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SummaryThe Golgi ribbon is a structural organization formed by linked Golgi stacks that is believed to be exclusive to vertebrate cells. Its functional contribution to cellular processes is unclear, yet its disruption is associated with several human pathologies. In this study we address the evolutionary origin of the Golgi ribbon, describe a potential molecular mechanism for its emergence and identify a cellular process in which it may be involved. We observed the ribbon-like architecture in the cells of several metazoan taxa, suggesting its early appearance during animal evolution before the emergence of vertebrates. Supported by AlphaFold2 modelling, we propose that the evolution of the complex between two Golgi resident proteins, Golgin-45 and GRASP, led to the tethering of Golgi stacks into the ribbon-like configuration. Finally, we find that the ribbon is assembled during the early embryogenesis of deuterostome animals, a strong indication of its role in development. Overall, our study indicates that the Golgi ribbon is functionally relevant beyond vertebrates and calls for further investigations to decipher its elusive functions.Graphical abstract

Objectives This study aimed to evaluate elastography features of deep infiltrating endometriosis (DIE), and to define whether this technique may discriminate lesions from surrounding non-endometriotic tissue. Methods This was an exploratory observational study on women affected by DIE treated in a third-level academic hospital gynaecology outpatient facility between 2020 and 2021. Strain elastography (SE) was conducted via transvaginal probe. Tissue deformation of DIE and surrounding tissue was expressed as percentage tissue deformation or as subjective colour score (CS; from blue=stiff to red=soft, assigned numerical values from 0 to 3). Ratios of normal tissue/DIE were compared to ratio of normal tissue/stiffer normal tissue area. Results Evaluations were performed on 46 DIE nodules and surrounding tissue of the uterosacral ligaments (n=21), parametrium (n=7), rectum (n=14), and recto-vaginal septum (n =4). Irrespective of location, DIE strain ratio (3.09, IQR 2.38–4.14 vs. 1.25, IQR 1.11–1.48; p Conclusions Both strain and CS ratios accurately distinguish DIE nodules at various locations. Applications of elastography in improving the diagnosis DIE, in distinguishing different DIE lesions and in monitoring DIE evolution can be envisioned and are worthy of further evaluation.

Psychological, emotional, and behavioral domains could be altered in COVID-19 patients and measurement of variables within these domains seems to be mandatory. Neuropsychological assessment could detect possible cognitive impairment caused by COVID-19 and the choice of appropriate tools is an important question. Aim of this exploratory study was to verify the effectiveness of an assessment model for patients with COVID-19. Twelve patients were enrolled and tested with Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Anxiety and Depression Short Scale (AD-R), and the Neuropsychiatry Inventory (NPI), at the time of their entrance (T0) and discharge (T1) from a rehabilitative unit. Moreover, a follow-up evaluation after 3 months (T2) has been conducted on eight patients. Results showed that at baseline (T0), 58.3% of the patients reported a score below cut-off at MMSE and 50% at MoCA. Although a significant amelioration was found only in NPI scores, a qualitative improvement has been detected at all tests, except for MoCA scores, in the T0-T1 trend analysis. A one-way repeated measures analysis of variance showed a significant variation in AD-R depression score, considering the three-assessment time (T0, T1, and T2). The evaluation and tracking over time of the impact of COVID-19 on cognitive, psychological, and behavioral domains has relevant implications for rehabilitation and long-term assistance needs planning. The choice of assessment tools should consider patients vulnerability and match the best compromise among briefness, sensitivity, and specificity.

