Domain-independent neural underpinning of task-switching: an fMRI investigation

The ability to shift between different tasks according to internal or external demands, which is at the core of our behavioral flexibility, has been generally linked to the functionality of left fronto-parietal regions. Traditionally, the left and right hemispheres have also been associated with verbal and spatial processing, respectively. We therefore investigated with functional MRI whether the processes engaged during task-switching interact in the brain with the domain of the tasks to be switched, that is, verbal or spatial. Importantly, physical stimuli were exactly the same and participants\u2019 performance was matched between the two domains. The fMRI results showed a clearly left-lateralized involvement of fronto-parietal regions when contrasting task-switching vs. single task blocks in the context of verbal rules. A more bilateral pattern, especially in the prefrontal cortex, was instead observed for switching between spatial tasks. Moreover, while a conjunction analysis showed that the core regions involved in task-switching, independently of the switching context, were localized both in left inferior prefrontal and parietal cortices and in bilateral supplementary motor area, a direct analysis of functional lateralization revealed that hemispheric asymmetries in the frontal lobes were more biased toward the left side for the verbal domain than for the spatial one and vice versa. Overall, these findings highlight the role of left fronto-parietal regions in task-switching, above and beyond the specific task requirements, but also show that hemispheric asymmetries may be modulated by the more specific nature of the tasks to be performed during task-switching

TECNICHE DI RICOSTRUZIONE DELLA SUPERFICIE POSTERIORE DEL PADIGLIONE AURICOLARE E DELLAMASTOIDE CON LEMBI LOCALI

B a c k g ro u n d. Reconstruction of the posterior auricular surface and of the mastoid has never been given much attention and there are no techniques described. The authors describe two techniques for reconstruction of these areas after cancer excision with local flaps. M e t h o d s . 13 patients have been treated after cancer resection with an advancement flap from the posterior auricular surface and a bilobed flap from the mastoid. R e s u l t s. All flaps healed uneventfully with a satisfactory aesthetic outcome. No relevant complications have been o b s e r v e d . C o n c l u s i o n s. Reconstruction of the posterior auricular surface and of the mastoid with the techniques described allows satisfactory defect closure even in complex situations such as cartilage or bone exposure

NECK DISSECTIONS: MISCONCEPTIONS, MALPRACTICE AND COMMON CONTROVERSIES

B a c k g ro u n d. Neck metastases are the single most important prognostic factor in Head and Neck Squamous Cell Carcinoma. Wise approach to neck treatment is then mandatory to give a chanche for cure. Still, there are some issues about neck dissection that need to be clarified. M e t h o d s. Through a review of the literature and of everyday clinical observations, the following issues are discussed: Functional Neck Dissection, biopsies, nodal levels, Selective Neck Dissections, Spinal Accessory Nerve, neck dissection classification. R e s u l t s. Integration of historical, anatomical, clinical and surgical concepts and up-to-date knowledge can allow to understand how to behave in diverse clinical situations. Conclusions. Standardized guidelines are far to be achieved. Wise behaviour, however, may allow to avoid some mistakes. The aim of this paper is to make the above mentioned issues clear and hopefully give more diffusion to concepts that too often seem to be overlooked

Dimensional measurements in the shipbuilding industry: on‑site comparison of a state‑of‑the‑art laser tracker, total station and laser scanner

Thanks to recent technological innovations, some large-volume-metrology measuring instruments—that would have been considered out of context one/two decades ago—are now efective for the shipbuilding industry, where dimensional errors of a few millimetres are generally tolerated. This paper considers three state-of-the-art instruments: a laser tracker, a total station, and a laser scanner, all with the latest generation of technology. While the frst instrument type has long been widespread for applications in industrial metrology, the last two have traditionally been used in other felds, such as as-built surveying, civil engineering, architecture and topography. Instruments are compared using experimental tests concerning the dimensional verifcation of cruise-ship modules in the relatively under-explored context of the construction of the hull, which represents the ship’s framework. The comparison is structured based on several qualitative and quantitative criteria, including but not limited to (i) simplicity of use for operator(s), (ii) time of acquisition/analysis of measurement data, (iii) metrological performance, and (iv) cost. The main contribution of this article is the on-site testing of instruments of interest, in the typical (unfavourable) working conditions of shipyards

Associations between depressive symptoms and disease progression in older patients with chronic kidney disease: results of the EQUAL study

Background Depressive symptoms are associated with adverse clinical outcomes in patients with end-stage kidney disease; however, few small studies have examined this association in patients with earlier phases of chronic kidney disease (CKD). We studied associations between baseline depressive symptoms and clinical outcomes in older patients with advanced CKD and examined whether these associations differed depending on sex. Methods CKD patients (>= 65 years; estimated glomerular filtration rate <= 20 mL/min/1.73 m(2)) were included from a European multicentre prospective cohort between 2012 and 2019. Depressive symptoms were measured by the five-item Mental Health Inventory (cut-off <= 70; 0-100 scale). Cox proportional hazard analysis was used to study associations between depressive symptoms and time to dialysis initiation, all-cause mortality and these outcomes combined. A joint model was used to study the association between depressive symptoms and kidney function over time. Analyses were adjusted for potential baseline confounders. Results Overall kidney function decline in 1326 patients was -0.12 mL/min/1.73 m(2)/month. A total of 515 patients showed depressive symptoms. No significant association was found between depressive symptoms and kidney function over time (P = 0.08). Unlike women, men with depressive symptoms had an increased mortality rate compared with those without symptoms [adjusted hazard ratio 1.41 (95% confidence interval 1.03-1.93)]. Depressive symptoms were not significantly associated with a higher hazard of dialysis initiation, or with the combined outcome (i.e. dialysis initiation and all-cause mortality). Conclusions There was no significant association between depressive symptoms at baseline and decline in kidney function over time in older patients with advanced CKD. Depressive symptoms at baseline were associated with a higher mortality rate in men

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Case report: difficulty in diagnosis of delayed spinal epidural hematoma in puerperal women after combined spinal epidural anaesthesia

Abstract Background Spinal epidural hematoma is a rare but serious complication of epidural anaesthesia and neurological impairment. Epidural hematoma usually becomes evident within a few hours of the procedure. Delayed clinical presentation of spinal epidural hematoma is even rarer and insidious. Case presentation We reported a case of a 44-year-old woman who underwent a caesarean section for a twin pregnancy during which a delayed dorsal spinal epidural hematoma occurred. Symptoms were reported 5 days after surgery and 72 h after removal of the epidural catheter. An MRI scan showed a dorsal epidural hematoma. The patient was moved to the Neurosurgical Department and underwent decompression surgery. Conclusion The possibility of the delayed onset of a spinal epidural hematoma in a pregnant woman who undergoes epidural anaesthesia in labour must always be taken into consideration. In order to achieve the best clinical result, we stress the importance of a timely diagnosis and prompt surgical treatment

Large volume metrology in shipbuilding

Recent technological innovations make some measuring instruments – that would have been considered unthinkable one/two decades ago – available in the shipbuilding industry, where dimensional errors of a few millimeters are generally tolerated. This article offers a structured comparison of three of these state-of-the-art instruments: a wireless laser tracker with (non-)contact measurements, a hybrid total station, and a portable high-speed laser scanner. The comparison is performed by referring to a real application on dimensional control of cruise-ship modules, based on several qualitative and quantitative criteria, including simplicity of use for operator, time of acquisition/analysis of measurement data, metrological performance, and cost. The major contribution of this article is the experimentation of three highly innovative instrument models in a relatively “difficult” and little explored industrial context