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372 result(s) for "Monaco, Francesco"
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Eye in the sky
\"Kion and his animal friends are ready for anything in this Little Golden Book based on an episode of Disney Junior's hit new show The Lion Guard. Boys and girls ages 2 to 5 will enjoy hearing about their awesome adventures in the Pride Lands!\"-- Provided by publisher.
Quality of life 10 years after cardiac surgery in adults: a long-term follow-up study
Background Quality of life (QoL) is a multifactorial concept that assesses physical and mental health. We prospectively studied the quality of life of patients undergoing coronary artery bypass graft (CABG) surgery using the Short-Form 36-item questionnaire (SF-36) up to 10 years after surgery. Methods Between January 2000 and December 2002, all patients undergoing elective isolated CABG in the cardiac & thoracic surgery department of a large university hospital in Eastern France underwent initial QoL evaluation with the SF-36. The same questionnaire was mailed to every patient annually (± 2 weeks around the date of surgery) up to 10 years after their operation. We recorded socio-demographic and clinical variables at inclusion. Predictors of impaired QoL at 10 years were identified by logistic regression. Results A total of 272 patients (213 men, 59 women) were enrolled; mean age at inclusion was 65 ± 10 years. At 10 years post-surgery, 81 patients had died (29.7%). The physical component summary (PCS) score was significantly higher at 5 years after surgery than at baseline ( p  < 0.01), and significantly lower at 10 years than at 5 years (p < 0.01), although there remained a significant difference between 10-year PCS and baseline score ( p  = 0.004). The mental component summary (MCS) score was significantly higher at 5 years than at the time of surgery ( p  < 0.001), and remained significantly higher compared to baseline at 10 years after surgery ( p  = 0.010). By multivariate analysis, diabetes and dypsnea were both associated with worse PCS at 10 years, while lower age was associated with better 10-year PCS. Only diabetes was associated with impaired MCS at 10 years. Conclusions Cardiac surgery appears to durably and positively affect both physical and mental components of quality of life.
Brain mechanisms of altered conscious states during epileptic seizures
Impaired consciousness is a hallmark of epileptic seizures, but the degree of impairment differs depending on the seizure type. Here, Andrea Cavanna and Francesco Monaco review recent insights into the brain mechanisms that underlie alterations of consciousness during epileptic seizures and argue that clinical assessment should take into account both patients' levels of awareness and their subjective contents of consciousness. Impaired consciousness has long been considered the hallmark of epileptic seizures. Both generalized seizures and complex partial seizures are characterized by a multifaceted spectrum of altered conscious states, in terms of the general level of awareness and the subjective contents of consciousness. Complete loss of consciousness occurs when epileptic activity involves both cortical and subcortical structures, as in tonic–clonic seizures and absence seizures. Medial temporal lobe discharges can selectively impair experience in complex partial seizures (with affected responsiveness) and certain simple partial seizures (with unaffected responsiveness). Electrical stimulation of temporal lobe structures has been shown to evoke similar subjective experiences. Findings from neurophysiological and brain-imaging studies in epilepsy have now demonstrated that involvement of the bilateral thalamus and upper brainstem leads to selective impairment of frontoparietal association cortices and midline 'default mode' networks, which results in ictal loss of consciousness. The spread of epileptic discharges from the medial temporal lobe to the same subcortical structures can ultimately cause impairment in the level of consciousness in the late ictal and immediate postictal phase of complex partial seizures. This paper reviews novel insights into the brain mechanisms that underlie alterations of consciousness during epileptic seizures and the implications for clinical practice in terms of diagnosis and management. Key Points A patient's level of general awareness and subjective contents of consciousness can both be altered to some degree during epileptic seizures Generalized seizures (tonic–clonic seizures and absence seizures) are characterized by complete loss of consciousness—that is, unresponsiveness in the absence of any ictal experience Complex partial seizures (especially those with a medial temporal lobe focus) are associated with variable degrees of responsiveness and specific alterations in the subjective ictal experience Neurophysiological and functional neuroimaging studies suggest that, in generalized and complex partial seizures, bilateral thalamus and upper brainstem involvement causes selective disruption of frontoparietal associative networks, which results in impaired consciousness Ictal impairment of the general level of awareness seems related to transient disruption of frontoparietal and midline associative networks, which subserve 'default mode' brain function during the conscious resting state
Identification of a coronary vascular progenitor cell in the human heart
Primitive cells capable of generating small resistance arterioles and capillary structures in the injured myocardium have been identified repeatedly. However, these cells do not form large conductive coronary arteries that would have important implications in the management of the ischemic heart. In the current study, we determined whether the human heart possesses a class of progenitor cells that regulates the growth of endothelial cells (ECs) and smooth muscle cells (SMCs) and vasculogenesis. The expression of vascular endothelial growth-factor receptor 2 (KDR) was used, together with the stem cell antigen c-kit, to isolate and expand a resident coronary vascular progenitor cell (VPC) from human myocardial samples. Structurally, vascular niches composed of c-kit-KDR-positive VPCs were identified within the walls of coronary vessels. The VPCs were connected by gap junctions to ECs, SMCs, and fibroblasts that operate as supporting cells. In vitro, VPCs were self-renewing and clonogenic and differentiated predominantly into ECs and SMCs and partly into cardiomyocytes. To establish the functional import of VPCs, a critical stenosis was created in immunosuppressed dogs, and tagged human VPCs were injected in proximity to the constricted artery. One month later, there was an increase in coronary blood flow (CBF) distal to the stenotic artery, resulting in functional improvement of the ischemic myocardium. Regenerated large, intermediate, and small human coronary arteries and capillaries were found. In conclusion, the human heart contains a pool of VPCs that can be implemented clinically to form functionally competent coronary vessels and improve CBF in patients with ischemic cardiomyopathy.
