Understanding the populism of the Five Star Movement – and its continuity with the past

Italy’s Five Star Movement has now been in government for over three years, but the party still defies easy classification. Drawing on a new study, Antonio Benasaglio Berlucchi examines how the party is defined by its electoral base

clinical and surgical features of lower brainstem hemangioblastomas in von hippel-Lindau disease

none5BACKGROUND: In the context of von Hippel-Lindau disease (VHL), the medulla oblongata is a relatively frequent site of growth of hemangioblastomas, posing related clinical and surgical difficulties. Their management requires a close correlation between clinical evolution and morphological surveillance. In order to describe their clinical and surgical features, we reviewed our experience in the treatment of these lesions. METHODS: Between 2001 and 2009, 14 patients (9 female and 5 male, mean age 34 years) underwent removal of 15 lower brain stem hemangioblastomas. Based on the review of the clinical records and outpatient long-term follow-up visits, their clinical course was analyzed. Functional evaluation was measured with the Karnofsky Performance Scale (KPS) on admission, at discharge and at the last follow-up. The mean follow-up period was 30.8 months (range 4-99). RESULTS: All the operated hemangioblastomas were located in the dorsal medulla oblongata, in the context of multiple lesions, cerebellar and/or spinal. In ten patients hemangioblastomas were located in a median position at the obex area; in four cases a lateral location was observed. Cystic component was absent in two cases. Clinical onset preceded surgery by a mean of 8.5 months. Preoperatively three patients showed a KPS lower than 80, ten patients between 80 and 90, and one patient scored 100 (asymptomatic). There was no surgical mortality. Nine out of 14 patients showed a temporary surgical morbidity. One patient required a tracheostomy. At follow-up ten patients scored a KPS better than before the operation, while the other four patients remained stable. Permanent morbidity was observed in three patients. CONCLUSIONS: Lower brain stem hemangioblastomas in the context of VHL show an often gradual onset of signs and symptoms except for patients who develop an obstructive hydrocephalus. Although transient surgical complications are possible, surgery provides favorable long-term results.nonePAVESI G; BERLUCCHI S; MUNARI M; MANARA R; SCIENZA R; OPOCHER G.Pavesi, G; Berlucchi, S; Munari, M; Manara, R; Scienza, R; Opocher, Giusepp

Neuropsychology of Consciousness: Some History and a Few New Trends

Consciousness is a global activity of the nervous system. Its physiological and pathological mechanisms have been studied in relation to the natural sleep-wake cycle and various forms of normal or morbid unconsciousness, mainly in neurophysiology and clinical neurology. Neuropsychology has been more interested in specific higher brain functions, such as perception and memory and their disorders, rather than in consciousness per se. However, neuropsychology has been at the forefront in the identification of conscious and unconscious components in the processing of sensory and mnestic information. The present review describes some historical steps in the formulation of consciousness as a global brain function with arousal and content as principal ingredients, respectively, instantiated in the subcortex and the neocortex. It then reports a few fresh developments in neuropsychology and cognitive neuroscience which emphasize the importance of the hippocampus for thinking and dreaming. Non-neocortical structures may contribute to the contents of consciousness more than previously believed

Implicit body representations and the conscious body image

Recent studies have revealed that somatosensory processing relies on a class of implicit body representations showing large distortions of size and shape. The relation between these representations and the conscious body image remains unclear. Dissociations have been reported in the clinical literature on eating disorders between different body image measures, with larger and more consistent distortions found with depictive measures, in which participants compare their body to a visual depiction of a body, than metric measures, in which participants compare their body to some non-body standard. Here, we compared implicit body representations underlying position sense to the body image measured with both depictive and metric methods. The body image was measured using both a depictive method (template matching) in which participants judged whether their hand was wider or more slender than a shown hand picture, and a metric method (line length) in which participants judged whether different parts of the their hand were shorter or longer than a presented line. Consistent with previous findings, characteristic distortions were found for the implicit body representation underlying position sense. These distortions were also found in attenuated form for metric – but not depictive – body image measures. While replicating the basic dissociation between implicit body representations and the conscious body image, these results demonstrate that this dissociation is not absolute and specific tasks may utilise both to varying degrees depending on task demands. Metric measures may not be pure measures of body image, but some combination of visual and somatosensory body representations

The Effect of Partially Exposed Connective Tissue Graft on Root‐Coverage Outcomes: A Systematic Review and Meta‐Analysis

The aim of this systematic review was to compare the root‐coverage outcomes of using a partially exposed connective tissue graft (CTG) technique with a fully covered CTG technique for root coverage. An electronic search up to February 28th, 2017, was performed to identify human clinical studies with data comparing outcomes of root coverage using CTG, with and without a partially exposed graft. Five clinical studies were selected for inclusion in this review. For each study, the gain of keratinized gingiva, reduction of recession depth, number of surgical sites achieving complete root coverage, percentage of root coverage, gain of tissue thickness, and changes of probing depth and clinical attachment level were recorded. Meta‐analysis for the comparison of complete root coverage between the two techniques presented no statistically significant differences. A statistically significant gain of keratinized tissue in favor of the sites with an exposed CTG and a tendency of greater reduction in recession depth were seen at the sites with a fully covered CTG. Based on the results, the use of a partially exposed CTG in root‐coverage procedures could achieve greater gain in keratinized gingiva, while a fully covered CTG might be indicated for procedures aiming to reduce recession depth

