bluuebunny/crossref_metadata_2025 huggingface dataset:
Repeat liver resection for recurrent intrahepatic cholangiocarcinoma: meta-analysis
Authors: Ramouz Ali , Ali-Hasan-Al-Saegh Sadeq , Shafiei Saeed , Fakour Sanam , Khajeh Elias , Majlesara Ali , Adeliansedehi Ali , Probst Pascal , Springfeld Christoph , Chang De-Hua , Rupp Christian , Carvalho Carlos , Golriz Mohammad , Hoffmann Katrin , Mehrabi Arianeb
Published: February 2022

Background

Intrahepatic cholangiocarcinoma (ICC) is a relatively rare malignancy. The aim of this meta-analysis was to evaluate outcomes of repeat liver resection and non-surgical approaches for treatment of recurrent ICC.

Methods

PubMed, Embase, and Web of Science databases were searched from their inception until March 2021 for studies of patients with recurrent ICC. Studies not published in English were excluded. Two meta-analyses were performed: a single-arm meta-analysis of studies reporting pooled short- and long-term outcomes after repeat liver resection for recurrent ICC (meta-analysis A), and a meta-analysis of studies comparing 1-, 3-, and 5-year overall survival (OS) rates after repeat liver resection and non-surgical approaches for recurrent ICC (meta-analysis B).

Results

Of 543 articles retrieved in the search, 28 were eligible for inclusion. Twenty-four studies (390 patients) were included in meta-analysis A and nine studies (591 patients) in meta-analysis B. After repeat liver resection, 1-, 3-, and 5-year OS rates were 87 (95 per cent c.i. 81 to 91), 58 (48 to 68), and 39 (29 to 50) per cent respectively. The 1-, 3-, and 5-year OS rates were higher after repeat liver resection than without surgery: odds ratio 2.70 (95 per cent c.i. 1.28 to 5.68), 2.89 (1.15 to 7.27), and 5.91 (1.59, 21.90) respectively.

Conclusion

Repeat liver resection is a suitable strategy for recurrent ICC in selected patients. It improves short- and long-term outcomes compared with non-surgical treatments.
Insular-associated causal network of structural covariance evaluating progressive gray matter changes in major depressive disorder
Authors: Lu Fengmei , Cui Qian , Chen Yuyan , He Zongling , Sheng Wei , Tang Qin , Yang Yang , Luo Wei , Yu Yue , Chen Jiajia , Li Di , Deng Jiaxin , Zeng Yuhong , Chen Huafu
Published: February 2022

Background

Morphometric studies demonstrated wide-ranging distribution of brain structural abnormalities in major depressive disorder (MDD).

Objective

This study explored the progressive gray matter volume (GMV) changes pattern of structural network in 108 MDD patients throughout the illness duration by using voxel-based morphometric analysis.

Methods

The causal structural covariance network method was applied to map the causal effects of GMV alterations between the original source of structural changes and other brain regions as the illness duration prolonged in MDD. This was carried out by utilizing the Granger causality analysis to T1-weighted data ranked based on the disease progression information.

Results

With greater illness duration, the GMV reduction was originated from the right insula and progressed to the frontal lobe, and then expanded to the occipital lobe, temporal lobe, dorsal striatum (putamen and caudate) and the cerebellum. Importantly, results revealed that the right insula was the prominent node projecting positive causal influences (i.e., GMV decrease) to frontal lobe, temporal lobe, postcentral gyrus, putamen, and precuneus. While opposite causal effects were detected from the right insula to the angular, parahippocampus, supramarginal gyrus and cerebellum.

Conclusions

This work may provide further information and vital evidence showing that MDD is associated with progressive brain structural alterations.
Planning for resilient central-city shopping districts in the post-Covid era: an explanatory case study of the Hoddle Grid in Melbourne
Authors: Rao Fujie , Han Sun Sheng , Pan Ran
Published: February 2022

This research explores how central-city shopping districts could be transformed to support a post-Covid lifestyle, where people re-embrace community, local streets and walking while relying more on online shopping. By reviewing metropolitan/city development plans since the 1980s and mapping changes of retail provisions, urban environment and pedestrian movements in Melbourne’s Hoddle Grid in the twenty-first century, this paper shows that planning policies focusing on people-centred experiences in the central-city shopping district helped to improve retail resilience. This paper thus adds insights to understanding the relentless retail landscape changes and has implications for central-city retail planning in the post-Covid era.
A case report of COVID-19-associated acute hand ischaemia in a young professional volleyball player
Authors: Achim Alexandru , Kákonyi Kornél , Jambrik Zoltán , Ruzsa Zoltán
Published: February 2022

Background

Several coronavirus disease-19 (COVID-19)-associated complications are being increasingly reported, including arterial and venous thrombo-embolic events that may lead to amputation of the affected limbs. So far, acute upper limb ischaemia (ULI) has been reported only in critically ill patients.

Case summary

Herein, we aimed to present a case of a 29-year-old, otherwise healthy male volleyball player, with acute ischaemic signs in the upper extremity who was diagnosed with COVID-19 1 month before the ischaemic event. It has been shown that volleyball players experience repetitive stress that involves their hands and, in particular, their fingers. Repetitive trauma can lead to local vascular abnormalities, such as reduced capillarization and lower resting blood flow that can lead to pain and cold digits, but never acute ULI.

