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This article discusses recent advancements in neurotechnologies and how they seem to support the Extended Mind Thesis (EMT), while also raising concerns about the mental integrity and privacy of individuals. In Sect. 1 we review recent research carried out at the frontiers of Brain Machine Interfaces (BMIs) and neuromorphic computing. Taking inspiration (Sect. 2) from research in these fields we present -with the help of some imagination- a futurist scenario of complete human-computer integration. We discuss a set of practical benefits and risks associated with the implementation of such a scenario, which -despite being fictional at the time of writing- is likely to be realized soon. We frame our discussion (Sect. 3) in the context of research conducted in the cognitive sciences on the extended mind thesis (EMT). We reflect on the epistemic and ontic aspects underlying such a scenario and argue that EMT finds supports in it. We further problematize (Sect. 4) around the significance of this envisaged scenario for research on neuro-rights. We therefore also discuss a series of ethical challenges related to their potential infringement. We conclude the paper (Sect. 5) by showing that the development of specific neurotechnologies can make the extension of the mind an increasingly pervasive and transformative phenomenon, while raising important concerns about the potential consequences for certain characteristics of individuals that may be crucial to preserve through the introduction of neurorights. [ABSTRACT FROM AUTHOR]

Advances in artificial intelligence and robotics stand to change many aspects of our lives, including our values. If trends continue as expected, many industries will undergo automation in the near future, calling into question whether we can still value the sense of identity and security our occupations once provided us with. Likewise, the advent of social robots driven by AI, appears to be shifting the meaning of numerous, long-standing values associated with interpersonal relationships, like friendship. Furthermore, powerful actors' and institutions' increasing reliance on AI to make decisions that may affect how people live their lives may have a significant impact on privacy while also raising issues about algorithmic transparency and human control. In this paper, building and expanding on previous works, we will look at how the deployment of Artificial Intelligence technology may lead to changes in identity, security, and other crucial values (such as friendship, fairness, and privacy). We will discuss what challenges we may face in the process, while critically reflecting on whether such changes may be desirable. Finally, drawing on a series of considerations underlying virtue ethics, we will formulate a set of preliminary suggestions, which—we hope—can be used to more carefully guide the future roll out of AI technologies for human flourishing; that is, for social and moral good. [ABSTRACT FROM AUTHOR]

Human extinction is something generally deemed as undesirable, although some scholars view it as a potential solution to the problems of the Earth since it would reduce the moral evil and the suffering that are brought about by humans. We contend that humans collectively have absolute intrinsic value as sentient, conscious and rational entities, and we should preserve them from extinction. However, severe threats, such as climate change and incurable viruses, might push humanity to the brink of extinction. Should that occur, it might be useful to envision a successor to humans able to preserve and hand down its value. One option would be to resort to humanoid robots that reproduce our salient characteristics by imitation, thanks to AI powered by machine learning. However, the question would arise of how to select the characteristics needed for our successors to thrive. This could prove to be particularly challenging. A way out might come from an algorithm entrusted with this choice. In fact, an algorithmic selection both at the social and at the individual level could be a preferred choice than other traditional ways of making decisions. In this sense, reflecting on human extinction helps us to identify solutions that are also suitable for the problems we face today. [ABSTRACT FROM AUTHOR]

There are several well-established theories of criminal punishment and of its justification. The quarantine model (advocated by Pereboom and Caruso) has recently emerged as one of the most prominent theories in the field, by denying the very idea of criminal justice. This theory claims that no one ought to be criminally punished because fundamentally people do not deserve any kind of punishment. On these grounds, the quarantine model proposes forms of incapacitation based on public safety considerations. In this article, we briefly review a series of objections raised against the quarantine model and propose some new or revised arguments, which are aimed at showing its inconsistencies and weaknesses. These arguments are related to (a) the lack of a reliable way of determining who is dangerous and the consequent need to make judgments about confinement based on probabilities, and (b) the prospect that the quarantine model may encourage certain crimes. Given the arguments we present in this paper, the quarantine model proves to be less solid, humane, and desirable than its proponents claim. [ABSTRACT FROM AUTHOR]

