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Background: Mild cognitive impairment in Parkinson's disease (PD-MCI) includes deficits in different cognitive domains, and one domain to explore for neurocognitive impairment following the DSM-V is social cognition. However, this domain is not included in current criteria for PD-MCI diagnosis. Moreover, tests vary across studies. It is, therefore, crucial to optimize cognitive assessment in PD-MCI. We aimed to do so by using Machine Learning. Methods: 275 PD patients were included. Four cognitive batteries were created: two Standard ones (Levels I and II), applying current criteria and "traditional" tests; two Alternative ones (Levels I and II), which incorporated a test of social cognition. These batteries were included in the Random Forest (RF) classifier. To assess RF performance, the AUC was considered, and the Variable Importance Index was estimated to understand the contribution of each test in PD-MCI classification. Results: Standard Level I and II showed an AUC of 0.852 and 0.892, while Alternative Level I and II showed an AUC of 0.898 and of 0.906. Variable Importance Index revealed that TMT B-A, Ekman test, RAVLT-IR, MoCA, and Action Naming were tests that most contributed to PD-MCI classification. Conclusion: The Alternative level I assessment demonstrated a similar classification capacity to the Standard level II assessment. This finding suggests that in the cognitive assessment of PD patients, it is crucial to consider the most affected cognitive domains in this clinical population, including social cognition. Taken together, these results suggest to revise current criteria for the diagnosis of PD-MCI.

analisi dell'applicazione del diritto della concorrenza alle imprese pubbliche

introduction to a book entirely devoted to the activities and instruments of UNIDROIT. PArt of a trilogy on Unidroit, Uncitral and HCCH

analysis of the specificities of adjudicatory means and mechanisms in WTO. To use as benchmark for a new international court for investment arbitration

Although it is clearly established that the abuse of alcohol is seriously harmful to health, many epidemiological and clinical evidences seem to underline the protective role of moderate quantities of alcohol and in particular of wine on health. This review aims to re-evaluate the relationship between the type and dose of alcoholic drink and reduced or increased risk of various diseases, in the light of the most current scientific evidence. In particular in vitro studies on the modulation of biochemical pathways and gene expression of wine bioactive components together with in vivo studies on cardiovascular pathologies, type 2 diabetes, neurological degenerative diseases and longevity were carefully evaluated. A brief discussion on oenological practices potentially affecting bioactive components content in wine is included. The analysis clearly indicates that wine differs from other alcoholic beverages and its moderate consumption not only does not increase the risk of chronic degenerative diseases but is also associated with health benefits particularly when included in a Mediterranean diet model. Obviously, every effort must be made to promote behavioral education to prevent abuse, especially among young people.

Emotion processing impairment is a common non-motor symptom in Parkinson’s Disease (PD). Previous literature reported conflicting results concerning, in particular, the performance for different emotions, the relation with cognitive and neuropsychiatric symptoms and the affected stage of processing. This study aims at assessing emotion recognition and discrimination in PD. Recognition of six facial expressions was studied in order to clarify its relationship with motor, cognitive and neuropsychiatric symptoms. Sensitivity in discriminating happy and fearful faces was investigated to address controversial findings on impairment in early stages of emotion processing. To do so, seventy PD patients were tested with the Ekman 60 Faces test and compared with 46 neurologically unimpaired participants. Patients’ performances were correlated with clinical scales and neuropsychological tests. A subsample of 25 PD patients and 25 control participants were also tested with a backward masking paradigm for sensitivity in happiness and fear discrimination. Results showed that PD patients were impaired in facial emotion recognition, especially for fearful expressions. The performance correlated with perceptual, executive and general cognitive abilities, but facial expression recognition deficits were present even in cognitively unimpaired patients. In contrast, patients’ sensitivity in backward masking tasks was not reduced as compared to controls. Taken together our data demonstrate that facial emotion recognition, and fear expression in particular, is critically affected by neurodegeneration in PD and related to cognitive abilities; however, it appears before other cognitive impairments. Preserved performances in discriminating shortly presented facial expressions, suggest unimpaired early stages of emotion processing.