Discussion

To our knowledge, this is the first case of such a hypercoagulable synergistic mechanism that leads to a high thrombus burden. Intra-arterial local thrombolysis and percutaneous transluminal angioplasty failed to succeed, and percutaneous large-bore embolectomy with the Indigo Aspiration System (Penumbra Inc., CA, USA) was deemed necessary.
Long-term outcomes with the On-X bileaflet mitral valve: clinical events up to 17 years in 661 patients
Authors: Reyes Guillermo , Muñoz Daniel , Monguio Emilio , Berastegui Elisabet , Camara Maria Luisa , de Antonio Nieves , Julia Ignasi , Aguirre Maria Fernanda , Fernandez Claudio , Badia Sara , Muñoz-Guijosa Christian
Published: February 2022

OBJECTIVES

This study reports long-term clinical outcomes—up to 17 years—among patients undergoing mitral valve replacement with the On-X bileaflet mechanical valve. Prior data regarding long-term outcomes with the On-X mitral valve have been limited.

METHODS

This retrospective observational study included all patients who underwent mitral valve replacement with the On-X (Standard or Conform-X) valve at 2 major Spanish cardiac surgery centres between 2001 and 2018. The primary study end point was freedom from death. The secondary study end points included surgical mortality and freedom from any valve-related events. Data were obtained from an institutional database, medical records review, direct telephone interviews or the Spanish population registry. Statistical and Kaplan–Meier analyses were performed.

RESULTS

A total of 661 patients (mean age 63.1 ± 10.9 years, 63% female) were followed for a mean of 5.6 years (range, 0–17.4 years). Survival at 5, 10 and 15 years was 85%, 71% and 63%, respectively. Surgical mortality was 7.3% (48/661). The linearized rate of global mortality was 1.3% patient-year. Freedom from reoperation was 97%, 95% and 92% at 5, 10 and 15 years, respectively; freedom from anticoagulation-related events was 94%, 89% and 89%, respectively. Multivariable analysis showed that mortality increased with total length of stay, age, smoking history, severe pulmonary hypertension and a permanent pacemaker. Patients who received the On-X 25 -mm valve had decreased long-term survival relative to patients who received other On-X valve sizes, possibly due to underlying risk factors.

CONCLUSIONS

Patients in this study showed good long-term survival and freedom from valve-related events.
Impact of different valve-in-valve positions on the hydrodynamic performance of the newest-generation self-expanding transcatheter heart valve
Authors: Sadat Najla , Bruhn Denise , Scharfschwerdt Michael , Schaller Tim , Aboud Anas , Saisho Hiroyuki , Eitel Ingo , Ensminger Stephan , Fujita Buntaro
Published: February 2022

OBJECTIVES

Transcatheter aortic valve-in-valve (ViV) procedures are increasingly performed for the treatment of degenerated surgical aortic valves with a high risk for a redo operation. For an optimal functional result, precise positioning of the transcatheter heart valve (THV) inside the SHV is crucial. The aim of this study was to systematically investigate the impact of implantation depth on the functional result after a ViV procedure in a standardized in vitro setting.

METHODS

A THV 23 mm (Evolut PRO) and 3 SHV 21 mm (Perimount Magna Ease, Trifecta and Hancock II) were used for hydrodynamic testing with a constant heartbeat 64/min and a range of 55–105 ml of stroke volume in 5 different positions of the THV. The following parameters were analysed: mean pressure gradient (MPG), effective orifice area (EOA), geometric orifice area, minimal internal diameter and pin-wheeling index.

RESULTS

MPG and EOA differed significantly regarding the position of the THV in the same SHV. The highest EOA and the lowest MPG were recorded for Evolut PRO with significance for both parameters in Hancock II at 4 vs 5 mm (P < 0.001), in Magna Ease at 2 mm (vs 3 mm and vs 6 mm, P < 0.001) and in Trifecta at 4 mm (vs 5 and 6 mm, P < 0.001). Leaflet coadaptation, minimal internal diameter and maximal geometric orifice area of the same TAV differ regarding the position of the TAV.

CONCLUSIONS

The optimal position for hydrodynamic performance of the THV as ViV differs among specific SHV models. The findings may be useful for planning a ViV procedure using the Evolut PRO THV.
The Polish Government-in-Exile: The United Nations War Crimes Commission and the Holocaust
Authors: Fleming Michael
Published: February 2022

The author discusses the engagement of the Polish Government-in-Exile with the issue of German war crimes and its involvement with the United Nations War Crimes Commission during the Second World War. Information sent by the Polish Underground State allowed the Polish War Crimes Office to compile its charge file submissions for the UNWCC in a strategic and organized manner. According to the author, the War Crimes Office attempted to ensure that German crimes against Jews received due attention in its charge file submissions.
A genome-wide analysis of 340 318 participants identifies four novel loci associated with the age of first spectacle wear
Authors: Patasova Karina , Khawaja Anthony P , Wojciechowski Robert , Mahroo Omar A , Falchi Mario , Rahi Jugnoo S , Hammond Chris J , Hysi Pirro G ,   the UK Biobank Eye & Vision Consortium, Shah R L , Guggenheim J A
Published: February 2022

