The neural bases of event monitoring across domains: a simultaneous ERP-fMRI study.

The ability to check and evaluate the environment over time with the aim to detect the occurrence of target stimuli is supported by sustained/tonic as well as transient/phasic control processes, which overall might be referred to as event monitoring. The neural underpinning of sustained control processes involves a fronto-parietal network. However, it has not been well-defined yet whether this cortical circuit acts irrespective of the specific material to be monitored and whether this mediates sustained as well as transient monitoring processes. In the current study, the functional activity of brain during an event monitoring task was investigated and compared between two cognitive domains, whose processing is mediated by differently lateralized areas. Namely, participants were asked to monitor sequences of either faces (supported by right-hemisphere regions) or tools (left-hemisphere). In order to disentangle sustained from transient components of monitoring, a simultaneous EEG-fMRI technique was adopted within a block design. When contrasting monitoring versus control blocks, the conventional fMRI analysis revealed the sustained involvement of bilateral fronto-parietal regions, in both task domains. Event-related potentials (ERPs) showed a more positive amplitude over frontal sites in monitoring compared to control blocks, providing evidence of a transient monitoring component. The joint ERP-fMRI analysis showed that, in the case of face monitoring, these transient processes rely on right-lateralized areas, including the inferior parietal lobule and the middle frontal gyrus. In the case of tools, no fronto-parietal areas correlated with the transient ERP activity, suggesting that in this domain phasic monitoring processes were masked by tonic ones. Overall, the present findings highlight the role of bilateral fronto-parietal regions in sustained monitoring, independently of the specific task requirements, and suggest that right-lateralized areas subtend transient monitoring processes, at least in some task contexts

Pitt-Hopkins syndrome: report of a case with a TCF4 gene mutation

<p>Abstract</p> <p>Aims</p> <p>We will discuss the clinical and genetic diagnosis of a child with severe psychomotor delay, who at 3 years of age presented with paroxysms of hyperpnea-apnea and seizures unrelated to breathing anomalies.</p> <p>Methods</p> <p>The child underwent genetic (karyotype, FISH telomeres) and neuroradiological (cranial CT and MRI) tests, which proved to be normal. He came under our clinical observation at 3 years and 5 months of age. Due to severe psychomotor delay and facial dysmorphisms we completed the genetic investigations based on his clinical feature and analysis of the available literature.</p> <p>Results</p> <p>The presence of severe mental retardation associated with anomalous breathing pattern may suggest the Joubert and Rett syndrome, however these were excluded on the basis of clinical and genetic examination. Angelman syndrome, suspected for facial dysmorphisms and absent language, was also excluded because of the presence of a normal pattern of methylation at SNRPN locus. Another possible diagnosis was the Pitt-Hopkins Syndrome (PHS), characterized by severe mental retardation, breathing anomalies (paroxisms of hyperpnea-apnea), dysmorphisms and sometimes epilepsy. Haploinsufficiency of TCF4 gene located at 18q21.2 region has been recently identified as causative of this syndrome. In our patient the research of TCF4 mutation by the Institute of Human Genetics, University Hospital Erlangen (Germany), showed a de novo mutation.</p> <p>Conclusions</p> <p>The diagnosis of Pitt-Hopkins syndrome, an underdiagnosed cause of mental retardation, was based on clinical and genetic findings. Searching for TCF4 mutations is highly recommended when others overlapping syndromes was excluded. At our knowledge our patient is the first italian case of PHS diagnosed at molecular level.</p

Placement of Covered Self-Expandable Metal Biliary Stent for the Treatment of Severe Postsphincterotomy Bleeding: Outcomes of Two Cases

We report two cases of severe postsphincterotomy bleeding in an adult and a pediatric patient treated, as first options, with available techniques to induce hemostasis without success. Because of persisting bleeding, an expandable, partially covered, metallic stent was placed into the choledocho to mechanically compress the bleeding site. The bleeding was stopped. In the following days, both patients remained hemodynamically stable with no further episodes of bleeding. We believe that the application of a covered metallic stent in a severe postendoscopic-sphincterotomy bleeding, refractory to injection therapy, should be considered to avoid additional interventions, which carry a higher risk of complications, even in pediatric patients

A new tissue acquisition technique in pancreatic cystic neoplasm: endoscopic ultrasound-guided through-the-needle forceps biopsy

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Dall'Università al mondo del lavoro. Il tirocinio come snodo per l’inclusione lavorativa e sociale

The university’s interconnections are played out through interlocked layers – from research to education, to the socio‐economic role. The university participates in networks both in business and social services at the territorial level and contributes to local development and well‐being. Concerning the inclusion of people with disabilities, it can play a sig‐nificant educational and social role within a territory: in addition to supporting enrolled students, it can be a hosting partner of traineeships co‐designed and co‐managed with social services. The paper reports a case study on Social Inclu‐sive Traineeship activated by the University of Macerata in cooperation with local social and health services institutions. It analyses the process and activities needed to implement inclusive environments and presents the achieved outcomes for those who are not higher education students, but are part of the university's community at territorial level. Findings highlight the relevance of the experience for the construction of the professional and social role of the intern. Conclusions stress the need for further research and joint work within the scientific community to strengthen the capacity of universities to implement inclusive practices with the territory and activate networks through meaningful traineeships.The university’s interconnections are played out through interlocked layers – from research to education, to the socio-economic role. The university participates in networks both in business and social services at the territorial level and contributes to local development and well‐being. Concerning the inclusion of people with disabilities, it can play a significant educational and social role within a territory: in addition to supporting enrolled students, it can be a hosting partner of traineeships co‐designed and co‐managed with social services. The paper reports a case study on Social Inclusive Traineeship activated by the University of Macerata in cooperation with local social and health services institutions. It analyses the process and activities needed to implement inclusive environments and presents the achieved outcomes for those who are not higher education students, but are part of the university's community at territorial level. Findings highlight the relevance of the experience for the construction of the professional and social role of the intern. Conclusions stress the need for further research and joint work within the scientific community to strengthen the capacity of univer‐sities to implement inclusive practices with the territory and activate networks through meaningful traineeships

ClearPath-assisted underwater endoscopic mucosal resection of a laterally spreading tumor of the colon

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