The alchemy of ideas

This article presents an assessment of the power of ideas and their role in initiating change and progress. The enormous potential cascade effect is illustrated by examining the movement of Modernism in the arts. Next, the immense scope and capabilities of the modern scientific endeavor—with robotic space exploration at the scale of 10⁹ meters at one extreme and the wonders of nanoscience at the scale of 10⁻⁹ m at the other—are examined. The attitudes and philosophies of neurological surgery are related to those involved in the Modernist movement and placed on the defined scale of contemporary scientific activity

Initial experience related to the use of the Cosman-Roberts-Wells stereotactic instrument

Journal ArticleInitial experience with a new arc-radius design of stereotactic frame that interfaced with the existing components of the Brown-Roberts-Wells instrument is reported. Over a 6-month period, 32 procedures were performed on 23 males and nine female patients (mean age 32 years); these included 27 stereotactic biopsy procedures, two stereotactic implantations of cyst catheter reservoirs, two ventriculoscopic aspirations of third ventricular colloid cysts, and one stereotactic aspiration of a craniopharyngioma. In all cases successful targeting was achieved and verified by postoperative computerized tomography. There were no operation-related complications. This new frame offers rapid and accurate targeting and is a useful adjunct to the stereotactic armamentarium

Management of cysticercosis cerebri

Journal ArticleInfestation of the central nervous system (CNS) with the parasitic larval form of the cestode Taenia solium, Cysticercosis Cerebri represents an endemic problem in much of the underdeveloped world. In such areas, up to 4% of the population maybe affected by neurocysticercosis, and it accounts for up to 11% of neurosurgical procedures performed in selected centers. The disease remains endemic in Central and South America, Mexico, Eastern Europe, and Asia. With an increasing immigrant influx, however, more cases of this enigmatic entity will be presenting to neurosurgeons in developed nations; therefore maintaining a high index of suspicion in persons of appropriate ethnic background, and recognizing the potential disease spectrum is paramount for all neurosurgeons

Utilization of unilateral and bilateral stereotactically placed adrenomedullary-striatal autografts in Parkinsonian humans: rationale, techniques, and observations

Journal ArticleA limited clinical pilot study involving an amalgam of specialized disciplines including neurology, neuropharmacology, neuropsychology, neurosurgery, neuroanesthesia, neuroradiology, surgical pathology, neuropathology, and urological surgery was organized to clarify issues related to patient selection, optimization of grafting materials, design of a safe, effective, standardized, and reproducible surgical technique, and possible modification of clinical patterns. After initial assessment of 82 Parkinsonian patients for periods of 6 to 20 months, 10 (age, 39-68 years) were selected for unilateral or bilateral adrenomedullary autografts to the caudate nucleus with ependymal and cerebrospinal fluid contact, employing image-directed stereotactic methods. Selection was made only after clear definition of clinical pattern and optimization of medication responses

Real-time Kernel Support for Engine Control Applications

Engine control applications typically include computational activities consisting of periodic tasks, activated by timers, and engine-triggered tasks, activated at specific angular positions of the crankshaft. Such tasks are typically managed by a OSEK-compliant real-time kernel using a fixed-priority scheduler, as specified in the AUTOSAR standard adopted by most automotive industries. Recent theoretical results, however, have highlighted significant limitations of fixed-priority scheduling in managing engine-triggered tasks that could be solved by a dynamic scheduling policy. This master thesis proposes a new kernel implementation within the ERIKA Enterprise operating system, providing EDF scheduling for both periodic and engine-triggered tasks. The proposed kernel has been conceived to have an API similar to the AUTOSAR/OSEK standard one, limiting the effort needed to use the new kernel with an existing legacy application. A simulation framework is presented, showing a powerful environment for studying the execution of tasks under the proposed kernel. Such framework is based on Lauterbach Trace32 Cortex simulator and it was extended with custom plugins for testing the proposed kernel. Performance tests are designed and executed in order to evaluate the proposed kernel in terms of run-time overhead and footprint, that represent the main drawbacks of the earliest deadline first kernel with respect to the fixed-priority scheduling. The thesis is organized as follows: the first chapter is an introduction about the engine control and related problems; then a related works and studies are presented, moreover the theoretical model of the engine control is reported. The second chapter shows the system architecture, with a description of the software tools and hardware devices adopted. Chapter four describes the design of the simulation framework with a special attention to the developed plugins, needed for simulating the proposed kernel. Then the experimental environment and result are shown and discussed