Refractive errors, particularly myopia, are the most common eye conditions, often leading to serious visual impairment. The age of onset is correlated with the severity of refractive error in adulthood observed in epidemiological and genetic studies and can be used as a proxy in refractive error genetic studies. To further elucidate genetic factors that influence refractive error, we analysed self-reported age of refractive error correction data from the UK Biobank European and perform genome-wide time-to-event analyses on the age of first spectacle wear (AFSW). Genome-wide proportional hazards ratio analyses were conducted in 340 318 European subjects. We subsequently assessed the similarities and differences in the genetic architectures of refractive error correction from different causes. All-cause AFSW was genetically strongly correlated (rg = −0.68) with spherical equivalent (the measured strength of spectacle lens required to correct the refractive error) and was used as a proxy for refractive error. Time-to-event analyses found genome-wide significant associations at 44 independent genomic loci, many of which (GJD2, LAMA2, etc.) were previously associated with refractive error. We also identified six novel regions associated with AFSW, the most significant of which was on chromosome 17q (P = 3.06 × 10−09 for rs55882072), replicating in an independent dataset. We found that genes associated with AFSW were significantly enriched for expression in central nervous system tissues and were involved in neurogenesis. This work demonstrates the merits of time-to-event study design in the genetic investigation of refractive error and contributes additional knowledge on its genetic risk factors in the general population.
Root-commando operation for a ruptured left ventricular outflow tract
Authors: Takaki Hidenobu , Hashizume Kenichi , Ikebata Koki , Ohno Masatoshi
Published: February 2022

Prosthetic valve endocarditis, especially when complicated by an aortic root abscess and a left ventricular outflow tract rupture, is a life-threatening condition. We present a case of infective prosthetic aortic valve endocarditis with a ruptured left ventricular outflow tract successfully treated with a root-commando operation using a secure anastomosis for reconstruction of the damaged aortic annulus.
Novel thoracoscopic segmentectomy combining preoperative three-dimensional image simulation and intravenous administration of indocyanine green
Authors: Matsuura Natsumi , Igai Hitoshi , Ohsawa Fumi , Numajiri Kazuki , Kamiyoshihara Mitsuhiro
Published: February 2022

OBJECTIVES

The aim of this study is to assess prospectively the validity and feasibility of segmentectomy using preoperative simulation and intravenous indocyanine green (ICG) with near-infrared (NIR) light thoracoscope to ensure a sufficient surgical margin.

METHODS

This study was a prospective, single-centre, phase II, feasibility study. From February to July 2021, 20 patients were enrolled in this study. All patients underwent preoperative three-dimensional computed tomography angiography and bronchography using simulation software. The dominant pulmonary artery of the targeted segment was selected to determine the dissection line and measure the surgical margin to the tumour. Intraoperatively, after the planned dissection of the pulmonary artery, ICG (0.3 mg/kg) was administered intravenously and observed with NIR, and dissection was performed along the line determined by preoperative simulation. Postoperatively, the pathological margin was compared with the simulation margin.

RESULTS

All surgeries were performed via an uniport (3.5–4.0-cm skin incision). The regions of segmentectomy were S2, S3, S6, S9 + 10 and S10 of the right side and S1 + 2 + 3, S3, S3 + 4 + 5, S6 and S8 of the left side. The difference between the simulation margin and the pathological margin was not significant (simulation 30.5 ± 10.1 vs pathological 31.0 ± 11.0 mm, P = 0.801). The simulation margin was well correlated with the pathological margin (R2 = 0.677). The proportion of cases successfully achieving the pathological margin of error of plus or minus 10 mm of the simulation margin was 90% (18 of 20 cases).

CONCLUSIONS

The combination of preoperative three-dimensional computed tomography simulation and ICG–NIR was effective for securing a sufficient margin in segmentectomy.
A systematic review of the outcomes reported in the treatment of uncomplicated urinary tract infection clinical trials
Authors: Duane Sinead , Beecher Claire , Vellinga Akke , Murphy Andrew W. , Cormican Martin , Smyth Andrew , Healy Patricia , Moore Michael , Little Paul , Devane Declan
Published: February 2022

Background

Uncomplicated urinary tract infections (UTIs) are amongst the most frequent infections presenting in the outpatient setting. A growing number of clinical trials are assessing the most effective treatment interventions for uncomplicated UTI. Due to the heterogeneity of the outcomes reported in these trials, however, comparing these outcomes is challenging.

Objectives

Identify the core outcomes that have been reported in trials and systematic reviews of interventions treating uncomplicated UTI in adults.

Methods

We conducted a systematic search for core outcomes used to evaluate treatments of UTIs. We searched the Cochrane Database of Systematic Reviews, PubMed and Embase. One researcher independently screened each article for inclusion, and the Core Outcome Set for treatment of Urinary Tract Infections (COSUTI) team acted as second reviewers. All included articles were screened by two reviewers. All outcomes were extracted verbatim, and similar outcomes were grouped into domains and subdomains.