In recent years, growing attention is rising to virtual reality (VR) tools and exergaming in rehabilitation management of patients with Parkinson disease (PD). However, no strong evidence supports the effectiveness of these cutting-edge technologies on cognitive function and the integration of these promising tool in the rehabilitation framework of PD patients is still challenging. Therefore, the present systematic review of randomized controlled trials (RCTs) aimed at assessing the effects of VR and exergames/telerehabilitation in the cognitive rehabilitation management of patients with PD.PubMed, Scopus and Web of Science databases were systematically searched up to February 14th, 2022, to identify RCTs assessing patients with PD undergoing cognitive rehabilitation including VR or exergames/telerehabilitation. The intervention was compared to conventional rehabilitation protocols. The primary outcome was cognitive function. The quality assessment was performed following the Version 2 of the Cochrane risk-of-bias tool for randomized trials (RoB 2). PROSPERO registration code: CRD42022319788.Out of 1419 identified studies, 66 articles were assessed for eligibility, and, at the end of the screening process, 10 studies were included in the present systematic review. Five RCTs (50%) assessed the exergaming devices, reporting significant positive results on cognitive outcomes scales (Trail Making test scale, Digit Span backward, MoCA, and MyCQ score). The other 5 RTCs (50%) assessed VR approaches, reporting significant improvement in executive functions. The RoB 2 showed an overall high risk of bias for the 40% of studies included.Exergaming and VR might be considered promising rehabilitation interventions in the cognitive rehabilitation framework of PD patients. Further high-quality studies are needed to define the role of exergames and VR in a comprehensive rehabilitation approach aiming at improving the multilevel cognitive impairment characterizing patients with PD.

Motor learning interacts with and shapes experience-dependent cerebral plasticity. In stroke patients with paresis of the upper limb, motor recovery was proposed to reflect a process of re-learning the lost/impaired skill, which interacts with rehabilitation. However, to what extent stroke patients with hemiparesis may retain the ability of learning with their affected limb remains an unsolved issue, that was addressed by this study. Nineteen patients, with a cerebrovascular lesion affecting the right or the left hemisphere, underwent an explicit motor learning task (finger tapping task, FTT), which was performed with the paretic hand. Eighteen age-matched healthy participants served as controls. Motor performance was assessed during the learning phase (i.e., online learning), as well as immediately at the end of practice, and after 90 min and 24 h (i.e., retention). Results show that overall, as compared to the control group, stroke patients, regardless of the side (left/right) of the hemispheric lesion, do not show a reliable practice-dependent improvement; consequently, no retention could be detected in the long-term (after 90 min and 24 h). The motor learning impairment was associated with subcortical damage, predominantly affecting the basal ganglia; conversely, it was not associated with age, time elapsed from stroke, severity of upper-limb motor and sensory deficits, and the general neurological condition. This evidence expands our understanding regarding the potential of post-stroke motor recovery through motor practice, suggesting a potential key role of basal ganglia, not only in implicit motor learning as previously pointed out, but also in explicit finger tapping motor tasks.

BackgroundLong COVID is a rapidly evolving global health crisis requiring interdisciplinary support strategies that incorporate the lived experience of patients. Currently, there is a paucity of research documenting the day-to-day experiences of patients living with Long COVID.ObjectiveTo explore the lived experience of Long COVID patients.Study designLongitudinal, observation study.SettingAn inductive, data-driven, qualitative approach was used to evaluate hand-written diaries obtained from individuals who had been referred to a Derbyshire Long COVID clinic.Participants12 participants (11 females, age 49±10 years, 11 Caucasians) were recruited. Participants were included if they had a previous confirmed or suspected COVID-19 infection with ongoing recovery, >18 years old, understood the study requirements and provided informed consent.MethodParticipants were directed to complete self-report diaries over 16 weeks. Responses were transcribed verbatim and analysed using thematic analysis.ResultsThree key themes were highlighted: (1) understanding who helps patients manage symptoms, (2) daily activities and the impact on quality of life and health status and (3) the effect of turbulent and episodic symptom profiles on personal identity and recovery.ConclusionsThe novel challenges presented by Long COVID are complex with varying inter-related factors that are broadly impacting functional status and quality of life. Support mechanisms must incorporate the lived experiences and foster true collaborations between health professionals, patients and researchers to improve patient outcomes.Trial registration numberNCT04649957.