Psychiatric Implications of Genetic Variations in Oligodendrocytes: Insights from hiPSC Models
Oligodendrocyte precursor cells (OPCs) are a dynamic and heterogeneous population of glial cells essential for brain development and myelination. Beyond their well-established role in oligodendrogenesis, emerging evidence suggests that OPCs contribute to synaptic regulation, neuronal communication, and brain plasticity. Recent studies have increasingly implicated OPC dysfunction in the pathophysiology of psychiatric disorders, particularly schizophrenia (SCZ), bipolar disorder (BD), and major depressive disorder (MDD). This narrative review integrates clinical, genetic, transcriptomic, and histological findings to examine the role of OPC alterations in mental illnesses. In SCZ, OPC abnormalities predominantly affect myelination, but recent data also suggest deficits in non-canonical functions, including neuron–OPC communication. Findings in BD largely mirror those in SCZ, implying shared OPC-related mechanisms across these disorders. In contrast, OPC involvement in MDD appears more complex, with evidence supporting both myelination deficits and non-canonical dysfunctions, such as impaired neuro–glial interactions and perineuronal network alterations. The developmental timing of OPC dysfunction may represent a common denominator underlying psychiatric disorders, as early-life stress and neurodevelopmental disturbances have been linked to OPC impairments. Moreover, given the shared developmental origins of OPCs and parvalbumin-positive interneurons, disruptions in their mutual interactions may contribute to broader neural network dysregulation. Despite these insights, the field remains in its infancy. Future studies integrating independent human cohorts with robust preclinical models are needed to clarify the extent of OPC involvement in psychiatric pathophysiology. Understanding OPC dysfunction may reveal novel biomarkers and open new avenues for individualized therapeutic interventions and preventive strategies in mental health.
Cellular and molecular features of COVID-19 associated ARDS: therapeutic relevance
The severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection can be asymptomatic or cause a disease (COVID-19) characterized by different levels of severity. The main cause of severe COVID-19 and death is represented by acute (or acute on chronic) respiratory failure and acute respiratory distress syndrome (ARDS), often requiring hospital admission and ventilator support. The molecular pathogenesis of COVID-19-related ARDS (by now termed c-ARDS) is still poorly understood. In this review we will discuss the genetic susceptibility to COVID-19, the pathogenesis and the local and systemic biomarkers correlated with c-ARDS and the therapeutic options that target the cell signalling pathways of c-ARDS.
Presence of Psychotic Spectrum Symptoms Before Age 12 in Schizophrenia Patients: A Retrospective Study on Clinical Implications for Early Detection and Intervention
Background/Objectives: Schizophrenia is a severe psychiatric disorder, with onset typically occurring in late adolescence or early adulthood. Early identification of psychotic symptoms, especially those occurring before age 12, has been linked to better long-term outcomes. This study aims to assess the presence of psychotic spectrum symptoms before the age of 12 in adult schizophrenia patients and explore their clinical implications for early detection and intervention. Methods: This retrospective, observational study included 170 adult patients diagnosed with schizophrenia, confirmed by the SCID-5. Patients were recruited from the University of Siena Medical Center and completed the modified lifetime version of the Psychotic Spectrum Self-Report (PSY-SR) questionnaire, which assessed the onset of specific psychotic symptoms before and after age 12. Symptom severity was evaluated using the Brief Psychiatric Rating Scale (BPRS) and the Clinical Global Impression Scale (CGI). This study also examined the impact of the duration of untreated psychosis (DUP) on symptom severity. Results: In our cohort, 21% of patients exhibited prodromal symptoms before age 12 (95% CI: 15–27%). Prodromal symptoms were linked to a 9.53-point increase in the BPRS scores (p = 0.0478) and a 0.50-point increase in the CGI scores (p = 0.0347). The age of symptom onset negatively correlated with the BPRS scores (p < 0.0001), with each year of delay resulting in a 1.33-point decrease. The DUP correlated significantly with both the BPRS (ρ = 0.97) and CGI scores (ρ = 0.94). The multivariate analysis revealed that a longer DUP was associated with significant increases in both scores: a 27.16-point increase in the BPRS (p < 0.0001) for a moderate DUP and a 67.51-point increase (p < 0.0001) for a severe DUP. The CGI scores increased by 1.11 points with a moderate DUP and 3.17 points with a severe DUP (p < 0.0001). However, the interaction between the DUP and prodromal symptoms at age 12 was not significant, indicating similar impacts of the DUP regardless of early symptom onset. Conclusions: The results support the critical importance of early detection and intervention in schizophrenia. Early psychotic spectrum symptoms, particularly those occurring before age 12, are significant predictors of later severity and functional impairment. This study underscores the value of screening tools like the PSY-SR for identifying prodromal symptoms and facilitating timely intervention. Our findings highlight the need for the early identification of psychotic symptoms, particularly in at-risk populations, to improve long-term outcomes. Intervening before the onset of full-blown psychosis may reduce the severity of schizophrenia and promote better clinical outcomes.