Results

In total, 334 outcomes were reported across 41 papers, the average number of outcomes reported being 8. Outcomes were categorized across 18 domains, the majority of which were related to clinical cure outcomes. Many outcomes varied in the timepoints within which the outcome was measured and reported.

Conclusions

Comparing the outcomes of trials investigating uncomplicated UTI treatment remains challenging due to the difference in outcomes currently reported. Consistency of reporting of outcomes would be improved by developing a minimum number of consistent outcomes that should be reported in all trials.
Hybrid molecule between platanic acid and LCL-161 as a yes-associated protein degrader
Authors: Nakano Naoko , Fukuda Kazuo , Tashiro Etsu , Ishikawa Haruka , Nagano Waka , Kawamoto Rie , Mori Alice , Watanabe Misao , Yamazaki Ryu , Nakane Takahisa , Naito Mikihiko , Okamoto Iwao , Itoh Susumu
Published: February 2022

Dysregulated yes-associated protein (YAP) is involved in several malignant cancers. However, discovering a druggable YAP inhibitor(s) is difficult because YAP itself does not have any enzymatic activity. In such cases, targeted protein degradation strategies based on hybrid molecules that bind to the target protein and an E3 ubiquitin ligase are useful for suppressing proteins that exhibit aberrant activation and/or excessive expression. Upon screening YAP-interacting small compounds, we identified HK13, a platanic acid, as a novel compound that interacts with YAP. Next, we synthesized hybrid compounds of platanic acid and LCL-161, which reportedly shows a high affinity for cIAP, one of E3 ubiquitin ligases. Among these compounds, HK24 possessed the ability to inhibit the growth of YAP overexpressing NCI-H290 cells. This inhibitory activity may be mediated by YAP degradation, although HK24 exhibited weak YAP degradation. Furthermore, we confirmed involvement of proteasome pathway in HK24-dependent YAP degradation by culturing NCI-H290 cells in the presence of a proteasome inhibitor. Therefore, it is possible that platanic acid is a potential candidate for molecular medicine targeting YAP.
Reverse β-oxidation pathways for efficient chemical production
Authors: Tarasava Katia , Lee Seung Hwan , Chen Jing , Köpke Michael , Jewett Michael C , Gonzalez Ramon
Published: February 2022

Microbial production of fuels, chemicals, and materials has the potential to reduce greenhouse gas emissions and contribute to a sustainable bioeconomy. While synthetic biology allows readjusting of native metabolic pathways for the synthesis of desired products, often these native pathways do not support maximum efficiency and are affected by complex regulatory mechanisms. A synthetic or engineered pathway that allows modular synthesis of versatile bioproducts with minimal enzyme requirement and regulation while achieving high carbon and energy efficiency could be an alternative solution to address these issues. The reverse β-oxidation (rBOX) pathways enable iterative non-decarboxylative elongation of carbon molecules of varying chain lengths and functional groups with only four core enzymes and no ATP requirement. Here, we describe recent developments in rBOX pathway engineering to produce alcohols and carboxylic acids with diverse functional groups, along with other commercially important molecules such as polyketides. We discuss the application of rBOX beyond the pathway itself by its interfacing with various carbon-utilization pathways and deployment in different organisms, which allows feedstock diversification from sugars to glycerol, carbon dioxide, methane, and other substrates.
Management of prostate cancer in older patients
Authors: Narita Shintaro , Hatakeyama Shingo , Sakamoto Shinichi , Kato Takuma , Inokuchi Juichi , Matsui Yoshiyuki , Kitamura Hiroshi , Nishiyama Hiroyuki , Habuchi Tomonori
Published: February 2022

The incidence of prostate cancer among older men has increased in many countries, including Asian countries. However, older patients are ineligible for inclusion in large randomized trials, and the existing guidelines for the management of patients with prostate cancer do not provide specific treatment recommendations for older men. Therefore, generation of evidence for older patients with prostate cancer is a key imperative. The International Society of Geriatric Oncology has produced and updated several guidelines for management of prostate cancer in older men since 2010. Regarding localized prostate cancer, both surgery and radiotherapy are considered as feasible treatment options for intermediate- and high-risk prostate cancer even in older men, whereas watchful waiting and active surveillance are useful options for a proportion of these patients. With regard to advanced disease, androgen-receptor axis targets and taxane chemotherapy are standard treatment modalities, although dose modification and prevention of adverse events need to be considered. Management strategy for older patients with prostate cancer should take cognizance of not only the chronological age but also psychological and physical condition, socio-economic status and patient preferences. Geriatric assessment and patient-reported health-related quality of life are important tools for assessing health status of older patients with prostate cancer; however, there is a paucity of evidence of the impact of these tools on the clinical outcomes. Personalized management according to the patient’s health status and tumour characteristics as well as socio-economic condition may be necessary for treatment of older patients with prostate cancer.
Empirical Asset Pricing with Functional Factors
Authors: Nadler Philip , Sancetta Alessio
Published: February 2022