A recent interpretation of artificial intelligence (AI) (Floridi 2013, 2022) suggests that the implementation of AI demands the investigation of the binding conditions that make it possible to build and integrate artifacts into our lived world. Such artifacts can successfully interact with the world because our environment has been designed to be compatible with intelligent machines (such as robots). As the use of AI becomes ubiquitous in society, possibly leading to the formation of increasingly intelligent bio-technological unions, there will likely be a coexistence of a plethora of micro-environments wrapped and tailored around humans and basic robots. The key element of this pervasive process will be the capacity to integrate biological realms in an infosphere suitable for the implementation of AI technologies. This process will require extensive datafication. This is because data is the basis of the logical-mathematical codes and models that drive and guide AI. This process will have huge consequences on workplaces, on workers, as well as on the decision-making processes required for the functioning of future societies. In this paper we will offer a comprehensive reflection on the moral and social implications of datafication as well as a set of considerations about its desirability, which will be informed by the following insights: (1) full protection of privacy may become structurally impossible, thus leading to undesirable forms of political and social control; (2) worker's freedom may be reduced; (3) human creativity, imagination, and even divergence from AI logic might be channeled and possibly discouraged; (4) there will likely be a push towards efficiency and instrumental reason, which will become preeminent in production lines as well as in society. [ABSTRACT FROM AUTHOR]

Neurotechnologies broadly understood are tools that have the capability to read, record and modify our mental activity by acting on its brain correlates. The emergence of increasingly powerful and sophisticated techniques has given rise to the proposal to introduce new rights specifically directed to protect mental privacy, freedom of thought, and mental integrity. These rights, also proposed as basic human rights, are conceived in direct relation to tools that threaten mental privacy, freedom of thought, mental integrity, and personal identity. In this paper, our goal is to give a philosophical foundation to a specific right that we will call right to mental integrity. It encapsulates both the classical concepts of privacy and non-interference in our mind/brain. Such a philosophical foundation refers to certain features of the mind that hitherto could not be reached directly from the outside: intentionality, first-person perspective, personal autonomy in moral choices and in the construction of one's narrative, and relational identity. A variety of neurotechnologies or other tools, including artificial intelligence, alone or in combination can, by their very availability, threaten our mental integrity. Therefore, it is necessary to posit a specific right and provide it with a theoretical foundation and justification. It will be up to a subsequent treatment to define the moral and legal boundaries of such a right and its application. [ABSTRACT FROM AUTHOR]

Pereboom and Caruso propose the quarantine model as an alternative to existing models of criminal justice. They appeal to the established public health practice of quarantining people, which is believed to be effective and morally justified, to explain why -in criminal justice- it is also morally acceptable to detain wrongdoers, without assuming the existence of a retrospective moral responsibility. Wrongdoers in their model are treated as carriers of dangerous diseases and as such should be preventively detained (or rehabilitated) until they no longer pose a threat to society. Our main concern in this paper is that Pereboom and Caruso adopt an idiosyncratic meaning of quarantine regulations. We highlight a set of important disanalogies between their quarantine model and the quarantine regulations currently adopted in public health policies. More specifically, we argue that the similarities that Pereboom and Caruso propose to substantiate their analogy are not consistent—despite what they claim—with the regulations underlying quarantine as an epidemiological process. We also notice that certain quarantine procedures adopted in public health systems are inadequate to deal with criminal behaviors. On these grounds, we conclude that Pereboom and Caruso should not appeal to the quarantine analogy to substantiate their view, unless they address the issues and criticism we raise in this paper. [ABSTRACT FROM AUTHOR]

The goal of this paper is to encourage participants in the debate about the locus of cognition (e.g., extended mind vs embedded mind) to turn their attention to noteworthy anthropological and sociological considerations typically (but not uniquely) arising from transhumanist and posthumanist research. Such considerations, we claim, promise to potentially give us a way out of the stalemate in which such a debate has fallen. A secondary goal of this paper is to impress trans and post-humanistically inclined readers to embrace (or at least seriously reflect on) the extended mind thesis as a potential gamechanger to the state of play in their own debates. We start off (Sect. 1) by reviewing two crucial ideas (homo faber and plasticity of the body schema) that are instrumental in setting up the dispute between extended and embedded. We then summarise (Sect. 2), the stalemate between these two competing accounts of cognition, and review some of the dialectics underlying it. In Sect. 3, to get out of the stalemate, we propose to focus on a series of important anthropological and sociological considerations derived from and related to trans and posthumanist research. In doing so, we claim (Sect. 4) that an extended approach to cognition becomes anthropologically preferable and morally as well as socially more desirable than an embedded one. [ABSTRACT FROM AUTHOR]

In a recent paper, Cassinadri (2022) raised substantial criticism about the possibility of using moral reasons to endorse the hypothesis of extended cognition (EXT) over its most popular alternative, the embedded view (EMB). In particular, Cassinadri criticized 4 of the arguments we formulated to defend EXT and argued that our claim that EXT might be preferable to EMB (on the grounds of its progressiveness and inclusiveness) does not stand close scrutiny. In this short reply, we point out—contra Cassinadri—why we still believe that there are moral reasons to prefer EXT over EMB, hence why we think that the former is more inclusive and more progressive than the latter. [ABSTRACT FROM AUTHOR]