Objective Clinical benefits of minimally invasive cardiac valve surgery (MIVS) have been reported. Improved postoperative mental status was never analyzed with dedicated psychological tests. In the present study we intend to investigate potential benefits of MIVS for patient psychological well-being, with special attention to the relevance of the patient perception of the chest surgical scar, of the self body image and cosmetic aspects. Methods Between 2016 and 2017, 87 eligible patients, age 66.5 ± 14.5 years, operated on for heart valve surgery, underwent either conventional full sternotomy (CS; n = 48) or MIVS by V-shape hemi-sternotomy approach ( n = 39). Before selection of the surgical approach, patients had undergone preoperative evaluation of their psychological status using Beck Depression Inventory-II (BDI-II), State-Trait Anxiety Inventory Form Y (STAI-Y), and EuroQol-5D (EQ-5D) psychological tests. Six months postoperatively, patients filled in dedicated questionnaires to assess their psychological status, quality of life, and subjective perception, thus repeating the above-mentioned tests and adding the Body Image Questionnaire (BIQ) and Patient and Observer Scar Assessment Scale (POSAS) v2.0 tests for scar-healing process evaluation. Results No patient died during the study.The 4 post-test scales of psychological well-being (BDI-II P = 0.04, STAI-Y P = 0.04, 2 indices of EQ-5D P = 0.03, P = 0.01) showed significant differences between the MIVS group and CS group, with MIVS-small incision patients having lower level of depression and anxiety symptoms and better quality of life. Mean score differences of scar perception (BIQ and POSAS v2.0) were significant, with MIVS patients having evaluated the scar quality significantly better than CS patients. Conclusions MIVS appears associated with significant esthetical and related psychological benefits, as documented by technical tests. These findings should be considered when selecting the most appropriate technique for heart valve surgery.

BACKGROUND: Stroke is the most common cause of disability in Western Countries. It can lead to loss of mobility, capability to walk and ultimately loss of independence in activities of daily living (ADL). Several rehabilitative approaches have been proposed in these years. Robot-assisted gait rehabilitation (RAGT) plays a crucial role to perform a repetitive, intensive, and task-oriented treatment in stroke survivors. However, there are still few data on its role in subacute stroke patients. AIM: The aim of the present study was to assess the efficacy of RAGT for gait recovery in subacute stroke survivors. DESIGN: Systematic review with meta-analysis. SETTING: The setting of the study included Units of Rehabilitation. POPULATION: The analyzed population was represented by subacute stroke patients. METHODS: PubMed, Scopus, Web of Science, CENTRAL, and PEDro were systematically searched until January 18, 2021, to identify randomized controlled trials (RCTs) presenting: stroke survivors in subacute phase (≤6 months) as participants; exoskeleton robots devices as intervention; conventional rehabilitation as a comparator; gait assessment, through qualitative scales, quantitative gait scales or quantitative parameters, as outcome measures. We also performed a meta-analysis of the mean difference in the functional ambulation category (FAC) via the random effect method. RESULTS: Out of 3188 records, 14 RCTs were analyzed in this systematic review. The 14 studies have been published in the last 14 years (from 2006 to 2021) and included 576 stroke survivors, of which 306 received RAGT, and 270 underwent conventional rehabilitation. Lokomat robotic system was the most investigated robotic exoskeleton by the RCTs included (N.=9), albeit the meta-analysis demonstrated a non-significant difference of -0.09 in FAC (95% CI: -0.22.0.03) between Lokomat and conventional therapy. According to the PEDro Scale, 11 (78.5%) were classified as good-quality studies, two as fair-quality studies (14.3%), and one as poor-quality study (7.1%). CONCLUSIONS: Taken together, these findings showed that RAGT might have a potential role in gait recovery in subacute stroke survivors. However, further RCTs comparing the efficacy of RAGT with conventional physical therapy are still warranted in the neurorehabilitation field. CLINICAL REHABILITATION IMPACT: This systematic review provides information on the efficacy of RAGT in allowing subacute stroke patients to perform high-intensity gait training with a lower physical burden on PRM professionals.

We report a patient that underwent a redo complex AVR. In the context of severe AR and dilated LV, we experienced that it is safer to start the LV venting after aortic cross clamping. NIRS in this setting can be a useful tool to prevent potential severe neurological damage.

The spontaneous vegetation of the Alimini district is represented by plant communities that vary in relation to geology and distance from the coastline: garrigue, scrub, scrub forest and Holm Oak forest, reforestation of Pinus halepensis and P. pinea. In the definition of the thinning treatment to be proposed, the identification of the chosen trees for the cutting was done not only based on their vegetational, morphological and phytosanitary features of the single plant, but, primarily keeping in mind the influence exerted by each arboreal element in terms of biospace to the underlying layers.