We propose a methodology to use functional factors in empirical asset pricing models. We establish conditions under which it is possible to recover linear beta pricing. The proposed estimation approach allows us to use high-dimensional functional curves, such as the term structure of interest rates or the implied volatility smile, as factors. This framework enables the estimation of functional factor loadings as well as risk premium parameters of factor models. We derive estimation algorithms and establish the asymptotic consistency and normality of the parameter estimates. In an empirical application, we show that the implied variance smile of the S&P500 is a potential pricing factor for momentum-sorted portfolios. In particular, a positive risk premium is earned by the convexity of the implied variance curve.
Genetics as a key to improving crop photosynthesis
Authors: Theeuwen Tom P J M , Logie Louise L , Harbinson Jeremy , Aarts Mark G M
Published: February 2022

Since the basic biochemical mechanisms of photosynthesis are remarkably conserved among plant species, genetic modification approaches have so far been the main route to improve the photosynthetic performance of crops. Yet, phenotypic variation observed in wild species and between varieties of crop species implies there is standing natural genetic variation for photosynthesis, offering a largely unexplored resource to use for breeding crops with improved photosynthesis and higher yields. The reason this has not yet been explored is that the variation probably involves thousands of genes, each contributing only a little to photosynthesis, making them hard to identify without proper phenotyping and genetic tools. This is changing, though, and increasingly studies report on quantitative trait loci for photosynthetic phenotypes. So far, hardly any of these quantitative trait loci have been used in marker assisted breeding or genomic selection approaches to improve crop photosynthesis and yield, and hardly ever have the underlying causal genes been identified. We propose to take the genetics of photosynthesis to a higher level, and identify the genes and alleles nature has used for millions of years to tune photosynthesis to be in line with local environmental conditions. We will need to determine the physiological function of the genes and alleles, and design novel strategies to use this knowledge to improve crop photosynthesis through conventional plant breeding, based on readily available crop plant germplasm. In this work, we present and discuss the genetic methods needed to reveal natural genetic variation, and elaborate on how to apply this to improve crop photosynthesis.
The Savoy–Piedmont “Renaissance”
Authors: Pareti Germana
Published: February 2022

During the Enlightenment, Turin became not only a political, but also intellectual and scientific capital. The French influence was remarkable, and physicians and scientists forged relationships with colleagues across the Alps. In this spirit of renewal, the Duke of Savoy Victor Amadeus reformed the University, and the teaching of medicine and surgery benefitted from this impulse. Medicine was moving away from the alchemical and animist tradition, and it was oriented toward the iatromechanical approach, which attracted many followers in Europe during the 18th century. Piedmontese physiology emerged as the most innovative branch, particularly in regard to exploring the brain and nervous functions. Advancements in physiology were also possible thanks to the research in electrology, a debated field within the recently established Academy of Sciences. Although the purpose of the Academy was disseminating knowledge, Turin remained the city of occultism, where magnetism mixed with mesmerism and charlatanism.
Exploring the Museum of Human Anatomy
Authors: Giacobini Giacomo , Cilli Cristina , Malerba Giancarla
Published: February 2022

By the beginning of the 19th century, the study of the nervous system was the principal research theme of the Turin anatomical school. During this century, the two main scholars were Luigi Rolando and Carlo Giacomini. Rolando is known for his accurate description of brain morphology, including the sulcus that bears his name. For his interest in morphology, function, development, comparative anatomy, and experimental observations, Rolando can be considered one of the pioneers of the modern method of investigating the nervous system. Carlo Giacomini is best known for his meticulous descriptions of the surface of the cerebral hemispheres and their individual variability. The Museum of Human Anatomy of the University of Turin, with its archives and historical library, preserves evidence of the activity of these two researchers and their colleagues. Documents, publications, and preparations interact with one another by telling stories about their scientific interests and discoveries.
Cesare Lombroso
Authors: Knepper Paul
Published: February 2022

Assessing Cesare Lombroso’s legacy in neuroscience is not a simple task. Lombroso wanted to be remembered as a scientist who had explored the deep origins of behavior, but his criminal anthropology moves beyond the history of science to wider social, political, and cultural histories. To understand his work, it is important to examine his motivation, the range of his interests, and changes in his outlook during his life. He filled hundreds of books and articles with superficial correlations, sloppy comparisons, and extraneous information. He made dangerous proposals based on overconfidence in the certainty of science. Scientific racism infused his outlook throughout his career, warping his theories, data collection, and findings interpretation. Yet he acknowledged his Jewish identity and turned his science against anti-Semitism. Near the end of his life, he acknowledged his belief in European racial superiority and advocated the wisdom of Indigenous peoples.
Neuroimaging before Neuroimaging
Authors: Sandrone Stefano
Published: February 2022

The physiologist Angelo Mosso (1846–1910) is one of the most important, yet often neglected, pioneers in the history of neuroimaging. He studied medicine in Turin, before visiting leading laboratories in Florence, Leipzig, and Paris, where he learned graphical methods to analyze physiological dynamics. Back in Turin, he applied some of these methods to the circulation in the human brain. With the “Mosso method,” he could record a series of local increases in blood flow during tasks of various nature in patients with skull damage. He also invented and refined several instruments, including the “human circulation balance,” which can be considered the first ante litteram noninvasive “neuroimaging” technique and the conceptual forerunner of neuroimaging. Moreover, Mosso established one of the oldest neuroscience journals globally and launched the first physiology laboratory in altitude, championed the importance of physical activity in schools, and wrote popular science books.
The Role of Federico Kiesow in the Development of Experimental Psychology in Europe
Authors: Zago Stefano , Lorusso Lorenzo
Published: February 2022

