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Background: Pediatric-onset multiple sclerosis (POMS) patients often exhibit a wide range of cognitive deficits. Therefore, therapeutic approaches should aim not only to prevent cognitive decline but also to promote cognitive improvement., Objective: This study aimed to explore the effects of natalizumab (NTZ) on cognitive function, as measured by the Symbol Digit Modalities Test (SDMT), in both POMS and adult-onset multiple sclerosis (AOMS) patients., Method: A total of 63 patients (34 AOMS and 29 POMS) were enrolled in this retrospective, single-center study. Patients were clinically and radiologically assessed every 6 months, and they completed the SDMT at baseline and after at least 24 months of follow-up. SDMT values were reported as corrected values (cSDMT) and z-scores (zSDMT). Annualized cSDMT and zSDMT scores were calculated by dividing the change in scores by the length of the follow-up period (expressed in years)., Results: Both POMS and AOMS groups showed improvement in annualized cSDMT and zSDMT scores, but the improvement was significantly greater in the POMS group compared to the AOMS group (+3.85 ± 4.32 vs. +1.76 ± 2.80, p  = 0.010 for cSDMT; 0.41 ± 0.40 vs. 0.25 ± 0.34, p  = 0.026 for zSDMT). After re-baselining at 6 months, 93% of POMS patients (27 patients) and 85.3% of AOMS patients (29 patients, p  = 0.84) achieved NEDA-3 (no evidence of disease activity). The NEDA-3 status, along with clinical and demographic parameters at baseline, did not account for the observed SDMT improvement., Conclusion: The favorable clinical, radiological, and neuropsychological outcomes observed in this study support the use of natalizumab as a viable treatment option in POMS., Competing Interests: M.Pu. report grants from Almirall, Teva, Sanofi Genzyme, Merck Serono, Biogen Italy, Novartis; consultancy for Novartis, Biogen Italy, Sanofi Genzyme; board membership Sanofi Genzyme, Novartis, Biogen Italy. P.P. reports grants from Almirall, Teva, Sanofi Genzyme, Merck Serono, Biogen Italy, Novartis, Roche; consultancy for Novartis, Biogen Italy, Sanofi Genzyme, Roche. R.F. report grants from Almirall, Teva, Sanofi Genzyme, Merck Serono, Biogen Italy, Novartis; consultancy for Novartis, Biogen Italy, Sanofi Genzyme. P.G. reports a grant from Almirall, Teva, Sanofi Genzyme, Merck Serono, Biogen Italy, Novartis, Roche, Bristol Myers Squibb; consultancy for Novartis, Biogen Italy, Sanofi Genzyme, Roche, Bristol Myers Squibb; board membership Sanofi Genzyme, Novartis, Biogen Italy, Roche, Merck Serono, Bristol Myers Squibb. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (Copyright © 2024 Puthenparampil, Scialpi, Gaggiola, Zanotelli, Miscioscia, Berardi, Riccardi, Nosadini, Sartori, Perini, Rinaldi and Gallo.)

Background: In multiple sclerosis (MS), imaging biomarkers play a crucial role in characterizing the disease at the time of diagnosis. MRI and optical coherence tomography (OCT) provide readily available biomarkers that may help to define the patient's clinical profile. However, the evaluation of cortical and paramagnetic rim lesions (CL, PRL), as well as retinal atrophy, is not routinely performed in clinic., Objective: To identify the most significant MRI and OCT biomarkers associated with early clinical disability in MS., Methods: Brain, spinal cord (SC) MRI, and OCT scans were acquired from 45 patients at MS diagnosis to obtain: brain PRL and non-PRL, CL, SC lesion volumes and counts, brain volumetric metrics, SC C2-C3 cross-sectional area, and retinal layer thickness. Regression models assessed relationships with physical disability (Expanded Disability Status Scale [EDSS]) and cognitive performance (Brief International Cognitive Assessment for Multiple Sclerosis [BICAMS])., Results: In a stepwise regression (R 2  = 0.526), PRL (β = 0.001, p = 0.023) and SC lesion volumes (β = 0.001, p = 0.017) were the most significant predictors of EDSS, while CL volume and age were strongly associated with BICAMS scores. Moreover, in a model where PRL and non-PRL were pooled, only the contribution of SC lesion volume was retained in EDSS prediction. OCT measures did not show associations with disability at the onset., Conclusion: At MS onset, PRL and SC lesions exhibit the strongest association with physical disability, while CL strongly contribute to cognitive performance. Incorporating the evaluation of PRL and CL into the initial MS patient assessment could help define their clinical profile, thus supporting the treatment choice., (© 2024. Springer-Verlag GmbH Germany, part of Springer Nature.)