Structural assessment of the 13th century great mosque and hospital of Divrigi: A world heritage listed structure

. The Great Mosque and Hospital of Divrigi is located in the central eastern part of Turkey, in Divrigi, Sivas. The historical facility consists of a monumental mosque and a two-story hospital, which are adjacent to each other. The structure dates back to 13th century Mengujekids period and has been listed by the UNESCO as a World Heritage since 1985. Great Mosque and Hospital of Divrigi is particularly notable for its monumental stone portals that are decorated with three-dimensional ornaments carved from stone. The structural system of the monument consists of multi-leaf stone masonry walls and stone piers that support the roof structure which consists of stone and brick arches and vaults. The structure is located about 90 km away from the North Anatolian Fault Line, that has been causing several destructive earthquakes. Consequently, the structure is prone to destructive seismic activities. In this study, after a brief introduction on the structural system and current condition of the structure, the structural performance of the Great Mosque and Hospital of Divrigi is investigated through site observations and structural analyses. For this purpose, linear and nonlinear 3D finite element models of the structure are developed and the structure is examined under the effects of vertical loads and seismic actions. In the light of the analyses results, recommendations for potential interventions are outlined for further preservation of the structure

Inter-hemispheric integration of tactile-motor responses across body parts

In simple detection tasks, reaction times are faster when stimuli are presented to the visual field or side of the body ipsilateral to the body part used to respond. This advantage, the crossed-uncrossed difference (CUD), is thought to reflect inter-hemispheric interactions needed for sensorimotor information to be integrated between the two cerebral hemispheres. However, it is unknown whether the tactile CUD is invariant when different body parts are stimulated. The most likely structure mediating such processing is thought to be the corpus callosum (CC). Neurophysiological studies have shown that there are denser callosal connections between regions that represent proximal parts of the body near the body midline and more sparse connections for regions representing distal extremities. Therefore, if the information transfer between the two hemispheres is affected by the density of callosal connections, stimuli presented on more distal regions of the body should produce a greater CUD compared to stimuli presented on more proximal regions. This is because interhemispheric transfer of information from regions with sparse callosal connections will be less efficient, and hence slower. Here, we investigated whether the CUD is modulated as a function of the different body parts stimulated by presenting tactile stimuli unpredictably on body parts at different distances from the body midline (i.e., Middle Finger, Forearm, or Forehead of each side of the body). Participants detected the stimulus and responded as fast as possible using either their left or right foot. Results showed that the magnitude of the CUD was larger on the finger (~2.6 ms) and forearm (~1.8 ms) than on the forehead (~-0.9 ms). This result suggests that the interhemispheric transfer of tactile stimuli varies as a function of the strength of callosal connections of the body parts

Atypical carcinoid tumour of the larynx treated with CO2 laser excision : case report

A case of atypical laryngeal carcinoid tumour of the right aryepiglottic fold is described in a 56-year-old female. The patient presented a 4-year history of dysphagia, occasional dyspnoea and pain originating in the right tonsillar fossa and radiating to the ear. A sessile, submucosal neoplasm of about 1 cm in diameter and apparently benign appearance was detected endoscopically in the supraglottic region. An excisional biopsy was collected by CO2 laser during direct microlaryngoscopy from which a diagnosis of atypical carcinoid tumour of the larynx was made, and later confirmed by histochemical and immunohistochemical staining. Post-operative course was uneventful, with return to a normal diet per os on the first post-operative day. Histopathological evaluation of the excised specimen revealed the presence of a neoplasm in proximity of the surgical margins, which were not, however, directly involved by the tumour. The close endoscopic follow-up was, nonetheless, implemented in order to promptly detect any evidence of relapse of the disease. After 18 months, a lesion, suspected of being a recurrence, was found, in the site of the original tumour. CO2 laser excision was again carried out, this time allowing for wider margins on the surgical resection. The post-operative diagnosis confirmed the clinical hypothesis of recurrence of atypical carcinoid tumour. The patient is presently alive and free from disease 7 years after the second endoscopic procedure. The difficult aspects of clinical and histopathological diagnoses, the surgical treatment as well as endoscopic and instrumental follow-up of this rare condition are discussed

What is embodiment? a psychometric approach

What is it like to have a body? The present study takes a psychometric approach to this question. We collected structured introspective reports of the rubber hand illusion, to systematically investigate the structure of bodily self-consciousness. Participants observed a rubber hand that was stroked either synchronously or asynchronously with their own hand and then made proprioceptive judgments of the location of their own hand and used Likert scales to rate their agreement or disagreement with 27 statements relating to their subjective experience of the illusion. Principal components analysis of this data revealed four major components of the experience across conditions, which we interpret as: embodiment of rubber hand, loss of own hand, movement, and affect. In the asynchronous condition, an additional fifth component, deafference, was found. Secondary analysis of the embodiment of runner hand component revealed three subcomponents in both conditions: ownership, location, and agency. The ownership and location components were independent significant predictors of proprioceptive biases induced by the illusion. These results suggest that psychometric tools may provide a rich method for studying the structure of conscious experience, and point the way towards an empirically rigorous phenomenology