Stimulus information guides the emergence of behavior-related signals in primary somatosensory cortex during learning

Neurons in the primary cortex carry sensory- and behavior-related information, but it remains an open question how this information emerges and intersects together during learning. Current evidence points to two possible learning-related changes: sensory information increases in the primary cortex or sensory information remains stable, but its readout efficiency in association cortices increases. We investigated this question by imaging neuronal activity in mouse primary somatosensory cortex before, during, and after learning of an object localization task. We quantified sensory- and behavior-related information and estimated how much sensory information was used to instruct perceptual choices as learning progressed. We find that sensory information increases from the start of training, while choice information is mostly present in the later stages of learning. Additionally, the readout of sensory information becomes more efficient with learning as early as in the primary sensory cortex. Together, our results highlight the importance of primary cortical neurons in perceptual learning

Use of Corticosteroids in Coronavirus Disease 2019 Pneumonia: A Systematic Review of the Literature

The aim was to investigate the effectiveness of glucocorticoid therapy in patients with COVID-19. A systematic search of the literature across nine databases was conducted from inception until 15th March 2020, following the PRISMA guidelines. Patients with a validated diagnosis of COVID-19 and using corticosteroids were included, considering all health outcomes. Four studies with 542 Chinese participants were included. Two studies reported negative findings regarding the use of corticosteroids in patients with COVID-19, i.e., corticosteroids had a detrimental impact on clinical outcomes. One study reported no significant association between the use of corticosteroids and clinical outcomes. However, one study, on 201 participants with different stages of pneumonia due to COVID-19, found that in more severe forms, the administration of methylprednisolone significantly reduced the risk of death by 62%. The literature to date does not fully support the routine use of corticosteroids in COVID-19, but some findings suggest that methylprednisolone could lower mortality rate in more severe forms of the condition

An umbrella review of systematic reviews with meta-analyses evaluating positive and negative outcomes of hydroxychloroquine and chloroquine therapy

Background & aims: Hydroxychloroquine (HCQ) and chloroquine (CQ) are anti-malarial drugs frequently used in the rheumatologic field. Recently they were identified as possible therapeutic options against Coronavirus Disease (COVID-19). Therefore, the present study aimed to map and grade the diverse health outcomes associated with HCQ/CQ using an umbrella review approach. Methods: Umbrella review of systematic reviews of observational and intervention studies. For observational studies, random-effects summary effect size, 95% confidence interval, and 95% prediction interval were estimated. We also assessed heterogeneity, evidence for small-study effect and evidence for excess significance bias. The quality of evidence was then graded using validated criteria from highly convincing to weak. The evidence from randomized-controlled trials (RCTs) was graded using the GRADE tool. Results: From 313 articles returned, 6 meta-analyses were included (n = 25 outcomes). Among meta-analyses of observational studies, HCQ/CQ is weakly associated with a reduced risk for cardiovascular events and diabetes when used for autoimmune diseases; it is also associated with higher risk of death when used for COVID-19 and with spontaneous abortion. Among meta-analyses of RCTs, HCQ/CQ is associated with an improvement of articular manifestations of the rheumatic diseases. Conclusions: There is high evidence of the efficacy of HCQ/CQ in the rheumatologic field. The lack of evidence for efficacy and risk of death associated with the use of HCQ/CQ for COVID-19, indicate the inappropriateness of its inclusion in recent COVID-19 therapy guidelines and urgent need for Randomised Controlled Trials to determine their eventual appropriateness as a therapy in that circumstance

The relationship between dietary vitamin K and depressive symptoms in late adulthood: a cross-sectional analysis from a large cohort study

Few studies assessed associations between dietary vitamin K and depressive symptoms. We aimed to investigate the association between dietary vitamin K and depressive symptoms in a large cohort of North American People. In this cross-sectional analysis, 4,375 participants aged 45-79 years from the Osteoarthritis Initiative were included. Dietary vitamin K intake was collected through a semi-quantitative food frequency questionnaire and categorized in quartiles. Depressive symptoms were diagnosed using the 20-item Center for Epidemiologic Studies-Depression (CES-D) > 16. To investigate associations between vitamin K intake and depressive symptoms, logistic regression analysis were run, adjusting for potential confounders. Overall 437 (=10%) subjects had depressive symptoms. After adjusting for 11 confounders, people with the highest dietary vitamin K intake had lower odds of having depressive symptoms (OR=0.58; 95%CI: 0.43-0.80). This effect was present only in people not taking vitamin D supplementation. In conclusion, higher dietary vitamin K intake was significantly associated with a lower presence of depressive symptoms, also after accounting for potential confounders. Future longitudinal research is required to explore the directionality of the association