Il coraggio degli infermieri ai tempi del COVID-19

La diffusione del SARS-COV-2 è stata annunciata a partire dal 9 gennaio 2020, quando l'Organizzazione Mondiale della Sanità (OMS) ha dichiarato che le autorità sanitarie cinesi avevano individuato un nuovo ceppo di coronavirus mai prima identificato nel genere umano. Il virus è stato chiamato dapprima 2019-nCoV, per poi essere ufficialmente e definitivamente classificato con il nome di SARS-CoV-2. La sua diffusione è stata associata a un focolaio di polmoniti segnalato il 31 dicembre 2019 in Cina, nella sua parte centrale, nella città di Wuhan. La malattia respiratoria causata dal nuovo coronavirus ha preso il nome di COVID-19 con dichiarazione dell'OMS del seguente 11 febbraio. I primi due casi presenti in Italia sono stati confermati dall'Istituto Superiore di Sanità (ISS) in data 30 gennaio, successivamente il 21 febbraio è stato individuato un nuovo caso, identificato come il primo caso autoctono su territorio nazionale1. In seguito alla velocità e alla dimensione del contagio da parte del nuovo virus, l’OMS, in data 11 marzo 2020 ha dichiarato che l’infezione internazionale poteva essere considerata una pandemia. Dall’inizio della diffusione del virus, la pandemia ha creato danni enormi in tutti i Paesi del globo, con milioni di persone che hanno perso la vita. Gli infermieri e gli operatori dei sistemi sanitari nazionali di tutti i Paesi colpiti hanno visto stravolgere le proprie vite e i propri setting lavorativi in maniera repentina per far fronte con coraggio a questa pandemia, spesso non senza conseguenze. Infatti, basti considerare che in Italia il 72,2% dei contagi sul lavoro avvengono nel settore sanitario e di questi l’83% è rappresentato dagli infermieri, e in totale si contano una percentuale che ha superato, in alcune fasi della pandemia, anche il 15% di tutti i casi di COVID19 su territorio nazionale.La diffusione del SARS-COV-2 è stata annunciata a partire dal 9 gennaio 2020, quando l'Organizzazione Mondiale della Sanità (OMS) ha dichiarato che le autorità sanitarie cinesi avevano individuato un nuovo ceppo di coronavirus mai prima identificato nel genere umano. Il virus è stato chiamato dapprima 2019-nCoV, per poi essere ufficialmente e definitivamente classificato con il nome di SARS-CoV-2. La sua diffusione è stata associata a un focolaio di polmoniti segnalato il 31 dicembre 2019 in Cina, nella sua parte centrale, nella città di Wuhan. La malattia respiratoria causata dal nuovo coronavirus ha preso il nome di COVID-19 con dichiarazione dell'OMS del seguente 11 febbraio. I primi due casi presenti in Italia sono stati confermati dall'Istituto Superiore di Sanità (ISS) in data 30 gennaio, successivamente il 21 febbraio è stato individuato un nuovo caso, identificato come il primo caso autoctono su territorio nazionale1. In seguito alla velocità e alla dimensione del contagio da parte del nuovo virus, l’OMS, in data 11 marzo 2020 ha dichiarato che l’infezione internazionale poteva essere considerata una pandemia. Dall’inizio della diffusione del virus, la pandemia ha creato danni enormi in tutti i Paesi del globo, con milioni di persone che hanno perso la vita. Gli infermieri e gli operatori dei sistemi sanitari nazionali di tutti i Paesi colpiti hanno visto stravolgere le proprie vite e i propri setting lavorativi in maniera repentina per far fronte con coraggio a questa pandemia, spesso non senza conseguenze. Infatti, basti considerare che in Italia il 72,2% dei contagi sul lavoro avvengono nel settore sanitario e di questi l’83% è rappresentato dagli infermieri, e in totale si contano una percentuale che ha superato, in alcune fasi della pandemia, anche il 15% di tutti i casi di COVID19 su territorio nazionale

