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Background: Noninvasive ventilation (NIV) in COVID-19 patients outside of intensive care unit (ICU) settings was a feasible support during the pandemic outbreak. The aim of this study was to assess the effectiveness of an “on the job” NIV training program provided to 66 nurses working in 3 COVID-19 wards in an Italian university hospital. Methods: A quasi-experimental longitudinal before–after study was designed. The NIV Team education program, provided by expert ICU nurses, included: 3 h sessions of training on the job during work-shifts about the management of helmet-continuous positive airway pressure (CPAP) Venturi systems, and NIV with oronasal and full-face masks. An eleven-item “brief skills self-report tool” was administered before and after the program to explore the perception of NIV education program attendees about their level of skills. Results: In total, 59 nurses responded to the questionnaire. There was an improvement in the skill levels of the management of Helmet-CPAP (median before training 2, inter-quartile range (IQR) 0–6; median after training 8, IQR 3–9; p < 0.0001), and mask-NIV (median before training 2, IQR 0–6; median after training 8, IQR 3–9; p < 0.0001). Conclusions: Training on the job performed by expert ICU nurses can be a valuable and fast means to implement new Helmet-CPAP and mask-NIV skills outside of ICUs.

Slowed processing speed is considered a hallmark feature of cognitive decline in cerebral small vessel disease (SVD); however, it is unclear whether SVD’s association with slowed processing might be due to its association with overall declining general cognitive ability. We quantified the total MRI-visible SVD burden of 540 members of the Lothian Birth Cohort 1936 (age: 72.6 ± 0.7 years; 47% female). Using latent growth curve modelling, we tested associations between total SVD burden at mean age 73 and changes in general cognitive ability, processing speed, verbal memory and visuospatial ability, measured at age 73, 76, 79 and 82. Covariates included age, sex, vascular risk and childhood cognitive ability. In the fully adjusted models, greater SVD burden was associated with greater declines in general cognitive ability (standardised β: −0.201; 95% CI: [−0.36, −0.04]; pFDR = 0.022) and processing speed (−0.222; [−0.40, −0.04]; pFDR = 0.022). SVD burden accounted for between 4 and 5% of variance in declines of general cognitive ability and processing speed. After accounting for the covariance between tests of processing speed and general cognitive ability, only SVD’s association with greater decline in general cognitive ability remained significant, prior to FDR correction (−0.222; [−0.39, −0.06]; p = 0.008; pFDR = 0.085). Our findings do not support the notion that SVD has a specific association with declining processing speed, independent of decline in general cognitive ability (which captures the variance shared across domains of cognitive ability). The association between SVD burden and declining general cognitive ability supports the notion of SVD as a diffuse, whole-brain disease and suggests that trials monitoring SVD-related cognitive changes should consider domain-specific changes in the context of overall, general cognitive decline.

Significance Nanotechnology and neurobiology combined efforts might succeed in the design of hybrid microsystems that, once functionally integrated into the nervous tissue, might help in healing the injured spinal cord. A substantial challenge in this area is the development of structural scaffolds favoring spinal cord reconstruction. The future success of such smart devices resides also in the use of nanomaterials exploiting spinal microenvironment physical properties, such as mechanical and electrical ones, and their potential in promoting axonal regeneration. We synthesized an artificial scaffold based on nanomaterials with the necessary characteristics to guide axonal rewiring. The translational potential of introducing physics rules to neural tissue repair strategies was tested by implanting such a scaffold in spinal cord injury animal models., The regrowth of severed axons is fundamental to reestablish motor control after spinal-cord injury (SCI). Ongoing efforts to promote axonal regeneration after SCI have involved multiple strategies that have been only partially successful. Our study introduces an artificial carbon-nanotube based scaffold that, once implanted in SCI rats, improves motor function recovery. Confocal microscopy analysis plus fiber tracking by magnetic resonance imaging and neurotracer labeling of long-distance corticospinal axons suggest that recovery might be partly attributable to successful crossing of the lesion site by regenerating fibers. Since manipulating SCI microenvironment properties, such as mechanical and electrical ones, may promote biological responses, we propose this artificial scaffold as a prototype to exploit the physics governing spinal regenerative plasticity.

Il saggio analizza la questione della riconoscibilità nell'ordinamento italiano di un provvedimento estero di adozione piena ad una coppia omogenitoriale maschile e, in particolare, le considerazioni della S.C. in relazione alla individuazione degli elementi che compongono il parametro dell'ordine pubblico internazionale

La scelta di affrontare il tema della responsabilità da inadempimento nella prospettiva del giudizio civile e dall’angolo visuale del regime probatorio, si colloca entro la celebre tradizione dottrinale che dell’obbligazione coglie la connessione forse inscindibile con il processo; e nel contempo rende inevitabile che i lavori raccolti all’interno dell’opera abbiamo tutti un’unica impronta metodologica. L’impronta nasce dalla inevitabile esigenza di raffrontare l’esperienza giurisprudenziale, all’interno della quale si svolge per intero la fase istruttoria e quindi la raccolta di prove, precostituite e no, con i principi che presiedono da un lato la prova, e dall’altro lato il sistema della responsabilità da inadempimento. Sulla base di questa impronta metodologica vengono così trattati i temi della prova (documentale e per testi) rispettivamente del credito volontario e del credito involontario; della prova di adempimento o inadempimento (anche nella prospettiva delle azioni sociali di responsabilità); della prova riferita ai casi di impossibilità liberatoria; della prova del danno (emergente e lucro cessante) e delle interferenze con la sua possibile liquidazione equitativa; ancora, dell’attività probatoria richiesta in funzione di quanto previsto in materia di inadempimento colposo e doloso (e quindi di danno prevedibile e imprevedibile), di fatto colposo del creditore e di evitabilità del danno. Il volume si chiude infine con la necessaria trattazione del tema della prova nel giudizio sulla causalità giuridica.