The construction sector has significant impacts on the environment due to the consumption of resources and the production of waste. The implementation of circular economy strategies can improve the environmental performance of the sector, optimising the current production and consumption patterns, slowing and closing material loops, and using waste as a source of raw materials. Biowaste represents a key waste flow at the European scale. However, research on its application in the construction sector is still limited and product-oriented, with little insights into the processes of valorisation undertaken at the company's level. This study presents eleven case studies of Belgian small and medium-sized enterprises involved in biowaste valorisation in the construction sector in order to tackle this research gap in the Belgian context. Semi-structured interviews were conducted to identify the enterprise's business profile and its current marketing practices, as well as to analyse opportunities and barriers for market expansion and highlight current research interests. Results show that the overall picture is extremely heterogeneous in terms of sourcing, production methods, and products, while the barriers and success factors that have been identified are recurrent. This study contributes to the circular economy research in the construction sector by providing insights into innovative waste-based materials and business models., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Tele-neuropsychology, i.e., the application of remote audio-visual technologies to neuropsychological evaluation or rehabilitation, has become increasingly popular and widespread during and after the COVID-19 pandemic. New tools with updated normative data and appropriate methodological developments are necessary. We present Tele-GEMS, a telephone-based cognitive screening developed on N = 601 Italian participants. It yields a global score tapping on orientation, memory, spatial representation, language, and pragmatic abilities. Its administration lasts about 10 min. Clinical cut-offs are provided, accounting for demographic variables (age, education, and sex) and also for a comprehensive index taking into account cognitively stimulating life experiences that can build up a cognitive reserve. Tele-GEMS shows good internal consistency and a good inter-rater agreement. The test includes the thresholds for estimating a significant change after repeated measurements. Tele-GEMS has a good construct validity as assessed with MoCA and a suitable criterion validity assessed with its in-person version (GEMS). All the materials and the instructions, including scripts and an online Application for the automatic calculation of cut-offs, are accessible on OSF at https://osf.io/t3bma/ under a Creative Commons license., (© 2023. Fondazione Società Italiana di Neurologia.)

The healthcare sector has to face changes happening fast and often in an unpredictable way, such as epidemiological trends, the advancements of medical technology and processes or evolving social and economic needs. This results in a frequent need for infrastructures' retrofitting, with an increasing focus on the environmental impact of buildings, which have one of the highest embodied carbon footprints per square meter in the construction sector. As result, interest in healthcare buildings' adaptability is growing among researchers and practitioners. After an introduction on the research topic, a focus on the definition of adaptability and the existing assessment models is provided to address the following research question: to what extent are adaptability models effective to evaluate and orient the design of healthcare buildings? A quite varied use of the term adaptability has been found in the literature, as well as a new research trend aiming to establish a link with circularity. Moreover, most of the assessment models do not have a focus and have never been tested on the healthcare sector. An approach to circular and adaptable design is presented through the case study of the Joseph Bracops Hospital (Belgium), which has been submitted for evaluation by the Reversible Building Design protocol developed by Dr. Durmisevic. The evaluation highlights some of the current barriers in the design of adaptable healthcare facilities. Insights for future research are provided to encourage data-collection about the service life of healthcare buildings, so to understand if the adaptability of these infrastructures should be mainly monofuntional or transfunctional., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2023 Scialpi and Declercq.)

Soil has been used as building material for thousands of years with a decrease in popularity after the industrial revolution. Nowadays, there is a growing interest in the implementation of unfired soil-based building solutions for their low environmental impact, performances and availability. Traditional soil construction techniques have recurrently included vegetal fibres to enhance soil performance and recent studies highlight a predominant use of agro- and non-agro-waste for unfired soil construction. The article reviews the state-of-the-art of the use of excavated soil and biowaste in the construction industry including a novel focus on urban-only waste and on building technologies using the integration of these two secondary construction material flows. Our literature review highlights a lack of references about the joint use of these secondary resources. Finally, future research orientations are suggested to promote their implementation in the building sector, which could improve urban waste management.

Purpose: To evaluate the outcome of three (fixed-on-3 = Fo3) vs four (fixed-on-4 = Fo4) implants immediately restored with metal-resin screw-retained cross-arch prostheses in fully edentulous jaws., Materials and Methods: Forty-eight edentulous or to be rendered edentulous patients were randomised in six centres (eight patients per centre) to the Fo3 group (24 patients: 12 maxillae and 12 mandibles) and to the Fo4 group (24 patients: 12 maxillae and 12 mandibles) according to a parallel group design. To be immediately loaded, implants had to be inserted with a minimum torque of 40 Ncm. Outcome measures were prosthesis and implant failures, complications and peri-implant marginal bone level changes evaluated up to 1 year post-loading., Results: One maxillary prosthesis per group was delayed loaded because implants could not be placed with a torque of at least 40 Ncm. Ten patients in the Fo3 group and four in the Fo4 group had implants placed flapless. One year after loading no drop out occurred. One patient of the Fo3 group lost three implants vs three patients of the Fo4 group who lost four implants, the difference being no statistically significant (risk difference = -0.08; 95% CI: -0.27 to 0.10; Fisher's exact test P = 0.609). One mandibular Fo3 and one maxillary Fo4 prosthesis failed. Six Fo3 patients were affected by complications vs three Fo4 patients (risk difference = 0.12; 95% CI: -0.10 to 0.34; Fisher's exact test; P = 0.461). Both groups lost marginal bone in a statistically significant way (0.22 ± 0.20 mm for Fo3 patients and 0.40 ± 0.21 mm for Fo4 patients), with Fo3 group showing less marginal peri-implant bone loss than Fo4 group (estimate of the difference = -0.18 (standard error: 0.06) mm; 95% CI: -0.30 to -0.06; P = 0.005). There were no differences in clinical outcomes between the six operators., Conclusions: These preliminary results suggest that immediately loaded cross-arch prostheses of both jaws can be supported by only three dental implants at least up to 1 year post-loading, though longer follow-ups are definitively needed., Competing Interests: Conflict of interest statement: Sweden & Martina, the manufacturer of the implants used in this investigation, supported this trial, however data belonged to the authors and by no means did the sponsor interfere with the conduct of the trial or the publication of its results.