This critical essay evaluates the potential integration of distinct kinds of expertise in policymaking, especially during situations of critical emergencies, such as the COVID-19 pandemic. This article relies on two case studies: (i) herd immunity (UK) and (ii) restricted access to ventilators for disabled people (USA). These case studies are discussed as examples of experts' recommendations that have not been widely accepted, though they were made within the boundaries of expert epistemic authority. While the fundamental contribution of biomedical experts in devising public health policies during the COVID-19 pandemic is fully recognized, this paper intends to discuss potential issues and limitations that may arise when adopting a strict expert-based approach. By drawing attention to the interests of minorities (disenfranchized and underrepresented groups), the paper also claims a broader notion of "relevant expertise." This critical essay thus calls for the necessity of wider inclusiveness and representativeness in the process underlying public health policymaking. [ABSTRACT FROM AUTHOR]

We begin (Sect. 1) by introducing our readers to the Extended Mind Thesis and briefly discuss a series of arguments in its favour. We continue (Sect. 2) by showing of such a theory can be resisted and go on to demonstrate that a more conservative account of cognition (called Embedded Theory) can be developed. We acknowledge (Sect. 3) a stalemate between these two different accounts of cognition and notice a couple of issues (namely, dimensions of transparency and excess of metaphysics in the debate) that we argue have prevented further progress in the field. To overcome the stalemate, we propose (Sect. 4) to focus on the ethical implications of these theories. We link (Sect. 5) work conducted on the Extended Mind Thesis with contemporary transhumanist research and claim that extended may be ethically preferred over embedded because it is a more progressive and inclusive theory. [ABSTRACT FROM AUTHOR]

Treponema paraluisleporidarum infects both rabbits (ecovar Cuniculus) and hares (ecovar Lepus). While the occurrence of the bacterium has previously been reported for European brown hares (Lepus europaeus) and domestic rabbits (Oryctolagus cuniculus f. domestica), there are no data available that report infection in the European context. We tested a total of 1,995 serum samples and 287 genital swabs from opportunistically sampled European brown hares (Lepus europaeus; n = 2135), Mountain hares (Lepus timidus; n = 4), European rabbits (Oryctolagus cuniculus; n = 138), and pet rabbits (O. cuniculus f. domestica; n = 5). The samples originated from eight European countries. In case only serum was available, we tested the samples for the presence of anti-treponemal antibodies. For this, we utilized the Treponema pallidum-particle agglutination test (TP-PA), which is suited for the use in lagomorphs due to the antigenic cross-reactivity of anti-T. pallidum and anti-T. paraluisleporidarum antibodies. In addition, the results of 380 sera were confirmed using the fluorescent-Treponema antibody absorption test (FTA-ABS). In all cases where swab samples were available, DNA was extracted and tested using quantitative PCR to test for the presence of the lagomorph syphilis-bacterium. We were able to detect antibodies in 825 of 1,995 lagomorph sera (41.4%; brown hare: 825/1,868; rabbit: 0/127) and obtained positive qPCR results from 182 of 287 swab samples (63.4%; European brown hare: 167/267; mountain hare: 4/4; rabbit: 11/16). While all rabbit sera (n = 127) tested negative for anti-treponemal antibodies, the presence of the bacterium was confirmed in eight wild (n = 8/11) and three domestic rabbits (n = 3/5) from Germany using qPCR. [ABSTRACT FROM AUTHOR]

Objectives: To assess changes in working patterns and education experienced by radiology residents in Northwest Italy during the COVID-19 pandemic. Methods: An online questionnaire was sent to residents of 9 postgraduate schools in Lombardy and Piedmont, investigating demographics, changes in radiological workload, involvement in COVID-19-related activities, research, distance learning, COVID-19 contacts and infection, changes in training profile, and impact on psychological wellbeing. Descriptive and χ2 statistics were used. Results: Among 373 residents invited, 300 (80%) participated. Between March and April 2020, 44% (133/300) of respondents dedicated their full time to radiology; 41% (124/300) engaged in COVID-19-related activities, 73% (90/124) of whom working in COVID-19 wards; 40% (121/300) dedicated > 25% of time to distance learning; and 66% (199/300) were more involved in research activities than before the pandemic. Over half of residents (57%, 171/300) had contacts with COVID-19-positive subjects, 5% (14/300) were infected, and 8% (23/300) lost a loved one due to COVID-19. Only 1% (3/300) of residents stated that, given the implications of this pandemic scenario, they would not have chosen radiology as their specialty, whereas 7% (22/300) would change their subspecialty. The most common concerns were spreading the infection to their loved ones (30%, 91/300), and becoming sick (7%, 21/300). Positive changes were also noted, such as being more willing to cooperate with other colleagues (36%, 109/300). Conclusions: The COVID-19 pandemic changed radiology residents' training programmes, with distance learning, engaging in COVID-19-related activities, and a greater involvement in research becoming part of their everyday practice. Key Points: • Of 300 participants, 44% were fully dedicated to radiological activity and 41% devoted time to COVID-19-related activities, 73% of whom to COVID-19 wards. • Distance learning was substantial for 40% of residents, and 66% were involved in research activities more than before the COVID-19 pandemic. • Over half of residents were exposed to COVID-19 contacts and less than one in twenty was infected. [ABSTRACT FROM AUTHOR]