Il contributo intende affrontare la prassi statutaria dei più recenti partiti politici, al fine di evidenziare la "crisi" della democrazia interna delle organizzazioni politiche. Ciò, almeno, sotto un duplica aspetto. Da un lato sono codificate regole che attribuiscono ampi poteri a pochi soggetti. Dall'altro, vi è la tendenza a superare le regole statutarie, privilegiando le scelte e ed i diktat di coloro che guidano il partito politico. Nella parte finale del contributo si dialoga con il futuro legislatore al fine di individuare alcune linee guida per una disciplina organica dei partiti politici.

2D cultures are useful platforms allowing studies of the fundamental mechanisms governing neuron and synapse functions. Yet, such models are limited when exploring changes in network dynamics due to 3D-space topologies. 3D platforms fill this gap and favor investigating topologies closer to the real brain organization. Graphene, an atom-thick layer of carbon, possesses remarkable properties and since its discovery is considered a highly promising material in neuroscience developments. Here, elastomeric 3D platforms endowed with graphene cues are exploited to modulate neuronal circuits when interfaced to graphene in 3D topology. Ex vivo neuronal networks are successfully reconstructed within 3D scaffolds, with and without graphene, characterized by comparable size and morphology. By confocal microscopy and live imaging, the 3D architecture of synaptic networks is documented to sustain a high rate of bursting in 3D scaffolds, an activity further increased by graphene interfacing. Changes are reported in the excitation/inhibition ratio, potentially following 3D-graphene interfacing. A hypothesis is thus proposed, where the combination of synapse formation under 3D architecture and graphene interfaces affects the maturation of GABAergic inhibition. This will tune the balance between hyperpolarizing and depolarizing responses, potentially contributing to network synchronization in the absence of changes in GABAergic phenotype expression.

Il contributo intende evidenziare come non siano sussistenti i presupposti per il riconoscimento del diritto al mantenimento, nella separazione giudiziale, qualora non si riscontri l'esistenza della comunione materiale e spirituale fra i coniugi

International audience; Synapses compute and transmit information to connect neural circuits and are at the basis of brain operations. Alterations in their function contribute to a vast range of neuropsychiatric and neurodegenerative disorders and synapse-based therapeutic intervention, such as selective inhibition of synaptic transmission, may significantly help against serious pathologies. Graphene is a two-dimensional nanomaterial largely exploited in multiple domains of science and technology, including biomedical applications. In hippocampal neurons in culture, small graphene oxide nanosheets (s-GO) selectively depress glutamatergic activity without altering cell viability. Glutamate is the main excitatory neurotransmitter in the central nervous system and growing evidence suggests its involvement in neuropsychiatric disorders. Here we demonstrate that s-GO directly targets the release of presynaptic vesicle. We propose that s-GO flakes reduce the availability of transmitter, via promoting its fast release and subsequent depletion, leading to a decline ofglutamatergic neurotransmission. We injected s-GO in the hippocampus in vivo, and 48 h after surgery ex vivo patch-clamp recordings from brain slices show a significant reduction in glutamatergic synaptic activity in respect to saline injections.

In recent years, the use of free-standing carbon nanotube (CNT) films for neural tissue engineering has attracted tremendous attention. CNT films show large surface area and high electrical conductivity that combined with flexibility and biocompatibility may promote neuron growth and differentiation while stimulating neural activity. In addition, adhesion, survival, and growth of neurons can be modulated through chemical modification of CNTs. Axonal and synaptic signaling can also be positively tuned by these materials. Here we describe the ability of free-standing CNT films to influence neuronal activity. We demonstrate that the degree of cross-linking between the CNTs has a strong impact on the electrical conductivity of the substrate, which, in turn, regulates neural circuit outputs.

In the last two decades, an increasing amount of studies have investigated the use of components based on carbon-(nano) materials in the engineering of neural interfaces, to improve the performance of current state of the art devices. Carbon is an extremely versatile element, characterized by a variety of allotropes and structures with different properties due to their sp, sp(2) or sp(3) hybridization. Among the diverse carbon nanomaterials, carbon nanotubes and graphene are naturally excellent electrical conductors, thus representing ideal candidates for interfacing electrical-excitable tissues. In addition, their dimensional range holds the potential to enhance the material interactions with bio-systems. Successful interfacing of the nervous system with devices that record or modulate neuronal electrical activity requires their stable electrical coupling with neurons. The efficiency of this coupling can be improved significantly by the use of conductive, ad hoc designed, nanomaterials. Here we review different carbon-based nanomaterials currently under investigation in basic and applied neuroscience, and the recent developments in this research field, with a special focus on in vitro studies. (C) 2018 Published by Elsevier Ltd.