Objective To analyze Italian Cardiac Surgery experience during the pandemic of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) identifying risk factors for overall mortality according to coronavirus disease 2019 (COVID‐19) status. Methods From February 20 to May 31, 2020, 1354 consecutive adult patients underwent cardiac surgery at 22 Italian Centers; 589 (43.5%), patients came from the red zone. Based on COVID‐19 status, 1306 (96.5%) were negative to SARS‐CoV‐2 (COVID‐N), and 48 (3.5%) were positive to SARS‐CoV‐2 (COVID‐P); among the COVID‐P 11 (22.9%) and 37 (77.1%) become positive, before and after surgery, respectively. Surgical procedures were as follows: 396 (29.2%) isolated coronary artery bypass grafting (CABG), 714 (52.7%) isolated non‐CABG procedures, 207 (15.3%) two associate procedures, and three or more procedures in 37 (2.7%). Heart failure was significantly predominant in group COVID‐N (10.4% vs. 2.5%, p = .01). Results Overall in‐hospital mortality was 1.6% (22 cases), being significantly higher in COVID‐P group (10 cases, 20.8% vs. 12, 0.9%, p

We study the non-equilibrium relaxational dynamics of a probe particle linearly coupled to a thermally fluctuating scalar field and subject to a harmonic potential, which provides a cartoon for an optically trapped colloid immersed in a fluid close to its bulk critical point. The average position of the particle initially displaced from the position of mechanical equilibrium is shown to feature long-time algebraic tails as the critical point of the field is approached, the universal exponents of which are determined in arbitrary spatial dimensions. As expected, this behavior cannot be captured by adiabatic approaches which assume fast field relaxation. The predictions of the analytic, perturbative approach are qualitatively confirmed by numerical simulations., Comment: 33 pages, 11 figures

Objective Previous studies reported unfavorable results in COVID-19 patients who underwent cardiac surgery. Complications most frequently observed were respiratory failure and higher incidence of thromboembolic events. We present our single-center experience in patients with perioperative diagnosis of COVID-19 infection undergoing cardiac surgery with extracorporeal circulation. Methods In this observational matched case-control (propensity match 1:2) study, we collected data of patients undergoing open heart cardiac surgery from January 2020 to May 2021, having positive perioperative diagnosis of COVID-19 infection confirmed by polymerase Chain Reaction-PCR (study group). Patients were compared with 56 corresponding controls (control group) who matched for age, sex, body mass index (BMI) and Euro-Score II. Results In the study period 1060 patients underwent cardiac surgery with cardiopulmonary bypass (CPB). Among them, 28 consecutive patients, aged 70.1±9.3 years, had perioperative diagnosis of COVID-19 infection. Four (14%) patients underwent emergency surgery for type-A aortic dissection, 2 (7%) patients died in the Intensive Care Unit for severe respiratory failure, shock and multiple organ failure. Significant bleeding complications occurred in 14 (50%) patients in the study group (vs 6% in the control group, p= Conclusions Clinical outcome of open heart cardiac surgery patients with perioperative COVID-19 infection appears significantly impaired in terms of mortality and postoperative complications. CPB-related inflammatory reaction could likely exacerbate the deleterious effect of COVID-19 on the respiratory and renal systems, as well as on the coagulation pathways. Early and late hemorrhagic complications were very frequent with significantly increased surgical reexplorations for bleeding, a higher incidence of severe thrombocytopenia, of blood components transfusion and procoagulant drugs administration. The increased surgical risk should suggest a cautious attitude in indicating open heart surgery in patients with perioperative COVID-19 infection and surgery should be limited to not postponable or to urgent cases.

The reduction of carbon dioxide is one of the hottest topics due to the concern of global warming. Carbon dioxide reduction is also an essential step for life's origins as photoautotrophs arose soon after Earth formation. Both the topics are of high general interest, and possibly, there could be a fruitful cross-fertilization of the two fields. Herein, we selected and collected papers related to photoreduction of carbon dioxide using compounds easily available on the Earth and considered of prebiotic relevance. This work might be useful also to scientists interested in carbon dioxide photoreduction and/or to have an overview of the techniques available.