Terminologia multilingue in medicina di famiglia Versione 2.5 italiana

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Consorzi di bonifica e sviluppo sostenibile. Itinerari e azioni per il raggiungimento degli Obiettivi dell’Agenda 2030. Obiettivo 2: Porre fine alla fame, raggiungere la sicurezza alimentare, migliorare la nutrizione e promuovere un’agricoltura sostenibile

Itinerari sostenibili per il raggiungimento degli obiettivi dell'Agenda 2030 dell'ONU. Sono proposte azioni e indicatori di performance per guidare le attività dei Consorzi di bonifica italiani al raggiungimento dell'Obiettivo 2 dell'Agenda 2030 dell'ONU: Fame zero

Terapia ormonale sostitutiva dopo tiroidectomia totale. Il trattamento ormonale combinato può essere considerato efficace strumento di adeguatezza metabolica? Risultati preliminari

Introduzione. Sebbene la terapia con T4 sia considerata un trattamento sostitutivo efficace nella maggior parte dei pazienti sottoposti a tiroidectomia totale, una terapia combinata di T4 e T3 è stata proposta come trattamento sostitutivo alternativo, in grado di riprodurre in modo più fedele la fisiologia della ghiandola tiroidea. Per tale motivo abbiamo condotto uno studio osservazionale prospettico sugli effetti del trattamento sostitutivo combinato di T4 e T3 in soggetti sottoposti a tiroidectomia totale. Pazienti e metodi. Sono stati arruolati 50 pazienti sottoposti a tiroidectomia totale per patologia non neoplastica ed in cura con trattamento ormonale sostitutivo con T4. Si è modificata la terapia somministrando un trattamento combinato di T3 e T4 in rapporto 1 a 16. Al momento dell’arruolamento (T0), dopo 30 giorni (T1) e dopo 60 giorni (T2), sono stati valutati parametri clinici, effetti indesiderati del trattamento e percezione dello stato di salute (questionario valutativo SF36). Risultati. Non ci sono state differenze da T0 a T2 per quanto riguarda peso corporeo, frequenza cardiaca e pressione arteriosa. Si è riscontrata una diminuzione dei valori medi di colesterolo totale (3 mg/dL) e trigliceridi (3,29 mg/dL), non statisticamente significativa. I principali effetti collaterali a T0 sono stati: sonnolenza (25 casi), cefalea (22), nervosismo (21), astenia (17), diminuzione della libido (11), tremori (8), palpitazioni (8) e nausea (6). Da T0 a T2 la presenza di nervosismo è passata da 21 pazienti a 13; la cefalea da 22 pazienti a 13; l’astenia da 17 a 8 pazienti (P <0.05); la sonnolenza da 25 a 15 pazienti (P <0.05). Per quanto riguarda il questionario, nel sub-score sulla percezione generale dello stato di salute si è registrata un’evoluzione positiva del parametro, anche se statisticamente non significativa. Discussione e conclusioni. La terapia sostitutiva con T4 è di dimostrata efficacia, tuttavia permangono disturbi che creano discomfort in una quota di malati. Nella continua ricerca volta al miglioramento della qualità della vita dei pazienti, appare rilevante la diminuzioni di tali effetti e il miglioramento del tono dell’umore che riscontriamo con l’utilizzo della terapia combinata. Inoltre, sebbene l’approvvigionamento di T3 attraverso la conversione periferica tissutale del T4 sia congruo in condizioni funzionali normali, è utile notare come condizioni patologiche intercorrenti ed alterazioni parafisiologiche indotte dalla senescenza siano condizioni capaci di interferire negativamente sull’efficienza dei processi enzimatici, sui quali si basa la monoterapia con T4. I risultati di questo studio preliminare incoraggiano lo sviluppo di ulteriori ricerche su un più ampio numero di pazienti