New Challenges for Sustainable Organizations in Light of Agenda 2030 for Sustainability

Sustainability is one of humanity’s most daunting issues at present. Increasing popula- tion, escalation of anthropogenic activities, industrialization, modern agricultural practices that pollute water, air, and soil around the world, and ever-increasing greenhouse gas emissions mean that sustainability is now in doubt [1]. In response to these critical concerns, the world has come up with several initiatives including Agenda 2030. Agenda 2030 is a commitment to eradicate poverty and achieve sustainable development worldwide, ensuring that no one is left behind by 2030. Its adoption was a landmark achievement, providing a shared vision towards sustainable development for all. Its 17 Sustainable Development Goals (SDGs) and 169 targets aim to end the plethora of development problems and deliver a better univers

Structural connectivity‐based topography of the human globus pallidus: Implications for therapeutic targeting in movement disorders

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Red nucleus structure and function: from anatomy to clinical neurosciences

The red nucleus (RN) is a large subcortical structure located in the ventral midbrain. Although it originated as a primitive relay between the cerebellum and the spinal cord, during its phylogenesis the RN shows a progressive segregation between a magnocellular part, involved in the rubrospinal system, and a parvocellular part, involved in the olivocerebellar system. Despite exhibiting distinct evolutionary trajectories, these two regions are strictly tied together and play a prominent role in motor and non-motor behavior in different animal species. However, little is known about their function in the human brain. This lack of knowledge may have been conditioned both by the notable differences between human and non-human RN and by inherent difficulties in studying this structure directly in the human brain, leading to a general decrease of interest in the last decades. In the present review, we identify the crucial issues in the current knowledge and summarize the results of several decades of research about the RN, ranging from animal models to human diseases. Connecting the dots between morphology, experimental physiology and neuroimaging, we try to draw a comprehensive overview on RN functional anatomy and bridge the gap between basic and translational research

In vivo probabilistic atlas of white matter tracts of the human subthalamic area combining track density imaging and optimized diffusion tractography

The human subthalamic area is a region of high anatomical complexity, tightly packed with tiny fiber bundles. Some of them, including the pallidothalamic, cerebello-thalamic, and mammillothalamic tracts, are relevant targets in functional neurosurgery for various brain diseases. Diffusion-weighted imaging-based tractography has been suggested as a useful tool to map white matter pathways in the human brain in vivo and non-invasively, though the reconstruction of these specific fiber bundles is challenging due to their small dimensions and complex anatomy. To the best of our knowledge, a population-based, in vivo probabilistic atlas of subthalamic white matter tracts is still missing. In the present work, we devised an optimized tractography protocol for reproducible reconstruction of the tracts of subthalamic area in a large data sample from the Human Connectome Project repository. First, we leveraged the super-resolution properties and high anatomical detail provided by short tracks track-density imaging (stTDI) to identify the white matter bundles of the subthalamic area on a group-level template. Tracts identification on the stTDI template was also aided by visualization of histological sections of human specimens. Then, we employed this anatomical information to drive tractography at the subject-level, optimizing tracking parameters to maximize between-subject and within-subject similarities as well as anatomical accuracy. Finally, we gathered subject level tracts reconstructed with optimized tractography into a large-scale, normative population atlas. We suggest that this atlas could be useful in both clinical anatomy and functional neurosurgery settings, to improve our understanding of the complex morphology of this important brain region

The cerebellum-periaqueductal gray connectivity: a constrained spherical deconvolution tractography study

The periaqueductal gray (PAG) is a relevant neuronal station situated in the midbrain, which play a pivotal role in triggering behavioral responses to stressful stimuli, such as pain or threat. Current knowledge concerning PAG functions is based on several tract-tracing studies conducted on animals, which unveiled PAG connectivity to both cortical and subcortical areas [1]. Considering that descending projections to spinal cord reach the dorsal horn and connections to motor related cortical areas have never been described yet, the neural structure which best fits PAG modulation of motor behavior is the cerebellum. Direct connections between PAG and cerebellar cortex were firstly described in cats and neurophysiological studies conducted on animals, suggesting either direct or undirect PAG influence to cerebellar activity. In the last decades, the rise of diffusion weighted imaging and tractography have made possible to reliably reconstruct white matter pathways in the human brain. To the best of our knowledge, few tractography studies explored PAG connectivity in humans and the evidences concerning direct or undirect connections with the cerebellar cortex are still sparse. Aimed at investigating PAG connectivity with particular focus on PAG-cerebellum connections, we used high quality diffusion weighted imaging data of thirty healthy subjects from the Human Connectome Project. Fiber tracts have been reconstructed using Spherical Informed Filtering of Tractograms, a novel algorithm improving streamline reconstruction and selection [2]. Connectivity analysis revealed that the PAG is mainly connected with subcortical structures, such as the thalamus and the cerebellum. Taken together our results show a direct interplay between the PAG and the cerebellum, thus suggesting the cerebellum as a likely candidate to modulate complex features of motor behavior in stressful conditions, such as adaptation after social defeat and computing strategies to avoid threatening situations