Bone marrow mesenchymal stem/stromal cells (BMSCs) show great promise for bone repair, however they are isolated by an invasive bone marrow harvest and their regenerative potential decreases with age. Conversely, cord blood can be collected non-invasively after birth and contains MSCs (CBMSCs) that can be stored for future use. However, whether CBMSCs can replace BMSCs targeting bone repair is unknown. This study evaluates the in vitro osteogenic potential of unprimed, osteogenically primed, or chondrogenically primed CBMSCs and BMSCs and their in vivo bone forming capacity following ectopic implantation on biphasic calcium phosphate ceramics in nude mice. In vitro, alkaline phosphatase (intracellular, extracellular, and gene expression), and secretion of osteogenic cytokines (osteoprotegerin and osteocalcin) was significantly higher in BMSCs compared with CBMSCs, while CBMSCs demonstrated superior chondrogenic differentiation and secretion of interleukins IL-6 and IL-8. BMSCs yielded significantly more cell engraftment and ectopic bone formation compared to CBMSCs. However, priming of CBMSCs with either chondrogenic or BMP-4 supplements led to bone formation by CBMSCs. This study is the first direct quantification of the bone forming abilities of BMSCs and CBMSCs in vivo and, while revealing the innate superiority of BMSCs for bone repair, it provides avenues to induce osteogenesis by CBMSCs. [ABSTRACT FROM AUTHOR]

Many governments have seen digital health technologies as promising tools to tackle the current COVID-19 pandemic. A much-talked example in this context involves the recent deluge of digital contact tracing apps (DCT) aimed at detecting Covid-19 exposure. In this short contribution we look at the bio-political justification of this phenomenon and reflect on whether DCT apps constitute, as it is often argued, a serious potential breach of our right to privacy. Despite praising efforts attempting to develop legal and ethical frameworks for DCT apps’ usage; we argue that such endeavours are not sufficient to tackle the more fundamental problem of mass surveillance, which will remain largely unaddressed unless we deal with the biopolitical arguments presented and resort to a technical and structural defence. [ABSTRACT FROM AUTHOR]

Can transfusions of blood plasma slow down ageing or even rejuvenate people? Recent preclinical studies and experimental tests inspired by the technique known as parabiosis have aroused great media attention, although for now there is no clear evidence of their effectiveness. This line of research and the interest it is triggering testify to the prominent role played by the idea of combating the "natural" ageing process in the scientific and social agenda. While seeking to increase the duration of healthy living time may be considered a duty, it also raises ethical questions about how to pursue this goal. Specifically, therapies and techniques accessible only to a fraction of the population seem destined to exponentially increase social inequality and to produce undesirable consequences. In this article we address the issue precisely in the light of the prospected use of plasma for the rejuvenation of a small elite of people. [ABSTRACT FROM AUTHOR]

Software defect prediction models are classifiers often built by setting a threshold t on a defect proneness model, i.e., a scoring function. For instance, they classify a software module non-faulty if its defect proneness is below t and positive otherwise. Different values of t may lead to different defect prediction models, possibly with very different performance levels. Receiver Operating Characteristic (ROC) curves provide an overall assessment of a defect proneness model, by taking into account all possible values of t and thus all defect prediction models that can be built based on it. However, using a defect proneness model with a value of t is sensible only if the resulting defect prediction model has a performance that is at least as good as some minimal performance level that depends on practitioners' and researchers' goals and needs. We introduce a new approach and a new performance metric (the Ratio of Relevant Areas) for assessing a defect proneness model by taking into account only the parts of a ROC curve corresponding to values of t for which defect proneness models have higher performance than some reference value. We provide the practical motivations and theoretical underpinnings for our approach, by: 1) showing how it addresses the shortcomings of existing performance metrics like the Area Under the Curve and Gini's coefficient; 2) deriving reference values based on random defect prediction policies, in addition to deterministic ones; 3) showing how the approach works with several performance metrics (e.g., Precision and Recall) and their combinations; 4) studying misclassification costs and providing a general upper bound for the cost related to the use of any defect proneness model; 5) showing the relationships between misclassification costs and performance metrics. We also carried out a comprehensive empirical study on real-life data from the SEACRAFT repository, to show the differences between our metric and the existing ones and how more reliable and less misleading our metric can be. [ABSTRACT FROM AUTHOR]

