Emergency Department Overcrowding. A Retrospective Spatial Analysis and the Geocoding of Accesses. A Pilot Study in Rome

The overcrowding of first aid facilities creates considerable hardship and problems which have repercussions on patients’ wellbeing, the time needed for a diagnosis, and on the quality of the assistance. The basic objective of this contribution, based on the data collected by the Hospital Policlinico Umberto I in Rome (Lazio region, Italy), is to carry out a territorial screening of the municipality using GIS applications and spatial analyses aimed at reducing—in terms of triage—code white (inappropriate) attendances, after having identified the areas of greatest provenance of improperly used emergency room access. Working in a GIS environment and using functions for geocoding, we have tested an experimental model aimed at giving a close-up geographical-sanitary look at the situation: recognizing the territorial sectors in Rome which contribute to amplifying the Policlinico Umberto I emergency room overcrowding; leading up to an improvement of the situation; promoting greater awareness and knowledge of the services available on the territory, a closer relationship between patient and regular doctor (general practitioner, GP) or Local Healthcare Unit and a more efficient functioning of the emergency room. In particular, we have elaborated a “source” map from which derive all the others and it is a dot map on which all the codes white have been geolocalized on a satellite image through geocoding. We have produced three sets made up of three digital cartographic elaborations each, constructed on the census sections, the census areas and the sub-municipal areas, according to data aggregation, for absolute and relative values, and using different templates. Finally, following the same methodology and steps, we elaborated another dot map about all the codes red to provide another kind of information and input for social utility. In the near future, this system could be tested on a platform that spatially analyzes the emergency department (ED) accesses in near-real-time in order to facilitate the identification of critical territorial issues and intervene in a shorter time to regulate the influx of patients to the ED

Behavioral and Imaging Studies of Infant Artificial Grammar Learning

Artificial grammar learning (AGL) paradigms have proven to be productive and useful to investigate how young infants break into the grammar of their native language(s). The question of when infants first show the ability to learn abstract grammatical rules has been central to theoretical debates about the innate vs. learned nature of grammar. The presence of this ability early in development, that is, before considerable experience with language, has been argued to provide evidence for a biologically endowed ability to acquire language. Artificial grammar learning tasks also allow infant populations to be readily compared with adults and non-human animals. Artificial grammar learning paradigms with infants have been used to investigate a number of linguistic phenomena and learning tasks, from word segmentation to phonotactics and morphosyntax. In this review, we focus on AGL studies testing infants\u2019 ability to learn grammatical/structural properties of language. Specifically, we discuss the results of AGL studies focusing on repetition-based regularities, the categorization of functors, adjacent and non-adjacent dependencies, and word order. We discuss the implications of the results for a general theory of language acquisition, and we outline some of the open questions and challenges

Septal thrombus formation after subcutaneous implantable cardioverter shock in a young female with dilated cardiomyopathy.

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Fingolimod phosphate protection against mitochondrial damage in neuronal cells

Background: Major role of oxidative stress in the pathogenesis of neurodegenerative diseases have been suggested, being mitochondria one of the main sources of ROS. Aim: In the present work, we have studied the antioxidant effect of fingolimod phosphate (FP) on neuronal mitochondrial function and morphology using a model of mitochondrial oxidative damage induced by menadione (Vitk3). Methods: SN4741 neuronal cells were grown (70-80% confluence) and used as control (non-treated cells) or treated cells with Vitk3 15 µM alone or in presence of FP 50 nM during 4 hours. Mitochondrial membrane potential (MMP), cytochrome c oxidase (COX) activity, mitochondrial oxygen consumption rate (OCR), mitochondrial distribution (MTG) and morphology (EM) were analysed. Statistical differences were determined using one-way ANOVA. Results: Vitk3 incubation produces a dramatical decrease in MMP compared to control (43.7 %); this can be almost totally reverted by the co-incubation of Vitk3 in presence of FP (p<0.05). A 20.7 % decrease in COX activity has been found after Vitk3 incubation, again this effect was counteracted when Vitk3 and FP are combined, restoring COX activity to control levels (p<0.05). Vitk3 incubation triggers initially an increase in OCR, decreasing dramatically (61%) after 4 hours. In experiments co-incubating Vitk3 in presence of FP, the OCR decrease found was reduced to only 17% (p<0.05). In experiments with MitoTracker™ Green, we found a change in the network pattern distribution after Vitk3 administration that partially disappears when co-incubated in presence of FP. Almost all the mitochondria treated with Vitk3 show ultrastructural alterations at the electron microscopy level while normal mitochondria can be found when Vitk3 and FP are combined. Conclusion: FP protects against the mitochondrial damage induced by Vitk3, as seen by the results obtained in mitochondrial functional markers, distribution and morphology.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech. PS13/14: Study of the non-immunological mechanisms of action of Gilenya (Fingolimod) as therapeutic tool in Multiple Sclerosis and/or other neurodegenerative diseases. Novartis Farmacéutica S.A