COVID-19 has shaped and changed our normalities, and, with the discovery of new variants, the long-COVID syndrome, and stress disorders, the end of the pandemic seems distant. The current scenario is impacting all aspects of our lives. In particular, many studies reported that the pandemic resulted in increased psychiatric disorders and grief-related symptoms in adolescents. The project developed between Italy and Slovenia investigated students’ experiences during the lockdown and, in particular, reported the perception of distanced learning, producing a transparent qualitative analysis that can inform future research and open to discussions on learning strategies. A survey was conducted with secondary school students in Southern Italy between 1 April and 31 May 2020 and in Central Slovenia between 16 March and 28 February 2021. Qualitative and quantitative data were collected based on students’ perception of distanced learning, via an online survey platform. The results focused on three main aspects: learning experience, relationships with peers and teachers, and anxiety levels. The data showed similarities and differences in the two cohorts and suggested strategies to improve education (e.g., with blended approaches) to prepare students, teachers, and tutors for the challenges of returning to classes. In particular, data showed that it is recommended to foster collaboration between EU countries and to work to prevent students’ social isolation.

Background In vertebrate cells, the Golgi functional subunits, mini-stacks, are linked into a tri-dimensional network. How this “ribbon” architecture relates to Golgi functions remains unclear. Are all connections between mini-stacks equal? Is the local structure of the ribbon of functional importance? These are difficult questions to address, without a quantifiable readout of the output of ribbon-embedded mini-stacks. Endothelial cells produce secretory granules, the Weibel-Palade bodies (WPB), whose von Willebrand Factor (VWF) cargo is central to hemostasis. The Golgi apparatus controls WPB size at both mini-stack and ribbon levels. Mini-stack dimensions delimit the size of VWF "boluses” whilst the ribbon architecture allows their linear co-packaging, thereby generating WPBs of different lengths. This Golgi/WPB size relationship suits mathematical analysis. Results WPB lengths were quantized as multiples of the bolus size and mathematical modeling simulated the effects of different Golgi ribbon organizations on WPB size, to be compared with the ground truth of experimental data. An initial simple model, with the Golgi as a single long ribbon composed of linearly interlinked mini-stacks, was refined to a collection of mini-ribbons and then to a mixture of mini-stack dimers plus long ribbon segments. Complementing these models with cell culture experiments led to novel findings. Firstly, one-bolus sized WPBs are secreted faster than larger secretory granules. Secondly, microtubule depolymerization unlinks the Golgi into equal proportions of mini-stack monomers and dimers. Kinetics of binding/unbinding of mini-stack monomers underpinning the presence of stable dimers was then simulated. Assuming that stable mini-stack dimers and monomers persist within the ribbon resulted in a final model that predicts a “breathing” arrangement of the Golgi, where monomer and dimer mini-stacks within longer structures undergo continuous linking/unlinking, consistent with experimentally observed WPB size distributions. Conclusions Hypothetical Golgi organizations were validated against a quantifiable secretory output. The best-fitting Golgi model, accounting for stable mini-stack dimers, is consistent with a highly dynamic ribbon structure, capable of rapid rearrangement. Our modeling exercise therefore predicts that at the fine-grained level the Golgi ribbon is more complex than generally thought. Future experiments will confirm whether such a ribbon organization is endothelial-specific or a general feature of vertebrate cells.

The Golgi apparatus plays a central role as a processing and sorting station along the secretory pathway. In multicellular organisms, this organelle displays two structural organizations, whereby its functional subunits, the mini-stacks, are either dispersed throughout the cell or linked into a centralized structure, called Golgi “ribbon”. The Golgi ribbon is considered to be a feature typical of vertebrate cells. Here we report that this is not the case. We show that sea urchin embryonic cells assemble Golgi ribbons during early development. Sea urchins are deuterostomes, the bilaterian animal clade to which chordates, and thus vertebrates, also belong.Far from being a structural innovation of vertebrates, the Golgi ribbon therefore appears to be an ancient cellular feature evolved before the split between echinoderms and chordates. Evolutionary conservation of the ribbon architecture surmises that it must play fundamental roles in the biology of deuterostomes.