La Movilidad y la Seguridad Vial en la Ciudad: Percepciones y Experiencias de las personas de edad avanzada

El envejecimiento progresivo de la población, que cada vez es más acelerado, los profundos cambios sociales, económicos y tecnológicos han derivado en un nuevo modelo de movilidad urbana. El interés por la calidad de vida en la ciudad más la inclusión de las personas de edad avanzada en un entorno urbano integrador y accesible que fomente el envejecimiento activo y prevenga la accidentalidad de las personas de edad avanzada hacen que el objeto de interés de esta investigación se centre en identificar y analizar las opiniones, motivaciones, creencias y experiencias personales y subjetivas de una muestra de personas de edad avanzada, en diferentes aspectos relacionados con la ciudad, la movilidad y la seguridad vial. Además las principales cifras de siniestralidad del colectivo de edad avanzada, entre los años 2010 a 2013 reflejan una elevada representación en los accidentes de tráfico y no debemos olvidar, que es uno de los grupos de población con mayor vulnerabilidad y comorbilidad. Debido a que es un “grupo de riesgo”, se plantea la necesidad fomentar la Seguridad Vial en el colectivo de edad avanzada. Es necesario intervenir, para prevenir y reducir la accidentalidad, en la que se ven implicadas las personas de edad avanzada, adoptando estrategias como la formación adecuada. El grupo de edad avanzada necesita programas y actuaciones específicas de educación y formación vial, que tengan en cuenta sus peculiaridades como grupo de riesgo. La presente investigación, ha partido de una entrevista en profundidad aplicada a una muestra de personas mayores. La aplicación de metodología cualitativa, es muy útil a la hora de facilitar la comprensión del fenómeno a estudiar y la visión específica de los participantes, se ha planteado como objetivo conocer en profundidad las percepciones y experiencias de las personas mayores en relación al tráfico y la Seguridad Vial, con especial atención al ámbito urbano en el que desarrollan el mayor número de sus desplazamientos. Algunos de los temas específicos elegidos para profundizar, tales como la agresividad, las emociones, la norma o la salud, han sido fruto de la selección resultante del análisis de los datos diferenciales de las personas de edad avanzada obtenidos de los estudios precedentes (Alonso et al., 2002 - 2008) más el interés personal por este colectivo. Para interpretar la información obtenida en la muestra objeto de estudio y poder comprobar las hipótesis planteadas en esta investigación, se ha empleado el análisis de contenido temático y lexicográfico. Mediante el análisis de contenido se ha preservado la naturaleza textual de los discursos de las personas de edad avanzada, obteniendo su realidad interna. Los resultados expuestos nos han permitido ver la magnitud del problema de las personas de edad avanzada en la ciudad y en las situaciones viales o de tráfico a las que se enfrentan diariamente. Entre las distintas conclusiones se plantea la necesidad de trabajar las emociones positivas y negativas en personas de edad avanzada, a través de la activación de estrategias cognitivas, conductuales y emocionales. Es necesario fomentar la autonomía y participación de este colectivo, implicar a otros colectivos (intergeneracionales) para aumentar el bienestar de los mayores y su calidad de vida. Además de impulsar el conocimiento, para uso y disfrute de nuestros mayores, de los servicios sociales que ofrece la ciudad, tanto para personas autónomas como dependientes. Hay que conseguir que la ciudad y los medios de transporte sean totalmente accesibles, fomentando su autonomía en los desplazamientos, porque “algún día todos seremos mayores”

