Background
Tremor disorders remain as clinical diagnoses and the rate of misdiagnosis between the commonest non‐parkinsonian tremors is relatively high.
Objectives
To compare the clinical features of ...Essential Tremor without other features (pure ET), ET plus soft dystonic signs (ET + DS), and tremor combined with dystonia (TwD).
Methods
We compared the clinical features of patients with pure ET, ET + DS, and TwD enrolled in The ITAlian tremor Network (TITAN). Linear regression models were performed to determine factors associated with health status and quality of life.
Results
Three‐hundred‐eighty‐three patients were included. Sex distribution was significantly different between the groups with males being more represented in pure ET and females in TwD. The initial site of tremor was different between the groups with about 40% of TwD having head tremor and ET + DS unilateral upper limb tremor at onset. This pattern mirrored the distribution of overt dystonia and soft dystonic signs at examination. Sensory trick, task‐specificity, and position‐dependence were more common, but not exclusive, to TwD. Pure ET patients showed the lowest degree of alcohol responsiveness and ET + DS the highest. Midline tremor was more commonly encountered and more severe in TwD than in the other groups. Regression analyses demonstrated that tremor severity, sex, age, and to a lesser degree the variable “group”, independently predicted health status and quality of life, suggesting the existence of other determinants beyond tremor.
Conclusions
Pure ET and TwD manifest with a phenotypic overlap, which calls for the identification of diagnostic biomarkers. ET + DS shared features with both syndromes, suggesting intra‐group heterogeneity.
From Socrates to Dewey, learning is linked to reality and movement, in relation to the aesthetic implications of the communication/education dynamic: the possibilities offered by the virtual in the ...educational logic exist as a choice to increase reality, not decrease it. The article retraces stages of pedagogical thought in which the question of movement is central, opening the history of education to the work of Marshall McLuhan who first investigated the relationship media-learning. Also in the didactic practices of the current pandemic moment of "distance learning” has been introduced, we cannot disregard the idea of education as an "aesthetic experience", in search of beauty and of a balance, precarious yet rich, between real and virtual.
Pinocchio without ears Simone di Biasio
Ricerche di pedagogia e didattica,
12/2020, Letnik:
15, Številka:
2
Journal Article
Recenzirano
Odprti dostop
Everybody knows that the main feature of Pinocchio is not listening to advice (even less of the “father”), lying, “doing one’s own thing”, following senses and instinct, constantly chasing, like ...every child, the wonder, which is also the “discovery” of the distraction and, face to face with the same medal, of the lie. But there is one detail of Collodi’s original story that could explain this stubborn tendency of the puppet not to “listen” to adults and their world: Geppetto in Pinocchio did not carve his ears. A non-text that recalls interdisciplinary readings of the story, between art and pedagogy, psychology and anthropology. How can a child listen without ears? Yet Pinocchio hears, he hears loud: then there is a difference between hearing and listening. The article intends to shed light, keeping faith with Collodi’s original text, on the puppet's anatomical-craftsmanlike shortcomings, but above all conceptual, therefore physical and metaphysical, shortcomings that have made this universal history of listening education possible: the ears, but also the "maternal" home and, precisely, the absent motherhood like the ears.
Revisional bariatric surgery (RBS) represents a further solution for patients who experience inadequate weight loss (IWL) following primary bariatric surgery (BS) or significant weight regain (WR) ...following initial satisfactory response. RBS guidelines are lacking; however, an increased trend in further BS offerings has been reported recently.
Analyze trend, mortality, complication, readmission, and reoperation rates for any reason at 30 days after RBS in Italy.
Ten Italian high-volume BS centers (university hospitals and private centers).
Prospective, observational, multicenter study enrolling patients undergoing RBS between October 1, 2021, and March 31, 2022, registering reasons for RBS, technique, mortality, intraoperative and perioperative complications, readmissions, and reinterventions for any reason. Patients undergoing RBS during the same calendar interval in 2016–2020 were considered control patients.
A total of 220 patients were enrolled and compared with 560 control-group patients. Mortality was .45% versus .35% (n.s), with an overall mortality of .25%, while open surgery or conversion to open surgery was registered in 1%. No difference was found for mortality, morbidity, complications, readmission (1.3%), and reoperation rates (2.2%). IWL/WR was the most frequent cause, followed by gastroesophageal reflux disease; Roux-en-Y gastric bypass was the most used revisional procedure (56%). Sleeve gastrectomy was the most revised procedure in the study group, while gastric banding was the most revised in the control group. RBS represents up to 9% of the total BS in the Italian participating centers.
Laparoscopy represents the standard approach for RBS, which appears safe. Current Italian trends show a shift toward sleeve gastrectomy being the most revised procedure and Roux-en-Y gastric bypass being the most frequent revisional procedure.