In un volume sul pensiero di Alberto Predieri, considerazioni sui suoi ultimi scritti premonitori su Unione Monetaria e mercati finanziari internazionali

various aspects and effects of the transition to renevable on international commerce

Background: Anemia is a common complication of chronic kidney disease (CKD), but its incidence in nephrology settings is poorly investigated. Similarly, the risks of adverse outcomes associated with new-onset anemia are not known. Methods: We performed a pooled analysis of three observational cohort studies including 1031 non-anemic CKD patients with eGFR <60 mL/min/1.73 m2 regularly followed in renal clinics. We estimated the incidence of mild anemia (hemoglobin 11-12 g/dL in women and 11-13 g/dL in men) and severe anemia (hemoglobin <11 g/dL or use of erythropoiesis-stimulating agents) during a 3-year follow-up period. Thereafter we estimated the risk of end-stage kidney disease (ESKD) and all-cause death associated with new-onset mild and severe anemia. Results: The mean age was 63 ± 14 years, 60% were men and 20% had diabetes. The mean estimated glomerular filtration rate (eGFR) was 37 ± 13 mL/min/1.73 m2 and the median proteinuria was 0.4 g/day [interquartile range (IQR) 0.1-1.1]. The incidence of mild and severe anemia was 13.7/100 patients-year and 6.2/100 patients-year, respectively. Basal predictors of either mild or severe anemia were diabetes, lower hemoglobin, higher serum phosphate, eGFR <30 mL/min/1.73 m2 and proteinuria >0.50 g/day. Male sex, moderate CKD (eGFR 30-44 mL/min/1.73 m2) and moderate proteinuria (0.15-0.50 g/day) predicted only mild anemia. The incidence of anemia increased progressively with CKD stages (from 8.77 to 76.59/100 patients-year) and the proteinuria category (from 13.99 to 25.02/100 patients-year). During a median follow-up of 3.1 years, 232 patients reached ESKD and 135 died. Compared with non-anemic patients, mild anemia was associated with a higher adjusted risk of ESKD {hazard ratio [HR] 1.42 [95% confidence interval (CI) 1.02-1.98]} and all-cause death [HR 1.55 (95% CI 1.04-2.32)]. Severe anemia was associated with an even higher risk of ESKD [HR 1.73 (95% CI 1.20-2.51)] and death [HR 1.83 (95% CI 1.05-3.19)].

Background: Emotion recognition and social deficits have been previously reported in Parkinson’s disease (PD). However, the extent of these impairments is still unclear and social cognition is excluded from the cognitive domains considered in the current criteria for PD mild cognitive impairment (MCI). This study aims to analyze emotion recognition, affective and cognitive theory of mind in early PD patients classified according to Level II MCI criteria, and to evaluate the prevalence of socio-cognitive deficits in this sample. Methods: We enrolled 45 participants with PD, classified as cognitively unimpaired (CU; n = 32) or MCI (n = 13) based on a standard neuropsychological assessment. Social cognitive skills were evaluated through validated tests for emotion recognition (i.e., Ekman 60-faces test, Ek60 Test) and mental states attribution (Story-based Empathy Task, SET) and compared to a group of 45 healthy controls (HC). Between-group differences in social tasks were performed, as well as correlation analyses to assess the relationship between social, cognitive, and clinical variables. Finally, the number of patients with social cognitive impairments in both MCI and CU subgroups was computed based on Italian normative data. Results: Statistical comparison revealed significant differences among groups in the Ek60 test, with MCI obtaining significantly lower scores than HC and CU, especially for negative emotions. Significant differences were detected also in the SET, with lower performance in emotion and intention attribution for both PD groups compared to HC. A significant correlation emerged between the Ek60 test and emotion attribution. Nine patients showed poor performance at social tasks, five of them being classified as PD-CU. Discussion: Parkinson’s disease cognitive profile was characterized by emotion recognition and attribution deficits. These results, as well as the detection of CU patients with isolated socio-cognitive impairments, underline the import

the contribution explains why competition and regulation overlap in the case of fintech and how technology has changed the market so changing also the instruments for regulation

storia del commerciointernazionale e sue modifiche in base alle teorie giuridiche ed economiche. Bretton Woods e la sua crisi

history of trade law and changes according to legal and economic theories in the years. Lex mercatoria and public international law. Current challenges

analisi dei lodi arbitrali sui Principi Unidroit

analysis of the international standards on outsourcing in the financial market and their implementation in the European Union

perspectives of recent reforms of ISDS in the light specifically of the works of WG III UNCITRAL

history of regulation of payment systems and services in the EU. A paradigm for international and domestic regulation