In-situ Low Power Tests of the ASDEX Upgrade ECRH Transmission Lines
An Electron Cyclotron Resonance Heating (ECRH) system employing 8 gyrotrons is in routine operation at the ASDEX Upgrade tokamak at IPP Garching. The gyrotrons are of two-frequency type operating at 105 and 140 GHz with a maximum output power of up to 1 MW and 10 s pulse length. The gyrotron output beams are coupled to 8 waveguide transmission lines via quasi-optical Matching Optics Units (MOUs). The oversized corrugated HE11 waveguides with a diameter of 87 mm are operated at atmospheric pressure with overall lengths between 65 and 103 meters. The number of quasi-optical miter bends per line is between 6 and 8. High mode purity in the transmission lines is critical with respect to both, losses and atmospheric breakdowns in the waveguides. Beam measurements at low power have been performed along the transmission lines and are compared to high power measurements. Near-field calculations and measurements of mm-wave beams radiated from open-ended HE11 waveguides show, that varying intensity patterns determine the distribution of Ohmic loading in compact mm-wave beam launching antennas, where the first mirror is located in the reactive near-field or close to the Fresnel maximum.
Palmitoylethanolamide: A Multifunctional Molecule for Neuroprotection, Chronic Pain, and Immune Modulation
Palmitoylethanolamide (PEA) is an endogenous lipid mediator belonging to the N-acyl-ethanolamine family, widely recognized for its multifaceted effects on neuroprotection, chronic pain management, and immune modulation. As a naturally occurring compound, PEA plays a crucial role in maintaining homeostasis under conditions of cellular stress and inflammation. Its pharmacological effects are primarily mediated through peroxisome proliferator-activated receptor-alpha (PPAR-α) activation, alongside indirect modulation of cannabinoid receptors CB1 and CB2, as well as interactions with novel targets such as GPR55 and TRPV1. These molecular mechanisms underpin its broad therapeutic potential, particularly in the management of neuroinflammatory and neurodegenerative disorders, pain syndromes, and immune dysregulation. A major advancement in PEA research has been the development of ultramicronized palmitoylethanolamide (umPEA), which significantly enhances its bioavailability and therapeutic efficacy by facilitating better tissue absorption and interaction with key molecular pathways. Preclinical and clinical studies have demonstrated that umPEA is particularly effective in reducing neuroinflammation, stabilizing mast cells, and enhancing endocannabinoid system activity, making it a promising candidate for integrative approaches in neuropsychiatric and chronic inflammatory diseases. Given its well-established safety profile, umPEA represents an attractive alternative or adjunct to conventional anti-inflammatory and analgesic therapies. This communication provides a comprehensive overview of the mechanisms of action and therapeutic applications of both PEA and umPEA, emphasizing their emerging role in clinical practice and personalized medicine.
Neuroimaging and machine learning in eating disorders: a systematic review
Purpose Eating disorders (EDs), including anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED), are complex psychiatric conditions with high morbidity and mortality. Neuroimaging and machine learning (ML) represent promising approaches to improve diagnosis, understand pathophysiological mechanisms, and predict treatment response. This systematic review aimed to evaluate the application of ML techniques to neuroimaging data in EDs. Methods Following PRISMA guidelines (PROSPERO registration: CRD42024628157), we systematically searched PubMed and APA PsycINFO for studies published between 2014 and 2024. Inclusion criteria encompassed human studies using neuroimaging and ML methods applied to AN, BN, or BED. Data extraction focused on study design, imaging modalities, ML techniques, and performance metrics. Quality was assessed using the GRADE framework and the ROBINS-I tool. Results Out of 185 records screened, 5 studies met the inclusion criteria. Most applied support vector machines (SVMs) or other supervised ML models to structural MRI or diffusion tensor imaging data. Cortical thickness alterations in AN and diffusion-based metrics effectively distinguished ED subtypes. However, all studies were observational, heterogeneous, and at moderate to serious risk of bias. Sample sizes were small, and external validation was lacking. Conclusion ML applied to neuroimaging shows potential for improving ED characterization and outcome prediction. Nevertheless, methodological limitations restrict generalizability. Future research should focus on larger, multicenter, and multimodal studies to enhance clinical applicability. Level of Evidence : Level IV, multiple observational studies with methodological heterogeneity and moderate to serious risk of bias.