May Glymphatic Drainage Improve Life Quality in Progressive Multiple Sclerosis Outpatients?

Sandro Mandolesi,1 Tarcisio Niglio,2 Chiara Lenci3 1Research Department of the Mediterranean Pole, Technoscience, Science and Technology Park, San Severo, Italy; 2Istituto Superiore di Sanità, Roma, Italy; 3“la Sapienza” University, Roma, ItalyCorrespondence: Tarcisio Niglio, Email [email protected]: The cerebral fluid-dynamic system plays a critical role in maintaining brain health and function. Recent studies identify the glymphatic system as primarily responsible for removing waste products and toxins from brain tissue. In recent years, we have achieved beneficial improvements in MS patients’ symptoms and lifestyle using a specific Fluid Dynamic Intensive MAM (FD-MAM) protocol.Methods: We treated 40 outpatients with progressive MS, aged 45– 55 years and with EDSS scores from 6 to 9. We applied FD-MAM in 10 daily sessions over two weeks. Before and after glymphatic drainage by FD-MAM, we assessed each patient’s clinical status and quality of life using six validated questionnaires.Results: Data from the six validated questionnaires administered to the 40 MS patients show an improvement in 83% of the scores. At the same time, we observed a shift from pathological to physiological values in 50% of the pathological scores after 10 sessions of FD-MAM protocol.Conclusion: This study confirms the positive improvements on life quality in outpatients with progressive multiple sclerosis after one cycle of Fluid Dynamic Intensive MAM (FD-MAM) protocol. Initial follow-up on few patients treated with the FD-MAM protocol suggests that the results persist for six to ten months post-treatment. Future detailed studies, on MS outpatients’ larger cohort, are essential to assess the duration of results and its effect on glymphatic system.Keywords: D009103 Multiple Sclerosis, D020528 Multiple Sclerosis, Chronic Progressive, D000077502 Glymphatic system, Fluid Dynamic MA

Prospective Study on Several Urinary Biomarkers as Indicators of Renal Damage in Children with CAKUT

Purpose The aim of the study was to investigate urinary levels of monocyte chemotactic protein-1 (MCP-1), epidermal growth factor (EGF), β-2-microglobulin (β2M), and FAS-ligand (FAS-L) in children with congenital anomalies of kidney and urinary tract (CAKUT) disease at risk of developing glomerular hyperfiltration syndrome. For this reason, we selected patients with multicystic kidney, renal agenesia and renal hypodysplasia, or underwent single nephrectomy. Materials and Methods This prospective, multicentric study was conducted in collaboration between the Pediatric Surgery Unit in Foggia and the Pediatric Nephrology Unit in Bari, Italy. We enrolled 80 children with CAKUT (40 hypodysplasia, 22 agenetic; 10 multicystic; 8 nephrectomy) who underwent extensive urological and nephrological workup. Exclusion criteria were recent urinary tract infections or pyelonephritis, age > 14 years, presence of systemic disease, or hypertension. A single urine sample was collected in a noninvasive way and processed for measuring by enzyme-linked immunosorbent assay urine levels of MCP-1, EGF, β2M, and FAS-L. As control, urine samples were taken from 30 healthy children. Furthermore, we evaluated the urinary ratios uEGF/uMCP-1 (indicator of regenerative vs inflammatory response) and uEGF/uβ2M (indicator of regenerative response vs. tubular damage). Results These results suggest that urinary levels of MCP-1 are overexpressed in CAKUT patients. Furthermore, our findings clearly demonstrated that both uEGF/uMCP-1 and uEGF/uβ2M ratios were significantly downregulated in all patient groups when compared with the control group. Conclusion These findings further support that CAKUT patients may, eventually, experience progressive renal damage and poor regenerative response. The increased urinary levels of MCP-1 in all groups of CAKUT patients suggested that the main factor responsible for the above effects is chronic renal inflammation mediated by local monocytes

Different outcome of six homozygotes for prothrombin A20210A gene variant

Prothrombin G20210A gene variant (FII G20210A) is a risk factor for venous thrombotic disease while conflicting results have been reported for the risk of arterial thrombotic events. However, vascular episodes were absent in up to 40% of the 67 homozygotes for the G20210A described so far, which indicates that the clinical expression depends on additional risk/trigger factors. We describe six homozygotes for the G20210A variant, among which the first pair of siblings (cases n. 3 and 4) reported so far that displayed a strongly heterogeneous clinical outcome. Case 1, a female of 27 years, developed a full thrombosis of common femoral, superficial and popliteal veins. She assumed oral contraceptives in the last two years. Case n. 2, 34 years old, suffered of recurrent pregnancy loss in absence of any causative alteration. Cases n. 3 and n. 5 experienced arterial thrombotic disease, i.e., juvenile myocardial infarction (40 years old) and stroke (48 years old), respectively, in absence of other risk factors. Finally, cases n. 4 and 6 identified as homozygotes for the FII G20210A variant being consanguineous of symptomatic subjects bearing the variant, did not experience any episode of venous nor arterial disease. Both of them have chronic liver disease with an impairement of the prothrombin time INR. Thus, homozygotes for the G20210A are at risk for arterial (in addition to venous) thromobotic events; chronic liver disease might modulate this risk

