding clinical history, management and outcome of the patients were also collected. Three hundred sixteen patients with a median age of 3.93 years (IQR 0.62–10.7) diagnosed with COVID-19 or MIS-C were enrolled. Fifty-eight patients (18.3%) showed a severe clinical outcome, 13 (4.1%) developed sequelae and 3 (0.9%) died. The univariate analysis showed that age, high D-dimer values, hyperfibrinogenemia, INR and aPTT elongation, and low platelet count were associated with an increased risk of pediatric intensive care unit (PICU) admission (p < 0.01). Three multivariate logistic regressions showed that a d-dimer level increase was associated with a higher risk of PICU admission. This study shows that D-dimer values play an important role in predicting the more severe spectrum of the SARS-CoV-2 infection, and was higher also in those that developed sequelae, including long COVID-19

Health-care organization for the management and surveillance of SARS-CoV-2 infection in children during pandemic in Campania region, Italy

Background: In comparison with adults, severe acute respiratory syndrome coronavirus (SARS-CoV-2) infection in children has a milder course. The management of children with suspected or confirmed coronavirus disease (COVID-19) needs to be appropriately targeted. Methods: We designed a hub-and-spoke system to provide healthcare indications based on the use of telemedicine and stringent admission criteria, coordinate local stakeholders and disseminate information. Result: Between March 24th and September 24th 2020, the Hub Centre managed a total of 208 children (52% males, median age, 5.2, IQR 2–9.6 years) with suspected or confirmed COVID-19. Among them, 174 were managed in cooperation with family pediatricians and 34 with hospital-based physicians. One hundred-four (50%) received a final diagnosis of SARS-CoV-2 infection. Application of stringent criteria for hospital admission based on clinical conditions, risk factors and respect of biocontainment measures, allowed to manage the majority of cases (74, 71.1%) through telemedicine. Thirty children (28%) were hospitalized (median length 10 days, IQR 5–19 days), mainly due to the presence of persistent fever, mild respiratory distress or co-infection occurring in infant or children with underlying conditions. However, the reasons for admission slightly changed over time. Conclusion: An hub-and-spoke system is effective in coordinate territorial health-care structures involved in management paediatric COVID-19 cases through telemedicine and the definition of stringent hospital admission criteria. The management of children with COVID-19 should be based on clinical conditions, assessed on a case-by-case critical evaluation, as well as on isolation measures, but may vary according to local epidemiological changes