Interventional Radiological Management and Prevention of Complications after Pancreatic Surgery: Drainage, Embolization and Islet Auto-Transplantation

Pancreatic surgery still remains burdened by high levels of morbidity and mortality with a relevant incidence of complications, even in high volume centers. This review highlights the interventional radiological management of complications after pancreatic surgery. The current literature regarding the percutaneous drainage of fluid collections due to pancreatic fistulas, percutaneous transhepatic biliary drainage due to biliary leaks and transcatheter embolization (or stent–graft) due to arterial bleeding is analyzed. Moreover, also, percutaneous intra-portal islet auto-transplantation for the prevention of pancreatogenic diabetes in case of extended pancreatic resection is also examined. Moreover, a topic not usually treated in other similar reviewsas percutaneous intra-portal islet autotransplantation for the prevention of pancreatogenic diabetes in case of extended pancreatic resection is also one of our areas of focus. In islet auto-transplantation, the patient is simultaneously donor and recipient. Differently from islet allo-transplantation, it does not require immunosuppression, has no risk of rejection and is usually efficient with a small number of transplanted islets

Constrained Spherical Deconvolution Tractography reveals a direct cerebello-ventro tegmental pathway in humans

Introduction. In addition to its role in motor control, reflex adaption and motor learning in the past years numerous studies demonstrated the role of the cerebellum in non-motor functions. Furthermore, lesional animal and neuroimaging in vivo human studies demonstrated connections of the cerebellum with brain regions involved in cognitive, emotional, motivation linguistic processing [1, 2]. Although, studies suggest the role of the cerebellum in neuropsychiatric disorders of the mesocorticolimbic structure (i.e. schizophrenia), at the present time the existence cerebello-ventro tegmental pathway has been demonstrated in only in rodents and only hypothesized in humans. Aim. The goal of this in vivo constrained spherical deconvolution (CSD) tractography study is the investigation on the presence of a direct cerebello-ventro tegmental pathway in the human brain. Material and Methods. We recruited 15 human subjects with no previous history of neurological or psychiatric disorders. The entire study was performed using a 3T Achieva Philips scanner; a SENSE 8 channels head coil, acquiring T1 weighted 3D TFE, DTI sequence; data were analyzed by using constrained spherical deconvolution techniques (CDS). Results. We demonstrated with CSD dentate-ventral midbrain connections. In particular, we found a direct route linking between the dentate nucleus and the ventro tegmental area. Conclusions. This study provides for the first time the existence of a human dentate nucleus connections with the ventro tegmental area, moreover the existence of this cerebello-midbrain pathway suggest that the cerebellum may be involved in the modulation of the mesocorticolimbic system and in related neuropsychiatric disorders such as the schizophrenia

Prescription appropriateness of anti-diabetes drugs in elderly patients hospitalized in a clinical setting: evidence from the REPOSI Register

Diabetes is an increasing global health burden with the highest prevalence (24.0%) observed in elderly people. Older diabetic adults have a greater risk of hospitalization and several geriatric syndromes than older nondiabetic adults. For these conditions, special care is required in prescribing therapies including anti- diabetes drugs. Aim of this study was to evaluate the appropriateness and the adherence to safety recommendations in the prescriptions of glucose-lowering drugs in hospitalized elderly patients with diabetes. Data for this cross-sectional study were obtained from the REgistro POliterapie-Società Italiana Medicina Interna (REPOSI) that collected clinical information on patients aged ≥ 65 years acutely admitted to Italian internal medicine and geriatric non-intensive care units (ICU) from 2010 up to 2019. Prescription appropriateness was assessed according to the 2019 AGS Beers Criteria and anti-diabetes drug data sheets.Among 5349 patients, 1624 (30.3%) had diagnosis of type 2 diabetes. At admission, 37.7% of diabetic patients received treatment with metformin, 37.3% insulin therapy, 16.4% sulfonylureas, and 11.4% glinides. Surprisingly, only 3.1% of diabetic patients were treated with new classes of anti- diabetes drugs. According to prescription criteria, at admission 15.4% of patients treated with metformin and 2.6% with sulfonylureas received inappropriately these treatments. At discharge, the inappropriateness of metformin therapy decreased (10.2%, P < 0.0001). According to Beers criteria, the inappropriate prescriptions of sulfonylureas raised to 29% both at admission and at discharge. This study shows a poor adherence to current guidelines on diabetes management in hospitalized elderly people with a high prevalence of inappropriate use of sulfonylureas according to the Beers criteria