Recent trends in global climate modeling, coupled with the availability of more fine-scale datasets, have opened up opportunities for deep learning-based climate prediction to improve the accuracy of predictions over traditional physics-based models. For this, however, large ensembles of data are needed. Generative models have recently proven to be a suitable solution to this problem. For a sound generative model for time-series forecasting, it is essential that temporal dynamics are preserved in that the generated data obey the original data distributions over time. Existing forecasting methods aided by generative models are not adequate for capturing such temporal relationships. Recently, generative models have been proposed that generate realistic time-series data by exploiting the combinations of unsupervised and supervised learning. However, these models suffer from instable learning and mode collapse problems. To overcome these issues, here we propose Wasserstein Time-Series Generative Adversarial Network (WTGAN), a new forecasting model that effectively imitates the dynamics of the original data by generating realistic synthetic time-series data. To validate the proposed forecasting model, we evaluate it by backtesting the challenging decadal climate forecasting problem. We show that the proposed forecasting model outperforms state-of-the- art generative models. Another advantage of the proposed model is that once WTGAN is tuned, generating time-series data is very fast, whereas standard simulators consume considerable computer time. Thus, a large amount of climate data can be generated, which can substantially improve existing data-driven climate forecasting models. [ABSTRACT FROM AUTHOR]

Perianal fistulas and abscesses may be cryptogenetic or associated with inflammatory bowel disease (IBD), specifically Crohn's disease. Proper identification and classification of these lesions are paramount for correct therapeutic management. Current diagnostic modalities include MRI (magnetic resonance imaging), EUS (endoscopic ultrasound), EUA (exam under anaesthesia) and recently, transperineal ultrasound (TPUS). The latter has been proposed as a noninvasive, easily available and cost-effective technique to diagnose, assess and follow up perianal disease particularly in IBD patients. This pictorial review focuses on the role of TPUS in clinical practice, highlighting the features of fistulas and abscesses. [ABSTRACT FROM AUTHOR]

An introduction to the special issue of the journal is presented that discusses topics including a new possible means of neuroenhancement, moral enhancement and the criticism of moral bioenhancement.

Moral bioenhancement is the attempt to improve human behavioral dispositions, especially in relation to the great ethical challenges of our age. To this end, scientists have hypothesised new molecules or even permanent changes in the genetic makeup to achieve such moral bioenhancement. The philosophical debate has focused on the permissibility and desirability of that enhancement and the possibility of making it mandatory, given the positive result that would follow. However, there might be another way to enhance the overall moral behavior of us humans, namely that of targeting people with lower propensity to trust and altruism. Based on the theory of attachment, people who have a pattern of insecure attachment are less inclined to prosocial behavior. We know that these people are influenced by negative childhood memories: this negative emotional component may be erased or reduced by the administration of propranolol when the bad memory is reactivated, thereby improving prosocial skills. It could be objected that memory-editing might be a threat for the person's identity and authenticity. However, if the notion of rigid identity is replaced by that of extended identity, this objection loses validity. If identity is understood as something that changes over time, moral bioenhancement through memory-editing seems indeed legitimate and even desirable. [ABSTRACT FROM AUTHOR]

Intraoperative neuromonitoring (IONM) has proven effective for intraoperative verification of RLN function in the conventional thyroid surgery. However, no studies have performed a systematic evidence-based assessment of this novel health technology in endoscopic and robotic thyroidectomy. Evidence-based criteria were used in a systematic review of relevant literature for years 2000-2015. Four electronic databases (CENTRAL, MEDLINE, Cochrane and EMBASE) were used to retrieve relevant reports published from January 1, 2000 to September 1, 2016. The search terms included 'endoscopic thyroidectomy', 'robotic thyroidectomy', 'IONM', 'continuous IONM (CIONM)', 'neural monitoring', 'recurrent laryngeal nerve monitoring', and 'superior laryngeal monitoring'. The following data were retrieved from eligible studies of patients undergoing endoscopic or robotic thyroidectomy: objective of study, design and setting of study, population, intervention examined, quality of data, follow-up and dropout rate, risk of bias, and outcomes assessed. Of 160 studies retrieved, only 9 (5%) studies used IONM. Eight studies reported 522 nerve at risk (NAR) with IONM. Only three were prospective randomized studies. Reports of IONM endoscopic and robotic procedures included their use for re-surgery and use in both benign and malignant cases. None of the IONM endoscopic procedures involved bilateral palsy. Two studies reported the use of a staged strategy. The rates of recurrent laryngeal palsy were 0-3.6% for transient and 0-0.4% for permanent. Only 30% of the studies performed vagus nerve stimulation, and only 25% performed superior laryngeal nerve monitoring. In addition to the use of IONM as an assistive technology for navigating the anatomy in challenging procedures such as endoscopic and robotic thyroidectomy, IONM has potential use as a routine adjunct to the conventional video-assisted nerve identification in thyroidectomy. [ABSTRACT FROM AUTHOR]