Resumo: O nudging como um instrumento de políticas públicas tem sido frequentemente criticado com base em dois pressupostos: 1) é mais perigoso para a dignidade humana e autonomia do que a tradicional regulação de “comando e controlo”; 2) é ainda mais problemático quando assenta em razões paternalistas, quando comparado com as suas aplicações não paternalistas. Este artigo procura desafiar ambos os pressupostos, mostrando que o principal problema do nudging é o da transparência, sendo que a mesma pode ser garantida sem prejudicar eficácia do nudging; além disso, o nudging paternalista corresponde a um paternalismo de meios e não a um paternalismo de fins, o que significa que não é uma forma de perfeccionismo que se sobrepõe aos fins individuais de cada pessoa.

Vertebrate cells display a specific Golgi apparatus architecture, known as the “ribbon”, where the functional subunits, the mini-stacks, are linked into a tridimensional network. The importance of the ribbon architecture is underscored by evidence of its disruption in a host of diseases, but just how it relates to the biological Golgi functions remains unclear. Are all the connections between mini-stacks functionally equal? Is the local structure of the ribbon of functional importance? These are difficult questions to address, due to the lack of a secretory cargo providing a quantifiable readout of the functional output of ribbon-embedded mini-stacks. Endothelial cells produce rod-shaped secretory granules, the Weibel-Palade bodies (WPB), whose von Willebrand Factor (VWF) cargo is central to hemostasis. In these cells, the Golgi apparatus exerts a dual control on WPB size at both mini-stack and ribbon levels. Mini-stack dimensions delimit the size of VWF ‘boluses” while the ribbon architecture allows their linear co-packaging at the trans-Golgi network generating WPBs of different lengths. This Golgi/WPB size relationship lends itself to mathematical analysis. Here, different ribbon structures were modeled and their predicted effects on WPB size distribution compared to the ground truth of experimental data. Strikingly, the best-fitting model describes a Golgi ribbon made by linked subunits corresponding to differentially functioning monomer and dimer ministacks. These results raise the intriguing possibility that the fine-grained structure of the Golgi ribbon is more complex than previously thought.

Surgical ventricular reconstruction (SVR) is the therapy of choice for patients with left ventricular dilatation, apical and anterolateral transmural scar, and low ejection fraction. STICH trial did not show that SVR led to improved survival but several observational studies did. However, because of the considerable operative risk, open heart surgery is considered risky in debilitated patients and clinical results are controversial. Alternative less invasive strategies for left ventricular aneurysm repair have been proposed. We present a case of a left ventricular aneurysm repair using the less invasive ventricular enhancement technique (LIVE) with the Revivent TC system (BioVentrix Inc., San Ramon, CA) in a totally surgical approach, instead of a hybrid interventional-surgical one, as previously described.

This contribution focuses on field and laboratory analyses of carbonate fault cores pertaining to high-angle extensional fault zones currently exposed in the central and southern Apennines, Italy. The fault zones studied crosscut Mesozoic platform-related carbonate rocks, strike ca. NW-SE, and dip steeply SW. They formed during the Plio-Quaternary downfaulting of the Apennine fold-and-thrust belt and were exhumed from shallow crustal levels ( < 1.5 km). The carbonate fault cores include grain-supported, matrix-supported, and cement-supported fault rocks, fluidized layers of ultracataclasites with injection veins, and main slip surfaces. Our results of microstructural, petrographic, and cathodoluminescence analyses highlight the contrasting diagenetic evolution of calcite- and dolomite-rich fault rocks. Physical compaction was common within the dolomite-rich fault rocks, whereas chemical compaction coupled with dissolution characterized the calcite-rich fault rocks. Furthermore, multiple generations of calcite cements are documented in the fault zones. The first generation consists of a microcrystalline calcite cement, which developed around survivor grains and lined intergranular pores. The second generation is made up of light-luminescent, fibrous calcite crystals, which precipitated within open fractures and around survivor grains. The third generation consists of an euhedral calcite cement that surrounded survivor grains and infilled both open fractures and intergranular pores.