Turin was one of the first centers in Europe for the development of psychology. In this city, the figure of the experimental psychologist began to emerge, as distinct from that of the philosopher. The main protagonist of this transformation was Federico Kiesow (1858–1940), who left Wundt’s laboratory of Leipzig to join Mosso’s laboratory in Turin. In the late 19th century, Kiesow established the first laboratory of experimental psychology in Italy and occupied one of the first three professorships of Psychology in Turin. He was the catalyst for several pupils with scientific interests in psychology and created or adapted numerous instruments for his experiments. Kiesow’s publications reveal clear insights into several scientific concepts, including blood pressure and pulse, sensations of taste, skin perceptions, reaction times, visual psychic processes, and eidetic typology.
Camillo Negro
Authors: Chiò Adriano , Calvo Andrea
Published: February 2022

Camillo Negro is considered one of the most outstanding Italian neurologists ever. Between the 19th and the 20th century, he founded the Neurological School in Turin. He was one of the precursors of the separation of neurology and psychiatry, a forerunner of the modern communication of scientific discoveries through the establishment of several scientific journals, as well as his famous movie Neuropatologia. Negro was also a keen scientist and authored more than one hundred papers. He described the three Negro’s signs: (1) the cogwheel rigidity in Parkinson’s disease, (2) the bulbo-palpebral event in peripheral palsy of the facial nerve, and (3) the meso-rotuleus sign associated with the pyramidal deficit. He also supported the doctrine proposed by Santiago Ramón y Cajal in the section titled, “The Theory of Neurons,” of the manual Patologia e Clinica del Sistema Nervoso. Finally, he mentored many students, including Carlo Angela, Mario Gozzano, and Luisa Levi.
A Real Imperfection? Rita and the Long Story of the Nerve Growth Factor
Authors: Pareti Germana
Published: February 2022

This chapter illustrates the Turin story of Rita Levi-Montalcini. It reconstructs some among the most important stages of her youth up to her enrollment in the Faculty of Medicine at the University of Turin, under Giuseppe Levi. The promulgation of the racial laws in 1938 had a dire impact on Rita’s personal life and scientific activity. Her refuge in Belgium, her clandestine return to Italy, the never-interrupted research in a simple home laboratory were a prelude to the meeting with Viktor Hamburger’s neuroembryological approach. After the war, the transfer to the United States and the collaboration with Hamburger and Stanley Cohen started an intense research season. This led to the discovery of nerve growth factor and culminated in the Nobel Prize, before her return to her native country.
Narcolepsy
Authors: Drakatos Panagis
Published: February 2022

Restless legs syndrome is a neurological disorder that frequently goes undiagnosed and untreated, despite its frequency. This is in part due to the variability in its presentation and consequences on sleep, causing both sleep initiation and sleep maintenance issues. However, until recently its very existence as a condition has been subject to debate, despite a wealth of clinical, genetic, biochemical and pathological evidence to the contrary. An awareness of this disorder is fundamental to the practice of medicine in a number of specialties and general practice, as diagnosis and management can have a very significant impact on quality of life.
Paediatric neurodisability and sleep
Authors: Gringras Paul
Published: February 2022

Sleep is essential to both physical and mental development and health of the growing child. However, sleep problems in children and young people are common, with around 10% of all parents of children of all ages reporting issues which disrupt the sleep of their child – and their own! While many are behavioural in origin, some have an underlying organic basis.
Conditions affecting sleep quality may not present in an obvious fashion, and formal diagnostic evaluation of sleep should be considered in any child with daytime symptoms potentially secondary to disrupted night-time sleep, such as inattention, behavioural problems, poor concentration and hyperactivity, as well as daytime somnolence.
Other medical issues which may affect sleep quality are common in childhood, and conditions such as asthma, anxiety, epilepsy, gastro-oesophageal reflux, eczema, constipation, hay fever and many more, can cause significant sleep disruption. These should be actively considered as part of the diagnostic evaluation and treatment optimised.
A number of conditions which disrupt or impair night-time sleep arise from sleep itself; this chapter considers the principal diagnoses in this area.
Sleep and headache disorders
Authors: Nesbitt Alexander D.
Published: February 2022

Sleep is a brain phenomenon, and the principal role for sleep in a number of cognitive and emotional processes is increasingly well understood.
Over the last few decades, clinicians, epidemiologists and neuroscientists have documented significant associations between the severity of sleep disturbance and the degree of impairment of selective cognitive functions, in a variety of clinical populations. Of particular clinical note, sleep disorders and associated cognitive deficits may be one of the earliest signs of neurodegenerative disorders, including early Alzheimer’s disease (AD) and Parkinson’s disorder (PD).
Sleep is likely to play an important role in numerous functions related to cognitive abilities, including memory processing and brain plasticity, and the glymphatic system.
This chapter discusses the nature of this association between sleep and congnition, and its clinical relevance.
Take a Chill Pill
Authors: Sahlani Lydia M. , McGrath Jillian L.
Published: February 2022