Carbon nanotube-based biomaterials critically contribute to the design of many prosthetic devices, with a particular impact in the development of bioelectronics components for novel neural interfaces. These nanomaterials combine excellent physical and chemical properties with peculiar nanostructured topography, thought to be crucial to their integration with neural tissue as long-term implants. The junction between carbon nanotubes and neural tissue can be particularly worthy of scientific attention and has been reported to significantly impact synapse construction in cultured neuronal networks. In this framework, the interaction of 2D carbon nanotube platforms with biological membranes is of paramount importance. Here we study carbon nanotube ability to interfere with lipid membrane structure and dynamics in cultured hippocampal neurons. While excluding that carbon nanotubes alter the homeostasis of neuronal membrane lipids, in particular cholesterol, we document in aged cultures an unprecedented functional integration between carbon nanotubes and the physiological maturation of the synaptic circuits.

A shared dream of ophthalmologists, neurologists and bioengineers is to recover sight ability in diseased eyes via coupling retinal cells with artificial devices. In the engineering of ophto-prosthetic devices the material directly exposed to the biological milieu is crucial, it has to guarantee tight contacts between retinal neurons and the interface, while assuring cell survival with physiological network development. Carbon nanotubes have been applied in several areas of nerve tissue engineering and are emerging as a promising material for neuro-interfacing applications, given their outstanding physical properties. In the current work we have tested carbon nanotube ability to interface cultured murine and human retinal neurons. We cultured rat retinal neurons on carbon nanotube substrates and described their morphology and synaptic functions via immunofluorescence microscopy and patch-clamp recordings. In a second set of experiments, we explored viability and morphology of human retinal ganglion cells (RGC) when grown on carbon nanotube substrates. We show here carbon nanotube ability to sustain the proper development of rat neurons and, more importantly, of human RGCs. In addition, patch-clamp recordings on rat retinal cells were functional to demonstrate that carbon nanotubes do not perturb the physiological synaptic activity when compared to controls. This result, strengthen by the shown biocompatibility with human cells and the nanotube well described high electrical conductivity, makes these nanomaterials promising candidates to interface, stimulate or record eye nerve cells.

During spinal cord maturation neuronal excitability gradually differentiates to meet different functional demands. Spontaneous activity, appearing early during spinal development, is regulated by the expression pattern of ion channels in individual neurons. While emerging excitability of embryonic motoneurons has been widely investigated, little is known about that of spinal interneurons. Voltage-dependent K+ channels are a heterogeneous class of ion channels that accomplish several functions. Recently voltage-dependent K+ channels encoded by erg subfamily genes (ERG channels) were shown to modulate excitability in immature neurons of mouse and quail. We investigated the expression of ERG channels in immature spinal interneurons, using organotypic embryonic cultures of mouse spinal cord after 1 and 2 weeks of development in vitro. We report here that all the genes of the erg family known so far (erg1a, erg1b, erg2, erg3) are expressed in embryonic spinal cultures. We demonstrate for the first time that three ERG proteins (ERG1A, ERG2 and ERG3) are co-expressed in the same neuronal population, and display a spatio-temporal distribution in the spinal slices. ERG immuno-positive cells, representing mainly GABAergic interneurons, were present in large numbers at early stages of development, while declining later, with a ventral to dorsal gradient. Patch clamp recordings confirmed these data, showing that ventral interneurons expressed functional ERG currents only transiently. Similar expression of the erg genes was observed at comparable ages in vivo. The role of ERG currents in regulating neuronal excitability during the earliest phases of spinal circuitry development will be examined in future studies. © 2005 Published by Elsevier Ltd on behalf of IBRO.

This paper summarizes three recent, novel algorithms developed within VAMPIRE, namely optic disc and macula detection, arteryvein classification, and enhancement of binary vessel masks, and their performance assessment. VAMPIRE is an international collaboration growing a suite of software tools to allow efficient quantification of morphological properties of the retinal vasculature in large collections of fundus camera images. VAMPIRE measurements are currently mostly used in biomarker research, i.e., investigating associations between the morphology of the retinal vasculature and a number of clinical and cognitive conditions.

To identify the pattern of pulmonary anatomy and pulmonary blood supply, we analyzed the angiocardiograms of 40 patients with pulmonary atresia and complex congenital heart disease. All patients but two (95%) had confluent pulmonary arteries supplied by a patent ductus arteriosus. These two patients (5%) had nonconfluent pulmonary arteries, one with major systemic-pulmonary collateral arteries and absent patent ductus arteriosus and the other with a patent ductus arteriosus supplying the right lung and small collateral arteries supplying the left. The low incidence of pulmonary arterial abnormalities and the uniform pattern of pulmonary blood supply make the patients with pulmonary atresia and complex congenital heart disease potential candidates for palliative operation without cardiac catheterization in the neonatal period.