Transoral endoscopic thyroidectomy vestibular approach (TOETVA) is a feasible novel surgical procedure that does not need visible incisions. We describe our initial experience with TOETVA. We recruited 15 patients who were willing to undergo TOETVA. Inclusion criteria were (a) patients who had a neck ultrasound (US) with a estimated thyroid diameter not larger than 10 cm; (b) US estimated gland volume ≤45 mL; (c) nodule size ≤50 mm; (d) a benign tumor, such as a thyroid cyst, single-nodular goiter, or multinodular goiter; (e) follicular neoplasm; (f) papillary microcarcinoma without evidence of metastasis. The procedure is carried out through a three-port technique placed at the oral vestibule, one 10-mm port for 30° endoscope and two additional 5-mm ports for dissecting and coagulating instruments. CO insufflation pressure is set at 6 mmHg. An anterior cervical subplatysmal space is created from the oral vestibule down to the sternal notch, laterally to the sternocleidomastoid muscle. Thyroidectomy is done fully endoscopically using conventional endoscopic instruments and intraoperative neuromonitoring. There were 34% total thyroidectomies and 66% hemithyroidectomies. All TOETVA procedures were performed successfully with no conversions. The mean operative time was 87.6 (59-118) min for lobectomy and 107.6 (99-135) min for bilateral procedure. We observed one case of transient postoperative hypocalcemia. There was no recurrent laryngeal nerve palsy. The cosmetic result was excellent in all patients. This is the first case series of TOETVA in Italy. TOETVA may provide a method for ideal cosmetic results. The results are encouraging, and we are optimistic about the future expansion of its applicability. [ABSTRACT FROM AUTHOR]

Purpose: The vagus nerve (VN) has essential regulatory roles in the gastric acid secretion and gastrin release. Continuous intraoperative neuromonitoring (CIONM) via VN stimulation is a promising technique in thyroid surgery because it potentially avoids injury to the recurrent laryngeal nerve. However, no studies have investigated changes in gastric acid secretion and gastrin release during CIONM. Method: This prospective study of 58 thyroid surgery patients compared gastric acid and serum gastrin at five time points: (1) before skin incision, (2) after baseline calibration of CIONM probe, (3) +20 min from baseline, (4) before probe removal, and (5) after extubation. Patients were excluded if they had any history of using tobacco, acid suppression medications, or drugs that affect gastric motility. Patients were also excluded if they had any history of gastroesophageal reflux symptoms, gastroesophageal reflux disease, peptic ulcer disease, helicobacter pylori infection, or chronic kidney disease. Results: Non significant differences in mean gastric pH values were observed at all time points, i.e., (1) before skin incision (2.2 ± 0.2; p = 0.50), (2) after baseline calibration of CIONM probe (2.0 ± 0.8; p = 0.62), (3) +20 min from baseline (2.5 ± 0.5; p = 0.24), (4) before probe removal (2.9 ± 0.9; p = 0.52), and (5) after extubation (2.6 ± 1.0; p = 0.60). Comparisons of pH monitoring parameters revealed no significant differences in age, gender, side of CIONM (left vs. right), sequence of CIONM, or duration of CIONM. Gastrin values were normal in sequential determinations and did not significantly differ at any time points. Conclusions: CIONM performed via VN stimulation during total thyroidectomy in healthy patients does not influence gastrin secretion and gastric pH. [ABSTRACT FROM AUTHOR]