Patients presenting to the emergency department with agitation secondary to acute medical or psychiatric conditions may pose a risk to themselves, caregivers, and other patients. They must be rapidly assessed to determine appropriate therapeutic measures and identify the underlying cause of their presentation. When agitated patients do not respond to verbal de-escalation techniques, escalating measures of physical and chemical restraint may be required for safe management. Chemical restraint achieves rapid sedation in acutely agitated patients. Commonly used classes of medication by emergency physicians and providers include benzodiazepines, antipsychotics, combination therapy (e.g., benzodiazepines plus first-generation antipsychotics), and ketamine. Factors such age, weight, past medical history, current medications, and suspected cause of the agitation should be considered when choosing medications for chemical restraint. Once sedation is achieved, thorough assessment for underlying medical conditions and specific causes of agitation can be done safely.
Compassionate Restraint in the ED
Authors: Freeman Clifford , Wolfe Carmen
Published: February 2022

Emergency medicine physicians are often tasked with caring for agitated and violent patients. Such incidents may be well controlled with verbal de-escalation and medication administration. However, these situations can escalate, posing risks to healthcare providers as well as the patients themselves. The initial approach in the management of a violent or agitated patient should include attempts at verbal de-escalation and then pharmacologic interventions before using physical restraints. Methods for applying safe and effective physical restraints should focus on shielding the healthcare team from harm, as well as preventing patients from harming themselves. Frequent monitoring, including cardiovascular monitoring and monitoring of restrained extremities, is crucial. Careful and compassionate use of physical restraints enables physicians to provide effective care while maximizing everyone’s safety.
The SAFE-T Wasn’t On
Authors: Grattan Bruce J.
Published: February 2022

The suicidal patient can be a challenge for emergency physicians. This case of an elderly male veteran and recent widower who presents to the emergency department with a vague history, intoxication, traumatic injuries, and respiratory depression outlines steps for the reader to take. The emergency physician is presented with a number of formidable tasks when managing suicidal patients because an accurate history is often lacking. This chapter reviews the current literature with emphasis on risk factors, risk stratification, and necessary precautions for the safety of both emergency department personnel and patients at high risk for further self-harm. While no screening tool can take the place of clinical judgment, helpful mnemonics and screening tools are reviewed. The emergency physician’s role in lethal means counseling and continuity of care is likewise addressed.
Risky Business
Authors: McGrath Jillian L. , Sahlani Lydia M.
Published: February 2022

Patients presenting to the emergency department with suicidal ideation or thoughts of self-harm must be appropriately assessed for suicide risk to determine a safe disposition. Many factors affect the long-term risk of suicide, including patient demographics, underlying psychiatric conditions, substance abuse history, prior suicidal behavior, and access to lethal means, including firearms. Acute crises may trigger suicide, including professional, financial, and social stressors. A brief, objective assessment should be employed by emergency physicians and providers to identify patients who require more comprehensive evaluation or emergent psychiatric consultation. For patients who are determined to be an imminent risk to themselves, appropriate suicide precautions are indicated.
You’re Staying, Whether You Like It or Not
Authors: Kraus Chadd K.
Published: February 2022

The evaluation of patients with acute psychiatric needs in the emergency department requires a determination of whether the patient requires inpatient hospitalization for additional evaluation and treatment or if the patient is appropriate for outpatient management. Involuntary commitment, legally holding a patient for psychiatric evaluation over his/her objections or without his/her consent, presents a challenging ethical dilemma for the emergency physician. For patients requiring inpatient psychiatric hospitalization, disposition might be made either by voluntary or involuntary commitment. For patients who represent an imminent danger to themselves or others, involuntary commitment might be indicated. Involuntary commitment should meet certain ethical standards, including a least restrictive approach that respects the dignity and autonomy of each individual patient.
Right into the Danger Zone
Authors: Derse Arthur R.
Published: February 2022

Patients who pose psychiatric emergencies present ethical and legal challenges to emergency physicians. Issues include consent for treatment and refusal of treatment, confidentiality and concomitant breach of confidentiality, duty to protect the patient and to warn or protect others, determination of dangerousness to self and others, emergency detention, and involuntary treatment. Emergency physicians must take care to evaluate patients with psychiatric emergencies to ensure safety for the patient, others, and the emergency physician and other healthcare personnel. Emergency physicians should know and understand the applicable statutes and common law (i.e., judicial case law) concerning emergency detention and involuntary treatment of patients who pose a risk of serious harm to self or others.
The muted voices of the ringworm patients and their families worldwide
Authors: Hoffer Liat
Published: February 2022

The main objective of this chapter is to provide a platform for the muted voices of former ringworm patients around the world to be heard. Most of the patients quoted in this chapter describe their treatment as harsh and traumatic, triggering a sense of fear, helplessness, and sadness. They recall feelings of embarrassment and shame, and painful memories of ridicule and rejection by peers and even by their immediate family. Sometimes their plight was accompanied by feelings of disappointment, shame, and anger regarding their caregivers. Their shared sense of distress is reflected in their comments contrasting the condition of their hair before and after treatment, and their feelings about their current lives as a result. Besides these sources of distress, there is also the shared worry about the health ramifications of the treatment. These feelings are strikingly similar between patients and their family members despite the geographic distances and cultural differences that divide them.
The Personality Syndromes
Authors: Shedler Jonathan
Published: February 2022

