The Brain Correlates of Laugh and Cataplexy in Childhood Narcolepsy

The brain suprapontine mechanisms associated with human cataplexy have not been clarified. Animal data suggest that the amygdala and the ventromedial prefrontal cortex are key regions in promoting emotion-induced cataplectic attacks. Twenty-one drug-naive children/adolescent (13 males, mean age 11 years) with recent onset of narcolepsy type 1 (NT1) were studied with fMRI while viewing funny videos using a "naturalistic" paradigm. fMRI data were acquired synchronously with EEG, mylohyoid muscle activity, and the video of the patient's face. Whole-brain hemodynamic correlates of (1) a sign of fun and amusement (laughter) and of (2) cataplexy were analyzed and compared. Correlations analyses between these contrasts and disease-related variables and behavioral findings were performed

The Exponential Phase of the Covid-19 Pandemic in Central Italy: An Integrated Care Pathway

The Coronavirus Disease (Covid-19) pandemic is rapidly spreading across the world, representing an unparalleled challenge for health care systems. There are differences in the estimated fatality rates, which cannot be explained easily. In Italy, the estimated case fatality rate was 12.7% in mid-April, while Germany remained at 1.8%. Moreover, it is to be noted that different areas of Italy have very different lethality rates. Due to the complexity of Covid-19 patient management, it is of paramount importance to develop a well-defined clinical workflow in order to avoid the inconsistent management of patients. The Integrated Care Pathway (ICP) represents a multidisciplinary outline of anticipated care to support patient management in the Sant’Andrea Hospital, Rome. The main objective of this pilot study was to develop a new ICP evaluated by care indicators, in order to improve the COVID-19 patient management. The suggested ICP was developed by a multi-professional team composed of different specialists and administrators already involved in clinical and management processes. After a review of current internal practices and published evidences, we identified (1) the activities performed during care delivery, (2) the responsibilities for these activities, (3) hospital structural adaptation needs and potential improvements, and (4) ICP indicators. The process map formed the basis of the final ICP document; 160 COVID-19 inpatients were considered, and the effect of the ICP implementation was evaluated over time during the exponential phase of the COVID-19 pandemic. In conclusion, a rapid adoption of ICP and regular audits of quality indicators for the management of COVID-19 patients might be important tools to improve the quality of care and outcomes

Preliminary analysis of urban surfaces for the characteriza\u373 tion and the mitigation of the heat island effect

The urban heat island (UHI) phenomenon is an issue of growing interest and the subject of numerous studies. UHI is defined as the metropolitan area that is significantly warmer than its surrounding rural areas. UHI has significant impacts on the buildings energy consumption and outdoor air quality, therefore it is considered an important environmental topic. The most effective approaches to mitigate UHI include, among others, the albedo increase of materials used for manmade surfaces (e.g. pavements, roofs), the increment of vegetated areas (e.g. parks, flowerbed, gardens), the increment of water surfaces (e.g. ponds). The UHI mitigation results in a reduction of the energy consumption and in an improvement of outdoor air quality. A recent model study carried by Rossi et al. (CIRIAF, University of Perugia) correlated the increase of materials albedo with energy saving in terms of reduction of carbon dioxide emissions. Therefore surfaces characterization is an useful information for planning UHI mitigation actions. Albedo of different types of urban surfaces can be obtained from bibliographic data, from laboratory measurements or retrieved from spaceborne or airborne remote sensing data. This data reported surface reflectance for each band, from which albedo can be directly obtained. In this work, airborne remote sensing data have been used for UHI characterization and for the study of UHI mitigation. The area of interest is the city of Modena in the Emilia Romagna region (Italy). On this area four orthorectified images acquired in the electromagnetic regions of the visible and near-infrared by an airborne sensor with a spatial resolution of 2 meters are used. Using an object-oriented technique, the four images have been segmented and classified into categories representing different types of land cover significant for UHI: Cultivated Soils, Green Areas, Roads, Parking, Railways and Buildings. The "Buildings" class is further divided in pitched roofs made of tiles (typical buildings of the historical center of the city) and in flat roofs of industrial buildings with both bright and dark coverings. This information will be used in the model described above in order to study UHI mitigation. This study presents some preliminary results of the application of this methodology that will be developed in the upcoming years for the application to various sites of interest

Identification of SUHI in Urban Areas by Remote Sensing Data and Mitigation Hypothesis through Solar Reflective Materials

The urban heat island (UHI) is an increasingly widespread phenomenon of concern to the wellbeing and the health of populations living in urban environments. The SUHI (Surface UHI) is directly related to UHI and influences its extension and intensity. Satellite images in the thermal infrared spectral region can be used to identify and study the SUHI. In this work, Landsat 8 TIR images were acquired to study the SUHI of a medium-sized municipality of the Po valley in the northern part of Italy. An additional Worldview 3 satellite image was used to classify the study area and retrieve the surface albedo of building roofs. Using the Local Climate Zone approach, existing roof materials were virtually replaced by solar reflective materials, and the mitigation potential of the SUHI and the UHI was quantified. This virtual scenario shows a decrease in the overheating of building roofs with respect to the ambient temperature of up to 33% compared to the current situation in the industrial areas. Focusing on UHI intensity, the air temperature decrease could be up to 0.5 °C

Identification of SUHI in Urban Areas by Remote Sensing Data and Mitigation Hypothesis through Solar Reflective Materials

The urban heat island (UHI) is an increasingly widespread phenomenon of concern to the wellbeing and the health of populations living in urban environments. The SUHI (Surface UHI) is directly related to UHI and influences its extension and intensity. Satellite images in the thermal infrared spectral region can be used to identify and study the SUHI. In this work, Landsat 8 TIR images were acquired to study the SUHI of a medium-sized municipality of the Po valley in the northern part of Italy. An additional Worldview 3 satellite image was used to classify the study area and retrieve the surface albedo of building roofs. Using the Local Climate Zone approach, existing roof materials were virtually replaced by solar reflective materials, and the mitigation potential of the SUHI and the UHI was quantified. This virtual scenario shows a decrease in the overheating of building roofs with respect to the ambient temperature of up to 33% compared to the current situation in the industrial areas. Focusing on UHI intensity, the air temperature decrease could be up to 0.5 °C

Correlation between remote sensing data and ground based measurements for solar reflectance retrieving

Surface and atmospheric modifications due to urbanization generally lead to the urban heat island effect (UHI). This phenomenon is an issue of growing interest and has long been studied by ground based observation. With the advent of remote sensing technologies, observation of UHIs became possible with airborne and spaceborne sensors. Remote sensing data allow urban surfaces characterization to study UHI mitigation methodologies such as the application of cool roofs and cool colors. In this study remote sensing data have been used first to identify urban surfaces and then to retrieve the solar reflectance value of these surfaces. The first area of interest is the city of Modena in the Emilia Romagna region (Italy). On this area orthorectified images by an airborne sensor are used. Available images do not allow to directly obtain the solar reflectance value. Therefore it has been investigated a correlation between satellite remote sensing data and ground based measurements. The solar reflectance was obtained for all urban surfaces of interest such as roofs and pavements. In this way it was possible to assess the real situation and to hypothesize achievable improvements in the solar reflectance of several urban surfaces aimed at improving thermal comfort and energy efficiency of buildings

Chemotherapy and Surgery in Children With Cystic Echinococcosis

[No abstract available