The contribution analyses some European Court of Justice case law on sovereign debt and the application of domestic law to any request of treasury bonds. Some inconsistencies are evidenced

EU State aids in the theory of fiscal law

the contribution comments recent CJEU case law on application of EU law in case of claimed based on treasury bonds following restructuring of sovereign debt

corporate social responsibility through the lenses of international soft law. An empirical analysis

how State obligations under domestic law coexist with sovereign powers on monetary policy. Private law and public law

Nowadays the classical conceptualization of international law undercomes challenges and we need to rethink premises

Cardio-renal syndrome is well – known clinical syndrome, describing both negative effects of impaired renal function on heart and circulation and, on the other hand, those of heart failure on renal function. Many author have investigated the usefulness of serological markers in identify and eventually follow this syndrome. Natriuretic peptides levels are not only directly associated with severity of heart failure, but on the other hand they can help to detect renal dysfunction before creatinine serum levels raise up. NGAL, Cystatin C, NAG, KIM-1 and IL-18 represent interesting biomarkers for early detection of acute kidney injury (AKI), while urinary KIM-1 and urinary IL-18 seems to be appropriate only for differential diagnosis of established AKI., La sindrome cardio-renale (SCR) è una sindrome clinica ben nota, che descrive tanto gli effetti negativi dell'insufficienza renale sull'equilibrio cardio-circolatorio quanto quelli dell'insufficienza cardiaca sulla funzione renale. Molti autori hanno studiato l'utilità di marcatori sierologici ai fini dell'identificazione e del monitoraggio ambulatoriale delle varie forme di questa sindrome. L'analisi dei livelli sierici dei peptidi natriuretici è, al momento, quella maggiormente utilizzata, in quanto essi stessi non sono solo direttamente associati alla gravità delhinsufficienza cardiaca, ma anche capaci di rilevare precocemente la disfunzione renale, certamente prima che sia possible osservare un incremento nei livelli sierici di creatinina. NGAL, cistatina C, NAG, KIM-1 e IL-18 rappresentano interessanti biomarcatori per la diagnosi precoce di danno renale acuto (AKI), e quindi per la diagnosi precoce delle forme renocardiache acute, mentre il loro utilizzo in altre forme di SCR non appare codificato. Al contrario, la valutazione di KIM-1 e IL-18 sembra più utile per cercare una diagnostica differenziale tra forme diverse di insufficienza renale acuta.

L'eritropoietina, per molti anni intesa unicamente come principale regolatore della massa eritrocitaria circolante, ha svelato nel corso degli anni sempre nuove pagine di fisiologia, che l'hanno mostrata come elemento centrale di un complesso sistema che mantiene l'equilibrio tra ossigenazione periferica, stabilità vascolare e stress ossidativo. Al crescere delle conoscenze sulla fisiologia autocrina e paracrina dell'EPO, sono cresciute le aspettative verso l'utilizzo clinico-pratico di tali conoscenze. La presente review propone una rapida carrellata sulle diverse potenziali applicazioni dell'EPO nel management clinico della cardiopatia ischemica, con particolare riguardo alle strategie testate per ottenere gli effetti pleiotropici dell'EPO senza indurre indesiderati incrementi dell'ematocrito., No abstract

No abstract, non disponibile

A fair number of scientific studies have investigated possible links between arteriovenous fistulas and heart failure, in some cases with consolidated results but in some cases with conflicting results. Other issues, such as right heart failure, were investigated in a marginal way. This survey presents a quick overview of the literature in recent years and raises some outstanding questions on cardionefrologia., Un discreto numero di lavori scientifici ha indagato i possibili nessi esistenti tra fistole arterovenose e scompenso cardiaco, con risultati in parte assolutamente consolidati ed in altra parte contrastanti. Altri temi, come lo scompenso del cuore destro, risultano indagati in maniera marginale. Questa rassegna presenta un rapido excursus della letteratura degli ultimi anni e solleva alcuni interrogativi insoluti in materia di cardionefrologia.

