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Background. This article presents the results of a pilot study investigating patients' satisfaction thresholds for pharmacological outcomes versus surgical outcomes. Materials and methods. A total of 150 participants were presented with two hypothetical scenarios depicting either pharmacological therapy or surgical interventions. Each scenario described a potential outcome, from a 10% clinical improvement (value 10) to a 100% clinical improvement (value 100) and asked participants to indicate the satisfactory level they would find acceptable. Conclusions. The results revealed distinct patterns in satisfaction thresholds between the two treatment modalities. Between the 150 participants, 52,7% were male and 47,3% female. We also identified a total of 28,8% whom were healthcare workers. Overall, the results for the pharmacological therapy outcomes observed a mean of 60,88 with a standard deviation of 22,77, a median of 60 and a mode of 70; while for the surgical outcomes the mean was 67,81 with a standard deviation of 23,03, the median 85 and the mode 80. We also observed that for the pharmacological therapy outcomes healthcare workers had a lower satisfactory cut off compared to non-healthcare workers. Another interesting finding was that for pharmacological therapy outcomes individuals under 50 y/o had a higher satisfactory cut off compared to individuals over 50 y/o, while for the surgical outcomes we got opposite results. Overall, the findings of this pilot study, even if limited, demonstrated higher minimum satisfaction expectations for surgical outcomes compared to pharmacological therapy outcomes. Specifically, participants tended to require more favorable results and outcomes from surgical interventions to meet their minimum satisfaction criteria. [ABSTRACT FROM AUTHOR]

Background. In Italy, the law n. 219/2017 regarding informed consent states that "Communication time between doctor and patient constitutes treatment time". Legal guardian is designated as a proxy to consent on the child's behalf. The issue of proxy informed consent should be approached with a model for parent-child decision-making that is participatory, collaborative, respects and supports the autonomy of child by recognizing their evolving capacities. We aim to assess the informed consent related to healthcare decisions for medically fragile child, using the MacArthur Competence Assessment Tool for Treatment (MacCAT-T). Materials and Methods. An observational study has been conducted at a Child Neuropsychiatry Service, administering a semi-structured interview with customized questionnaire to examine their capacities in four areas of the MacCAT-T. Results were evaluated with the Pearson correlation coefficient for the cognitive and adaptive levels of the Wechsler-Intelligence-Scale-for-Children (WISC-IV) and the Vineland-Adaptive-Behavior-Scales-II (VABS-II). Conclusions. The MacCAT-T domains Understanding, Appreciation, Reasoning, Expressing a Choice were correlated with the cognitive and adaptive levels of the WISC-IV and the VABS-II. Understanding, Appreciation and Expressing a choice have positive correlation with the Communication and Socialization scores of VABS-II; Reasoning has positive correlation with the Working-Memory-Index scores of the WISC-IV. The study enabled to assess the informed consent processes in vulnerable children and although demonstrating how they participate in their care process in a mostly unconscious way, making the frail children more involved in their own care process was possible. Future studies should assess the impact of incorporating MacCAT-T into standard informed consent in other settings. [ABSTRACT FROM AUTHOR]

Income distribution affects market demand and its elasticity, and, as a consequence, the optimal behaviour of firms and market equilibrium. This paper focuses on the effects of income polarization, and presents a model where – for any unimodal density function describing income distribution of the consumers – income polarization leads to market concentration, i.e., to a smaller number of firms able to survive in the long run, provided that the firms' fixed costs are sufficiently low. [ABSTRACT FROM AUTHOR]

Time-related changes in oculomotor function and of metabolic activity patterns in selected brain networks, as assessed by the quantitative 2-deoxyglucose technique, were investigated in Long-Evans rats following intraperitoneal administration of a ketamine anesthetic dose. During ketamine-induced anesthesia a nystagmic-like behavior was present, characterized by unidirectional slow ocular drifts with superimposed paroxystic bursts of quick (saccadic-like) eye movements; all quick movements were executed in the horizontal direction, were strictly confined to an ocular hemifield of vision, and were followed by a backward (centripetal) drift. A metabolic hyperactivity was found in the dorsomedial shoulder region of the frontal cortex, corresponding to the rat saccadic cortical generator area, whereas functional activity levels were decreased in cerebellum and in several brainstem regions, including portions of the reticular formation and medial vestibular nuclei, putatively indicated as the locus of the oculomotor neural integrator. Starting 2 h after drug injection, a gradual recovery of oculomotor function occurred, with the disappearance of slow ocular drifts. However, an almost uninterrupted sequence of individual saccades was still present. Significant metabolic increases were found at this time in the cingulate and frontal cortex, basal ganglia, superior colliculus, paramedian reticular formation and oculomotor nuclei, the cerebellar vermis and paraflocculus. In medial vestibular nuclei, metabolic levels were undistinguishable from controls. These results suggest different concentration-dependent actions of ketamine on cortical and subcortical circuits involved in saccade generation and gaze holding. These effects are likely to be related at least in part to antagonism of N-methyl- d-aspartate receptor-mediated functions. [ABSTRACT FROM AUTHOR]

The intrinsic morpho-functional organization of the medial terminal nucleus of the accessory optic system was investigated in the guinea pig. The distribution of the retinal afferents, as assessed by the axoplasmic transport of C-valine, showed a remarkable asymmetry within the nucleus. Thus, while the retinal terminal field covered the entire medial terminal nucleus, by far the largest density of labeled retinofugal axon terminals was found within its dorsal division. In this same portion of the nucleus, we found the greatest density of large cells and the maximum intensity of functional activation, this latter as estimated by the increase in metabolic activity of neurons using the C-2-deoxyglucose autoradiographie method in the vertical and horizontal whole-field movement in the visual field. [ABSTRACT FROM AUTHOR]

A single-step method of activation of monomethoxy-polyethylene glycols suitable for its binding to polypeptides and proteins is proposed. Based on the reaction with 2,4,5-trichloro-phenylchloroformate or p-nitrophenylchloroformate, it gives reactive PEG-phenylcarbonate derivatives. The PEG intermediate is stable on storage, the activating group is easily quantified, and the reaction with amino acid and proteins proceeds rapidly at pH near neutrality. The PEG derivatization of enzymes with this procedure is less inactivating than those previously reported. Ribonuclease and super-oxide dismutase were modified and the effect of (a) bound polymer on clearance time in rats, (b) antibody recognition, and (c) on the enzymatic activity toward low and high molecular weight substrates were studied. [ABSTRACT FROM AUTHOR]

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