Carnivores are potential carriers of agents that infect their prey species, even though they themselves are not susceptible, such as the lagovirus that causes European brown hare syndrome (EBHS), a severe disease of brown hares endemic in Europe. During our wildlife surveillance in Lombardy, we identified an EBHS outbreak in a protected area by both virological analyses (sandwich ELISA and RT-PCR) of the target organs from one dead hare and serological examinations (competitive ELISA) of captured animals. Since four red foxes were contemporarily hunted in the same area, we examined their organs by RT-PCR for the EBHS agent (EBHSv). The intestinal content of one fox tested positive, while the fox' other organs (liver, spleen, and mesenteric lymph nodes), and all of the samples from the remaining three foxes, tested negative. Moreover, in the gastrointestinal content of the positive fox, we found food debris that was genetically identified as being of hare origin. The competitive ELISA test for EBHSv antibodies gave negative results in all of the fox sera. Genetic analyses of the EBHSv amplicons obtained by RT-PCR in the hare and the fox indicated a full homology (99.9 % nucleotide and 100 % amino acid identity). These results support the fact that red fox, as other predators, feeding on EBHSv infected hares may have genetic prints of the virus in their gut contents. Even if we did not prove that lagovirus particles remained infective in the excreted feces and, thus, contaminated the ground in the outbreak area, these eventualities cannot be excluded, and we could at least conclude that red foxes might assume a potential role in the indirect transmission of lagovirus, as EBHSv. [ABSTRACT FROM AUTHOR]

The objective is to compare the consequences of routine visualization (RV) and the application of intermitted (I-IONM), standardized (S-IONM), and continuous monitoring (C-IONM) of recurrent laryngeal nerve (RLN) management. RV includes that 698 RLNs managed solely with visual identification. In a second period 777, RLNs were handled by the I-IONM. The third period 768 RLNs monitoring was performed according to the standards. C-IONM via VN stimulation included 626 RLNs. The following issues were analyzed and compared per each period study: RLN identification rate, branching detection, assessment of NRLN, intraoperative recognizable nerve damage, stage thyroidectomy rate, transient or definitive lesions, bilateral nerve palsy, and recovery time. Significance for nerve identification rate was achieved ( p = 0.03) when the statistical analysis was applied between RV vs. S-IONM and C-IONM. Extralaryngeal bifurcation was identified in 21, 44, 43, and 46 of RLN dissected, respectively, per period ( p = 0.005). The incidence of paralysis in identified and unidentified RLN was 3.8 % (107/2806) and 82 % (52/63), respectively. Rates of temporary/permanent RLNP were 16.7/1.7, 5/1.1, 4.5/1, and 3.1/0 % per period study, respectively ( p = 0.07). Recognizable intraoperatively nerve damage was, respectively, 15, 45, 100, and 100 % for period study (p = 0.03). The recovery of injured nerves was significantly faster in C-IONM group. S-IONM and C-IONM cumulate 40-stage procedures. The standardized technique, guidelines adherences, and C-IONM allowed to (1) increase RLN identification; (2) reduce the severity of injuries in terms of (a) reset bilateral RLNP, (b) faster recovery time, and (c) lower definitive RLNP; (3) gather detection of branching and NRLN; (4) recognize nerve stress; and (5) cumulate stage procedures. [ABSTRACT FROM AUTHOR]

Human mesenchymal stem cells (MSC) are promising cell types in the field of regenerative medicine. Although many pathways have been dissected in the effort to better understand and characterize MSC potential, the impact of protein N- or O-glycosylation has been neglected. Deficient protein O-mannosylation is a pathomechanism underlying severe congenital muscular dystrophies (CMD) that start to develop at the embryonic developmental stage and progress in the adult, often in tissues where MSC exert their function. Here we show that O-mannosylation genes, many of which are putative or verified glycosyltransferases (GTs), are expressed in a similar pattern in MSC from adipose tissue, bone marrow, and umbilical cord blood and that their expression levels are retained constant during mesengenic differentiation. Inhibition of the first players of the enzymatic cascade, POMT1/2, resulted in complete abolishment of chondrogenesis and alterations of adipogenic and osteogenic potential together with a lethal effect during myogenic induction. Since to date, no therapy for CMD is available, we explored the possibility of using MSC extracellular vesicles (EVs) as molecular source of functional GTs mRNA. All MSC secrete POMT1 mRNA-containing EVs that are able to efficiently fuse with myoblasts which are among the most affected cells by CMD. Intriguingly, in a pomt1 patient myoblast line EVs were able to partially revert O-mannosylation deficiency and contribute to a morphology recovery. Altogether, these results emphasize the crucial role of protein O-mannosylation in stem cell fate and properties and open the possibility of using MSC vesicles as a novel therapeutic approach to CMD. [ABSTRACT FROM AUTHOR]

Although wild boar can act as a persistent Aujeszky's disease (AD) reservoir, limited data are available on long-term epidemiology in free-ranging wild boar living in areas where industrial swine herds are limited. Hence, this study provides crucial information, which fills this knowledge gap, on the natural dynamics of AD infection. From 3260 sera sampled during eight hunting seasons, 162 (4.97%) were tested positive. Factors, including the animal's age class, and the sampling year, had significant effects on the probability of the wild boar being seropositive, while wild boar mean abundance per area, yearly abundance and the total number of pig farms, as well as interactions among age, year and sex, were not significant. In particular, a positive trend of seroprevalence was observed over the years, with values ranging from 2.1 to 10.8%. This long-term surveillance showed an increase in seroprevalence with a higher probability of being seropositive in older individuals and the independence of wild boar seropositivity from the likelihood of contact with pigs in the area. [ABSTRACT FROM AUTHOR]