Microenvironment in neuroblastoma: Isolation and characterization of tumor-derived mesenchymal stromal cells

Background: It has been proposed that mesenchymal stromal cells (MSCs) promote tumor progression by interacting with tumor cells and other stroma cells in the complex network of the tumor microenvironment. We characterized MSCs isolated and expanded from tumor tissues of pediatric patients diagnosed with neuroblastomas (NB-MSCs) to define interactions with the tumor microenvironment. Methods: Specimens were obtained from 7 pediatric patients diagnosed with neuroblastoma (NB). Morphology, immunophenotype, differentiation capacity, proliferative growth, expression of stemness and neural differentiation markers were evaluated. Moreover, the ability of cells to modulate the immune response, i.e. inhibition of phytohemagglutinin (PHA) activated peripheral blood mononuclear cells (PBMCs) and natural killer (NK) cytotoxic function, was examined. Gene expression profiles, known to be related to tumor cell stemness, Wnt pathway activation, epithelial-mesenchymal transition (EMT) and tumor metastasis were also evaluated. Healthy donor bone marrow-derived MSCs (BM-MSC) were employed as controls. Results: NB-MSCs presented the typical MSC morphology and phenotype. They showed a proliferative capacity superimposable to BM-MSCs. Stemness marker expression (Sox2, Nanog, Oct3/4) was comparable to BM-MSCs. NB-MSC in vitro osteogenic and chondrogenic differentiation was similar to BM-MSCs, but NB-MSCs lacked adipogenic differentiation capacity. NB-MSCs reached senescence phases at a median passage of P7 (range, P5-P13). NB-MSCs exhibited greater immunosuppressive capacity on activated T lymphocytes at a 1:2 (MSC: PBMC) ratio compared with BM-MSCs (p = 0.018). NK cytotoxic activity was not influenced by co-culture, either with BM-MSCs or NB-MSCs. Flow-cytometry cell cycle analysis showed that NB-MSCs had an increased number of cells in the G0-G1 phase compared to BM-MSCs. Transcriptomic profiling results indicated that NB-MSCs were enriched with EMT genes compared to BM-MSCs. Conclusions: We characterized the biological features, the immunomodulatory capacity and the gene expression profile of NB-MSCs. The NB-MSC gene expression profile and their functional properties suggest a potential role in promoting tumor escape, invasiveness and metastatic traits of NB cancer cells. A better understanding of the complex mechanisms underlying the interactions between NB cells and NB-derived MSCs should shed new light on potential novel therapeutic approaches

Governance nell'innovazione: Sanità Digitale, Mobile Health, Big Data, Virtual Reality

The introduction of modern Information and Communication Technologies (ICT) was one of the most remarkable innovations of recent decades. ICT brings with it a remarkable technological background that conveys all kinds of information and multimedia content with a significant change in human-technology interaction and significant implications also in the health sector. The constant process of digitization is increasingly affecting national health systems (SSN) and they turn out to be influenced by the process itself, where the literature shows itself in favor of the use of technologies in health, improving their effectiveness and efficiency. These include eHealth, Telemedicine, Electronic Health File, Big Data, Virtual Reality, Augmented Reality, ePrescription. The technologies allow, even remotely, to have an always active and direct contact, between the various professionals, and between professionals and users, and are also useful for the training of both healthcare professionals and users themselves. The use of technology in the healthcare sector should therefore be encouraged as it allows direct contacts between users and healthcare personnel, speed and correlation of data analysis, tracking, time and cost savings, reduction of errors and a positive environmental impact with a reduction in the use of printed paper. For all the points listed, the technological revolution in hospital and territorial care can no longer be postponed