Upgrading of a Dynamic Space-Time Diffusion Simulator in a GIS Environment developed to analyse the COVID-19 spread in Rome. A replicable exemplification

Questo lavoro fornisce dapprima un quadro incentrato su alcune lite-rary review condotte a livello internazionale per sintetizzare ed eviden-ziare i possibili benefici traibili dalle applicazioni GIS e di Intelligenza Artificiale (AI) per far fronte all’emergenza provocata dalla pandemia di COVID-19. Successivamente, il lavoro fornisce una rassegna di ri-cerche applicate svolte in Italia per fornire valore aggiunto, tramite analisi geospaziale e temporale e mediante specifiche elaborazioni e funzionalità, nella disamina interpretativa e di comparazione terri-toriale, nella rappresentazione dinamica del fenomeno, nelle ipotesi predittive e nelle misure attuative per la gestione delle fasi critiche. Nell’ambito delle proposte geotecnologiche, lo studio si focalizza poi sul Simulatore dinamico di diffusione spazio-temporale in ambiente GIS sviluppato per analizzare la propagazione del COVID-19 a Roma, mostrando alcune applicazioni esemplificative basate sui dati forni-ti dalla UOC Servizio Igiene e Sanità Pubblica – ASL Roma 1, per il periodo 25 febbraio – 26 settembre 2020, ed elaborati dopo apposi-ti processi di data cleaning e ottimizzazione. In particolare, vengono discussi e analizzati alcuni set di screenshot, estratti dal Simulatore, che evidenziano l’evoluzione spaziale e diacronica del fenomeno con riferimento a: numero totale di casi di COVID-19 nel periodo in esame; numero totale di decessi dovuti a COVID-19; numero totale di casi di COVID-19 con indicazione dei diversi esiti. Il Simulatore, basato su accurati processi di geocoding e pensato quale strumento per il moni-toraggio e la sorveglianza in tempo reale, consente di muoversi nell’ot-tica della preparedness di precisione, degli screening territoriali a ele-vato grado di dettaglio e dell’integrazione interdisciplinare, al fine di testare soluzioni operative efficaci e replicabili nei casi di emergenza.dovuti a COVID-19; numero totale di casidi COVID-19 con indicazione dei diversi esiti. Il Simulatore, basato suaccurati processi di geocoding e pensato quale strumento per il monitoraggioe la sorveglianza in tempo reale, consente di muoversi nell’otticadella preparedness di precisione, degli screening territoriali a elevatogrado di dettaglio e dell’integrazione interdisciplinare, al fine ditestare soluzioni operative efficaci e replicabili nei casi di emergenzaThis work first provides a framework focused on a number of literary re-views carried out at international level to summarise and highlight the possible benefits that can be obtained by GIS and Artificial Intelligence (AI) applications to tackle the emergency caused by the COVID-19 pan-demic. Later, the present work gives a synthesis of the applied research conducted in Italy to provide added value, through geospatial and tem-poral analysis and specific elaborations and functionalities, in the in-terpretative examination and territorial comparison, the dynamic rep-resentation of the phenomenon, the predictive hypotheses and in the implementational measures for the management of critical phases. In the field of the geotechnological proposals, this study then focuses on the Dynamic Space-Time Diffusion Simulator in a GIS Environment de-veloped to analyse the COVID-19 spread in Rome, showing some demon-strative applications based on the data provided by the UOC Hygiene and Public Health Service – Local Health Unit Rome 1, for the period from February 25th to September 26th 2020, which have been elaborated af-ter ad hoc processes of data cleaning and optimisation. In particular, some sets of screenshots extracted by the Simulator are discussed and analysed in order to put in evidence the spatial and diachronic evolu-tion of the phenomenon with reference to: the total number of cases of COVID-19; the total number of deaths due to COVID-19; the total number of cases of COVID-19 with information regarding the different outcomes. Based on accurate geocoding processes and devised as a real-time mon-itoring and surveillance tool, the Simulator makes it possible to move in the perspectives of precision preparedness, highly detailed territorial screening and interdisciplinary integration, in order to test effective and replicable operational solutions in the cases of emergency

Refractory Status Epilepticus in Genetic Epilepsy-Is Vagus Nerve Stimulation an Option?