•prospective multicenter observational study on revisional bariatric surgery RBS•222 patients enrolled 01.10.21–31.03.22, compared with 560 patients control group•RBS is safe with acceptable mortality and morbidity, performed 99% laparoscopically•Sleeve is the most revised and RY gastric bypass the most used revisional procedure
The current study was aimed to characterize a bacterial strain isolated from Cr(VI)-polluted sediments for its role in Cr(VI)-reduction as whole cell and by cell free extract. A new moderately ...halophilic Cr (VI)-resistant bacterial strain TA-04 was isolated from polluted marine sediments near a stainless steel plant in Southern Italy, 16S rRNA analysis placed the isolate close to the species
Halomonas aquamarina. Growth was inhibited at 4.0 mM Cr (VI), and reduction of Cr (VI) in the presence of 80 g l
−1 NaCl was highlighted. Immobilized cells showed removal of Cr (VI) from sediment leachate. The cell free extract reduced Cr (VI) with a maximum of activity at pH 6.5 and at temperature of 28 °C, in the presence of NADH. Cr (VI) reduction activity was improved by Cu
2+ and Fe
2+ additions, whereas Hg
2+ depleted it. Free and immobilized cells of the isolate could be used for bioremediation of Cr (VI)-contaminated sites. Cell free extract could represents an alternative in conditions where the whole cells result difficult to apply. A bacterial strain of the genus
Halomonas is characterized in term of whole cells and cell-free extract Cr(VI)-reduction. The results suggest a good potential for bioremediation processes, in particular concerning detoxification of saline polluted environments.
► An efficient hexavalent chromium reduction by whole cells and cell free extract of
Halomonas acquamarina. ► Chromate removal capacity of immobilized
Halomonas aquamarina cells of 91.2% from sediments leachate. ► Hexavalent chromium reduction at moderate halophilic conditions by whole cells.
BACKGROUNDThe construct of Essential Tremor plus (ET-plus) refers to patients who also have rest tremor and/or mild neurologic signs of unknown significance. It is unclear whether soft signs ...represent confounding factors or are useful in suspecting an alternative condition. METHODSUsing a Bayesian approach to ET-plus patients recruited in The ITAlian tremor Network (TITAN), we analyzed the probability that these patients do not have ET. RESULTSThe data of 274 ET-plus patients were extracted from the TITAN database. The majority of patients (240/274; 87.5%) had a single soft sign. The post-test probability of not having ET was different according to the specific soft sign: namely, 0.64 (rest tremor); 0.46 (questionable dystonia); 0.85 (questionable bradykinesia); 0.19 (soft gait impairment); and 0.09 (questionable cognitive issues). In patients with multiple soft signs, the post-test probability of not having ET was higher than 50% for 7 out of 11 combinations, accounting for 44.1% of subjects. Overall, the post-test probability of not having ET was higher than 50% in up to 71.5% of ET-plus patients. DISCUSSIONWe have here shown that: 1) the soft signs differently contribute in modulating the probability that a patient does not have ET; and 2) the effect of multiple soft signs are not always addictive. Future studies are needed to collect prevalence figures of soft signs in different neurological disorders as well as in the elderly and to calculate their value in predicting the development of an alternative tremor syndrome.
In spite of being considered the gold-standard of care, little is known about the real-life use of in-home and multidisciplinary care in atypical parkinsonism.
Primary: Examine real-life ...multidisciplinary care use for Progressive Supranuclear Palsy (PSP). Secondary: a) Compare PSP care to advanced Parkinson's disease (APD) care; (b) Explore demographic and clinical variables associated with care needs in both groups.
A cross-sectional multicenter observational study enrolled 129 PSP patients and 65 APD patients (Hoehn and Yahr ≥3), matched for sex and age. Univariate and multivariate regression analysis were performed.
Over the previous year, 40 % of PSP patients did not encounter a physical therapist, while only one-third met a speech and language therapist and 5 % an occupational therapist. More than 20 % received in-home care and 32 % needed home structural changes. Compared to APD, PSP patients required more day-time, night-time and home structural changes. When considering both PSP and APD in multivariate analysis, reduced functional autonomy and living without a family caregiver were both related to day-time home assistance and to the need of at least one home care service. A PSP diagnosis compared to APD was a risk factor for having at least four multidisciplinary visits in a year. Finally, PSP diagnosis and being from the Northern Italy were significantly related with home structural changes.
There's a significant gap in providing multidisciplinary care for PSP patients. Our findings emphasize the need for a shared, integrated care plan at a national level for patients with atypical parkinsonism.
•Multidisciplinary care use was explored in PSP.•40 % did not encounter a physical therapist.•32 % needed home structural changes.•Living without a family caregiver was related to day-time home assistance.
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