Menstrual pain is consequent to intense uterine contraction aimed to expel menstrual flow through downstream uterine cervix. Herein it was evaluated whether characteristics of uterine cervix are associated with intensity of menstrual pain. Ultrasound elastography was used to analyze cervix elasticity of 75 consecutive outpatient women. Elasticity was related to intensity of menstrual pain defined by a Visual Analogue Scale (VAS). Four regions of interest (ROI) were considered: internal uterine orifice (IUO), anterior (ACC) and posterior cervical (PCC) compartment and middle cervical canal (MCC). Tissue elasticity, evaluated by color score (from 0.5 = blue/violet (low elasticity) to 3.0 = red (high elasticity), and percent tissue deformation was analyzed. Elasticity of IUO was lower (p = 0.0001) than that of MCC or ACC, and it was negatively related (R2 = 0.428, p = 0.0001) to menstrual VAS (CR −2.17, 95%CI −3.80, −0.54, p = 0.01). Presence of adenomyosis (CR 3.24, 95% CI 1.94, 4.54, p = 0.0001) and cervix tenderness at clinical examination (CR 2.74, 95% CI 1.29, 4.20, p = 0.0004), were also independently related to menstrual VAS. At post hoc analysis, women with vs. without menstrual pain had lower IUO elasticity, expressed as color score (0.72 ± 0.40 vs. 0.92 ± 0.42, p = 0.059), lower percent tissue deformation at IUO (0.09 ± 0.05 vs. 0.13 ± 0.08, p = 0.025), a higher prevalence of cervical tenderness at bimanual examination (36.2% vs. 9.5%, p = 0.022) and a higher prevalence of adenomyosis (46.5% vs. 19.9%, p = 0.04). These preliminary data indicate that IUO elasticity is associated with the presence and the intensity of menstrual pain. Mechanisms determining IUO elasticity are useful to be explored.

The aim of this study was to assess the prevalence of adenomyosis in symptomatic women in relation to the angle of flexion of the uterus. A total of 120 patients referring to our Chronic Pelvic Pain Center were prospectively enrolled. Each woman scored menstrual pain, intermenstrual pain, and dyspareunia on a 10 cm visual analogue scale and underwent a clinical examination and transvaginal ultrasound. MUSA criteria were used for the diagnosis of adenomyosis. The angle of flexion of the uterus on the cervix was categorized as 210° (18.3% of cases). Adenomyosis was diagnosed in 76/120 women (63.3%). In women with adenomyosis, the VAS of intermenstrual pain was higher than in women without adenomyosis (4.04 ± 3.79 vs. 2.57 ± 3.34; p < 0.034). The angle of uterine flexion >210° was more prevalent in women with than without adenomyosis (25.0% vs. 6.8%; p < 0.015). The odds ratio of suffering from adenomyosis markedly increased in the presence of an angle of uterine flexion >210° (OR 5.8 95% CI 1.19, 28.3; p > 0.029). The data indicate that the ultrasound-estimated angle of uterine flexion >210° is related to a higher prevalence of adenomyosis.

© 2020 by the authors. Licensee MDPI, Basel, Switzerland. The first case of pneumonia was reported on 8 December 2019 and identified on 7 January 2020 as COVID-19. On 9 March 2020, to stop the spread of COVID-19 cases, the Italian government declared a health emergency, forcing all citizens to go into lockdown. Suddenly, schools were constrained to using distance learning strategies with little or limited experience on the topic. Particularly, in the southern regions of Italy, approximately 20% of the students did not have access to any devices and were excluded from learning, producing a direct risk of increased adolescent delinquency. This research team intended to report the results of an observational study that focused on the perceptions of distance learning in adolescents from secondary school in Naples (Italy) between April and May 2020. The questionnaire comprised 11 questions focused on the perceptions of distance learning in comparison to live classrooms, relationships with peers and teachers, and levels of anxiety. The study is amongst the first to report the effect of the pandemic from a student-centred perspective and hopes to produce information to develop future research on asynchronous learning.