Antigen recognition by immunoglobulins depends upon initial rearrangements of heavy chain V, D, and J genes. In leporids, a unique system exists for the VH genes usage that exhibit highly divergent lineages: the VHa allotypes, the Lepus sL lineage and the VHn genes. For the European rabbit ( Oryctolagus cuniculus), four VHa lineages have been described, the a1, a2, a3 and a4. For hares ( Lepus sp.), one VHa lineage was described, the a2L, as well as a more ancient sL lineage. Both genera use the VHn genes in a low frequency of their VDJ rearrangements. To address the hypothesis that the VH specificities could be associated with different environments, we sequenced VDJ genes from a third leporid genus, Sylvilagus. We found a fifth and equally divergent VHa lineage, the a5, and an ancient lineage, the sS, related to the hares' sL, but failed to obtain VHn genes. These results show that the studied leporids employ different VH lineages in the generation of the antibody repertoire, suggesting that the leporid VH genes are subject to strong selective pressure likely imposed by specific pathogens. [ABSTRACT FROM AUTHOR]

The progressive decline in the hare population across Europe has been associated with the occurrence of European brown hare syndrome (EBHS), a highly contagious disease considered endemic in all European countries. This study aimed to evaluate the in-field temporal dynamics of European brown hare syndrome virus (EBHSV) infection in wild European brown hares ( Lepus europaeus) and to test the influence of population density on EBHS seroprevalence. A total of 512 blood samples were collected from free ranging hares captured for restocking in seven different areas of the province of Brescia (Northern Italy) during seven consecutive years (2006-2013) and tested using a competitive ELISA. A generalized linear mixed model estimated the yearly effects of population density on EBHS prevalence. Of the 512 tested, 344 (67.2 %) tested positive for EBHSV antibodies, with the annual seroprevalence ranging from 94.3 to 35.8 %. The prevalence was 3.303 times higher in areas with a density of over 15 hares/km and declined over the years. The results indicate the ongoing transmission of the virus in the tested brown hare population. Since the eradication of EBHS in a wild population is not feasible, a strategy aimed at promoting the endemic stability of the virus through density-dependent mechanisms could be applied; however, this seems more difficult in practice than in theory and would most likely require a very high density of brown hares. [ABSTRACT FROM AUTHOR]

The frequency of neuromonitoring during thyroid surgery is underreported in Italy. The present survey depicts and describes the patterns of use, management, documentation for IONM devices of IONM during thyroid surgery by surgeons in Italy. A point prevalence survey was undertaken. Source data were mixed from Italian surgeons attending the 2014 International Neuromonitoring Study Group (INMSG) meeting, four IONM manufacturers available in Italy and surgical units were identified from Company sales data. Qualitative and quantitative data were used to analyze. Questions probed IONM prevalence, surgeon background, hospital geographic practice locations, type of hospital, rationale for IONM use, sources of initial capital investment for IONM acquisition, type of equipment, use of continuous IONM, monitoring management, use of distinctive standards, and IONM documentation. IONM is currently delivered through 48 units in Italy. In 2013, the distribution of IONM by specialties included: general (50 %), ENT (46 %), and thoracic surgery (4 %). Overall, 12.853 IONM procedures were performed in the period from 2006 to 2013: 253 were performed in 2007 and about 5,100 in 2013. Distribution according to the type of hospital is: public 48 %, academic setting 37 %, and private maintenance 15 %. The use category of high volume thyroid hospitals represented 33 %. Initial capital investment for the acquisition of the monitoring equipment was 67 % public and 33 % with charitable/private funding. Audio plus graphic and EMG electrodes surface endotracheal tube-based monitoring systems accounted for the majority. Continuous IONM was introduced in 5 Academic Centers. Overall motivations expressed are legal (30 %), RLN confirmation (20 %), RLN identification (20 %), prognosis (10 %), helpful in difficult cases (10 %), decrease surgical time (5 %), and educational (5 %). The survey revealed that participants had few experience with the standardized approach of IONM technique (28 %). General IONM information to patients and/or subsequent specific IONM informed consent was initiated in 8 % of centers. EMG determinations were included in medical chart in 20 %. There were no significant associations found between all parameters considered. The present study describes an increased utilization of IONM in Italy. We highlighted areas for improvement in the management and documentation of IONM. [ABSTRACT FROM AUTHOR]