Città Metropolitane e Smart Governance Iniziative di successo e nodi critici verso la Smart City

The volume contains the results of the research project "Governance Analysis Project (GAP) for the Smart Energy City. The actualization of Smart Cities in the Metropolitan Areas of Europe and Italy” conducted within the PON “Smart Energy Master for the energy management of the territory” at the University Federico II of Naples (TeMA Lab of the Department of Civil, Architectural and Environmental Engineering). Smart Cities have gained increasing relevance in the scientific debate and in the national and international operational practice, emerging as one of the opportunities to rethink cities and, more generally, the life of urban communities. First reflections, researches and projects on the issue seem to converge towards the idea that a “smart” urban development should not only be a result of the yet necessary and unavoidable infrastructural endowment (physical capital) and of its continuing innovation, but also of the quality of human, social and environmental capital, conceived as strategic factors for development. A “smart” city is, primarily, a city able to effectively satisfy the needs of its citizens respecting the rules imposed by the environmental context. It is in such a debate that the project GAP fits with the aim to address Smart Cities in light of the administrative reorganization of Italian large cities as a consequence of the Law 56/2014. With a scientific approach, the volume provides a comprehensive and updated framework of how Italian and European Metropolitan cities are declining the Smart City issue and this thanks to the collection of a wide-ranging screening represented by more than 1.000 initiatives including researches, projects, interventions, technologies, etc. Furthermore, one original element of this research is that after an analysis conducted through indirect sources, a phase of dialogue with “stakeholders” was carried out (and of this there is a wide picture in the volume in which, by the way, are reported long excerpts of the interviews). This has enabled to give a clearer framework of what is now experimenting in Italian and European cities, avoiding being totally naïve for interventions and projects labelled as “smart”, but often lacking of innovative methods and contents

Placemaking and Cultural Landscapes

Placemaking and cultural landscapes are worldwide multidisciplinary global concerns that cover many points of view of the common impacts of socio-economic cultural and rights jurisprudence planning, wellbeing and related advancements. Concerned with the complex interactions between the development and environment of those factors, it is important to seek ways, paths and implications for framing sustainability in all social activities. This book is mostly based on the 10th ACLA – Asian Cultural Landscape Association International Webinar Symposium that took place during September 26–27, 2020, in the Banaras Hindu University, Varanasi, India. It examines contemporary social–cultural issues in the context of the United Nations Sustainable Development Goals (UN-SDGs) and associated cultural and sacred landscapes. There, the emphasis is on awakening deeper cultural sensitivity in harmonizing the world and the role of society and spiritual systems, drawing upon multi-disciplinary and cross-cultural interfaces—all within the scope of the future of the earth. The book’s chapters add a new dimension of cultural understanding in the broad domain of emerging human geoscience, considered as key policy science for contributing towards sustainability and survivability science together with future earth initiatives

Interfaces Among Placemaking and Cultural Landscapes: Review and Appraisal

The concept of placemaking is used in comprehensive and complex ways in different contexts of disciplinary boundedness and application in prospective planning and pathways to sustainable development. There is no mutual agreement on a common definition or its attributes. This concept is also taken as an approach and procedure too. Among all the concerns, at the core is ‘place’, which synthesises the multidimensional system of interdependency and interconnectedness. Culture is discussed as a vital force in practising placemaking. In the recent era of the paradigm shift, culture is accepted as the fourth pill that envelops the three basic pillars of SDG, viz. society, environment, and economy, as provoked in the Mexico Declaration in 1982. Through the recently developed mission of Reconnecting With Your Culture (RWYC), a new march is in the move to enhance quality and deeply-rooted education and dialogues making a bridge between locality and universality. The attributes of cultural landscapes and cultural heritage are the essential ingredients of placemaking. Ultimately, it is accepted that placemaking belongs to everyone: its message and mission are bigger than any one person or organisation. These are illustrated here within a frame of appraisal and review of the recent trends in understanding and studying placemaking