AIM: of this paper was to characterize the impact of rehabilitation in reducing fatigue in a series of Coronavirus Disease 2019 (COVID-19) free patients, attested by two negative Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) swab tests. We described 7 post-COVID-19 patients, mean aged 65.7±11.9 years, referred to a Northern-Italy Rehabilitation Unit due to generalized muscle weakness. They came from specialized COVID-19 Unit after two negative SARS-CoV-2 swab tests. The 57.1% suffered from severe dyspnoea affecting activities of daily living. We noticed that almost all patients (85.7%) showed a perception of exertion, but only Case 2, that needed intensive care unit in the acute phase, presented a severe fatigue (Borg Category Ratio 10 scale=7). After the rehabilitation treatment the 71.4% showed no fatigue and the other 2 cases reported only a very light perception of exertion. This case series suggested that, starting from an adequate assessment of functional complications, a patient-tailored rehabilitation intervention should be planned for reducing fatigue and improving functioning in COVID-19 free patients. This article is protected by copyright. All rights reserved.

The civil education approach uses sports practise as a preventive intervention to increase self-awareness and to help modulate emotion in adolescents. Indeed, sports participation results in a better quality of life, more favourable cardio-metabolic and sleeping profiles and a healthier body composition. Adolescents involved in sport activities also report a higher level of social and emotional skills, and reduced mental health distress. However, the Italian school&rsquo, s program provides only two hours weekly of physical education, with lack of options and participation. In alignment with the civil educational approach, the research team aims to develop a predictive sport, movement, eating habits, relationships and technologies (S.M.A.R.T.) questionnaire to identify the youths that present a higher risk of delinquency. The following research aims to explore preliminary data from 501 adolescents completing the S.M.A.R.T. The results show that the female group (n = 260) was healthier than the male group (n = 241), particularly, the female group demonstrated a higher level of self-awareness in the use of technologies (p &lt, 0.05). Our results produce the first data set on a cohort of young adolescents in Italy using the S.M.A.R.T. questionnaire. The questionnaire possesses a high response rate and should now be implemented towards validation.

OBJECTIVES: Feasibility and results of cardiovascular hub-spoke networks to face COVID19 pandemic. The COVID-19 pandemic in Italy had the primary outbreak in the northern part of the country forcing the regional health care system to expand the availability of beds in the wards and intensive care units and to institute a Hub and Spoke hospital network to ensure assistance continuity for urgencies and emergencies. We report a descriptive analysis of the activity of the first 30 days of the Hub center. METHODS: Role of our Hub center was to guarantee 24/24h 7/7days cardiovascular surgical care for an area of 3.145.312 inhabitants’ area. Hub-spoke reorganization permitted a significant increase of ICU and ward beds availability for COVID patients needing hospitalization in all peripheral centers. Records of all consecutive patients admitted were collected and analyzed. RESULTS: a total of 100 patients were evaluated in the study period . Hub and spoke cooperation have been successful, all patients affected by cardiovascular urgencies or emergencies found a highly specialized hospital and was evaluated and treated. Global reduction of elective and non-deferrable interventions in spoke centers was achieved for both vascular and cardiac surgery while we detected a significant increase of urgent vascular interventions for acute limb ischemia. We did not observe an increase of in-hospital mortality in non-infected patients. CONCLUSION: Hub and spoke network for cardiovascular pathology is an effective way to face healthcare needs during the pandemic.

Structural foot deformities consequent to Charcot Marie Tooth (CMT) can be treated by functional surgery (FS). This study aims to evaluate both long-term walking ability and patients' satisfaction in CMT subjects who underwent FS during their lifetime. We conducted a retrospective observational study. Age, sex, CMT type, comprehensive surgical history, current walking ability assessed by the Walking Handicap Scale (WHS) and patients' global impression of change (pGIC) were retrieved from a custom database managed at our institution. WHS and pGIC were assessed between mid-2018 and mid-2019. Data from 79 patients were screened and 63 were included, 35W-28M, mean age 42 (15), with demyelinating (75%), axonal (20%), and other types (5%) of CMT, who underwent FS between 1967 and 2018. FS evolved significantly over the years from bone-related procedures (e.g., arthrodesis) to both bone and soft tissues-related procedures. The re-intervention rate decreased from 70% before 2000 to 32% in the last decade. Complications arose in five cases. FS was mainly performed on adults (73%). WHS was ≥ 5 in three-quarters of the sample (range 1-6) and was significantly affected by age groups in patients with demyelinating CMT (n=47, p