Refractory and super-refractory status epilepticus (RSE, SRSE) are severe conditions that can have long-term neurological consequences with high morbidity and mortality rates. The usefulness of vagus nerve-stimulation (VNS) implantation during RSE has been documented by anecdotal cases and in systematic reviews; however, the use of VNS in RSE has not been widely adopted. We successfully implanted VNS in two patients with genetic epilepsy admitted to hospital for SRSE; detailed descriptions of the clinical findings and VNS parameters are provided. Our patients were implanted 25 and 58 days after status epilepticus (SE) onset, and a stable remission of SE was observed from the seventh and tenth day after VNS implantation, respectively, without change in anti-seizure medication. We used a fast ramp-up of stimulation without evident side effects. Our results support the consideration of VNS implantation as a safe and effective adjunctive treatment for SRSE

Papel del receptor S1P sobre el estrés oxidativo mitocondrial en cultivo neuronal

Introducción: Fingolimod, fármaco inmunomodulador, presenta propiedades neuroprotectoras que podrían promover la recuperación de la función cognitiva en enfermedades neurodegenerativas. El estrés oxidativo parece tener un papel fundamental en la patogénesis de dichas enfermedades, siendo la mitocondria una de las fuentes más importantes de especies reactivas de oxigeno (ROS). Objetivo: Determinar la implicación del receptor S1P en los efectos neuroprotectores mostrados por fingolimod fosfato (FP), forma activa de fingolimod, en un modelo celular de estrés oxidativo mitocondrial inducido por menadiona (Vitk3). Material y métodos: La línea celular SN4741 (70-80 % confluencia), se utilizó como control o se trató con Vitk3 15 µM en presencia o ausencia de FP 50 nM o FP 50 nM + W123 10 µM (antagonista S1P) durante 4 horas para estudiar: niveles de ROS mitocondrial según el marcaje de la producción de anión superóxido (O2−.); activación de caspasa-3; niveles de tioles totales (TTLs); marcadores mitocondriales (potencial de membrana mitocondrial-PMM-, actividad citocromo c oxidasa-COX- y consumo de oxígeno-OCR-). Las diferencias estadísticas se determinaron usando ANOVA de un factor. Resultados: W123 revierte parcialmente el efecto protector de FP sobe muerte celular programada, desencadenada por aumento de ROS (p<0,05) y consumo de reserva de antioxidante (p<0,05). El efecto de FP sobre los marcadores mitocondriales PMM, actividad COX y OCR es abolido con W123 (p<0,05). Conclusión: El receptor S1P está implicado en gran parte de los efectos protectores de FP, indicando un papel fundamental de S1P en el mantenimiento de la homeostasis mitocondrial. Proyecto financiado por Novartis Farmacéutica SA (PS13/14).Campus de Excelencia Internacional Andalucía Tech. Proyecto financiado por Novartis Farmacéutica SA (PS13/14). Programa operativo de empleo juvenil; Junta de Andalucía and Fondo Social Europeo (EU). CTS507 and CTS156 from Consejería de Economía Innovación Ciencia y Empresa, Junta de Andalucía and Plan Propio de la Universidad de Málaga 2016

Dispersal and molecular characterisation of the Echinococcus granulosus (Batsch, 1786) complex isolated from various intermediate hosts in the Calabria region, southern Italy

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Voldria parar el temps : realització d'un curt de no-ficció a partir de l'estil de Mia Hansen-Løve

Projecte amb resultat d'un curt de no-ficció amb component fort autobiogràfic que segueix el nostre diàleg sobre el pas del temps amb una metàfora articulada a través del mobiliari urbà de la ciutat de Barcelona. Pren com a referent principal la cinematografia de la Mia Hansen-Løve que té com a tema significatiu la joventut i la transició cap a fer-se adult.Proyecto con resultado de un corto de no ficción con fuerte componente autobiográfico que sigue nuestro diálogo sobre el paso del tiempo con una metáfora articulada a través del mobiliario urbano de la ciudad de Barcelona. Toma como referente principal la cinematografía de Mia Hansen-Løve que tiene como tema significativo la juventud y la transición hacia hacerse adulto.Project as a result of a non-fiction short with a strong autobiographical component that follows our dialogue about the passage of time with a metaphor articulated through the street furniture of the city of Barcelona. The main reference is Mia Hansen-Løve's cinematography, whose main theme is youth and the transition to adulthood