Personality refers to an individual’s characteristic patterns of thought, feeling, behavior, motivation, defense, interpersonal functioning, and ways of experiencing self and others. Knowledge accrued over generations of clinical experience has given rise to a taxonomy of personality styles or syndromes, and empirical research has confirmed the major syndromes and their features. Each personality syndrome is introduced and discussed. Diagnostic prototypes, which are succinct description of personality syndromes in their “ideal” or pure form, are provided to facilitate day-to-day clinical diagnosis. The personality constructs provide the broad strokes of clinical case formulations that address the psychological difficulties underlying many presenting complaints and diagnoses. Several personality syndromes are discussed as psychological pathways to depression.
Levels of Personality Organization
Authors: Caligor Eve , Clarkin John F. , Sowislo Julia F.
Published: February 2022

Level of personality organization refers to a system of classification of personality pathology based in object relations theory. Within this framework, personality disorders are characterized according to severity of pathology, ranging from mild to extreme, based on assessment of the individual’s identity, quality of object relations, defensive functioning, management of aggression, moral functioning, and reality testing. The object relations theory model of personality and personality disorders prioritizes personality functioning, while focusing on the mental representations of self and others that organize subjective experience and observable behavior. Assessment of the level of personality organization guides clinical intervention, including determinations of level of care, treatment goals, and clinical foci. The object relations theory model of classification both overlaps significantly with and can also be distinguished from the Alternative Model of Personality Functioning of DSM-5.
Schema Therapy
Authors: Schaich Anja , Fassbinder Eva , Arntz Arnoud
Published: February 2022

Schema therapy (ST), developed by Jeffrey Young, is an evidenced-based treatment approach for patients with personality disorders (PDs) and other chronic mental health problems. ST is a therapy method based on a cognitive model, integrating elements and techniques from various theoretical orientations such as attachment theory, cognitive, behavioral, psychodynamic, and experiential therapies. In ST, a special focus is placed on the therapeutic relationship and experiential treatment techniques like chair dialogues and imagery rescripting. While ST is a transdiagnostic approach, disorder-specific case formulations have been developed for most of the PDs. ST has not only proven to be a highly effective and cost-effective treatment option for patients with PDs, but it is also well accepted by both therapists and patients and has very low dropout rates. In this chapter we will provide an overview of the background and underlying theory of ST, as well as information on the practical application and empirical evidence of ST. The case formulation and therapeutic techniques will be illustrated by one case example of a Cluster B and one of a Cluster C personality disorder.
Good Psychiatric Management (GPM) for Borderline Personality Disorder
Authors: Hersh Richard G. , McCommon Benjamin , Golkin Emma , Sotsky Jennifer
Published: February 2022

Good psychiatric management (GPM) for borderline personality disorder (BPD) is an empirically validated treatment promoted specifically to be used by the generalist clinician. GPM was evaluated initially as a control intervention in a study comparing it to dialectical behavioral therapy (DBT); the robust response of both groups in the study led to consideration of GPM as a practical, alternative intervention that could be widely disseminated. Despite its name, GPM is a treatment that can be and is provided by mental health clinicians of varying backgrounds because it is relatively easy to learn and to practice. The pressing public health mission to empower more clinicians to treat patients with BPD has fueled the enthusiasm for this treatment. The hallmarks of GPM are its eclectic orientation and flexibility. GPM provides guidance for the clinician, using elements of psychodynamic psychotherapy, case management, and cognitive-behavioral therapy (CBT), with a goal of providing “good enough” treatment. This chapter includes: (1) a summary of the level of evidence for the effectiveness of GPM; (2) an overview of the central tenets and core theoretical underpinnings; (3) the indications for treatment; (4) an outline of the GPM treatment approach with a focus on diagnosis sharing and psychoeducation, the establishment of treatment goals, the adjustment of the intensity and duration of the treatment, the management of self-harm and suicidality, the integration of psychotherapy elements, case-management techniques, and a guide for pharmacotherapy and management of co-occurring conditions; and (5) relevant resources for clinicians, patients, and their families.
Paranoid Personalities (Vigilant Style)
Authors: Lee Royce , Santos Edwin
Published: February 2022

Paranoid personality disorder (PPD) has held an uncertain position in psychiatric nosology, but remains a construct of interest because of its frequent presentation in the community and clinic. It remains misunderstood, in part due to a superficial similarity to schizophrenia and other psychotic disorders. Stronger relationships are found with trauma-related psychopathology and other impulsive, emotionally unstable personality disorders. From this point of view, PPD can be best understood through recent epidemiological, neurobiological, and psychological research. This literature is reviewed and summarized for the clinician to guide the processes of screening, assessment, and treatment planning. While the field awaits definitive treatment studies, some clues are available from preliminary studies. This research points to the need for interventions that account for the habitual nature of PPD-related behaviors, and directly target the issue of mistrust by utilizing interaction with the therapist as a form of exposure and new learning.