No abstract (Cardionephrology), non disponibile (Cardionephrology)

A fair number of scientific studies have investigated possible links between arteriovenous fistulas and heart failure, in some cases with consolidated results but in some cases with conflicting results. Other issues, such as right heart failure, were investigated in a marginal way. This survey presents a quick overview of the literature in recent years and raises some outstanding questions on cardionefrologia. (Cardionephrology), Un discreto numero di lavori scientifici ha indagato i possibili nessi esistenti tra fistole arterovenose e scompenso cardiaco, con risultati in parte assolutamente consolidati ed in altra parte contrastanti. Altri temi, come lo scompenso del cuore destro, risultano indagati in maniera marginale. Questa rassegna presenta un rapido excursus della letteratura degli ultimi anni e solleva alcuni interrogativi insoluti in materia di cardionefrologia. (Cardionephrology)

No abstract, L'eritropoietina, per molti anni intesa unicamente come principale regolatore della massa eritrocitaria circolante, ha svelato nel corso degli anni sempre nuove pagine di fisiologia, che l'hanno mostrata come elemento centrale di un complesso sistema che mantiene l'equilibrio tra ossigenazione periferica, stabilità vascolare e stress ossidativo. Al crescere delle conoscenze sulla fisiologia autocrina e paracrina dell'EPO, sono cresciute le aspettative verso l'utilizzo clinico-pratico di tali conoscenze. La presente review propone una rapida carrellata sulle diverse potenziali applicazioni dell'EPO nel management clinico della cardiopatia ischemica, con particolare riguardo alle strategie testate per ottenere gli effetti pleiotropici dell'EPO senza indurre indesiderati incrementi dell'ematocrito.

Patients with Chronic Kidney Disease may present all typical pericardial clinical entities but some of them are surely more common than others. Last decades have witnessed to a dramatic improvement in caring patients with kidney failure and uremic pericarditis (as seen in the past) is quite rare to observe. Pericardial effusion (idiopathic or secondary) is more frequent, especially in hemodialysis patients and in those patients who start renal replacement therapy in critical care conditions (i.e. patients with chronic and or acute heart failure). In CKD patients following clinical conditions can be present: pericardial effusion (idiopathic or secondary), acute pericarditis, constrictive pericarditis. Pericardial effusion can be classified as mild, moderate or severe; acute pericarditis could be idiopathic or secondary to wide spectrum of infectious, immunologic or neoplastic diseases. Constrictive pericarditis can represent final pathway of many secondary conditions leading to pericardic and myocardic fibrosis.  (Cardionephrology), I pazienti affetti da malattia renale cronica possono andare incontro a tutta una serie di patologie che colpiscono il pericardio ma, sicuramente, alcune entità nosologiche sono più frequenti di altre. Gli ultimi decenni hanno assistito, per fortuna nostra e dei nostri pazienti, a un netto miglioramento per quanto concerne i protocolli terapeutici per i pazienti nefropatici e le forme tipiche di pericardite uremica, così frequenti negli anni passati, sono ormai uno sbiadito ricordo. È tuttora frequente osservare pazienti con versamento pericardico (idiopatico, ovvero secondario a malattie sistemiche), soprattutto per quanto concerne i pazienti sottoposti a trattamenti depurativi extracorporei ed i pazienti che iniziano il trattamento dialitico in condizioni di emergenza/urgenza (ad esempio, pazienti affetti da scompenso cardiaco congestizio); il versamento pericardico viene schematicamente classificato in lieve, moderato e severo in base all'interessamento più o meno globale del pericardio. Meno frequenti sono gli episodi di pericardite acuta (anch'essa idiopatica o secondaria), spesso su base virale, neoplasticae/o immunologica (vedi pazienti trapiantati in terapia immunosoppressiva). Le forme di pericardite costrittiva sono più rare a documentarsi in corso di malattia renale cronica e, in genere, rappresentano lo stadio finale di diverse patologie sistemiche: l'esito finale è, in genere, la fibrosi pericardica. (Cardionephrology)

No abstract (Cardionephrology), non disponibile (Cardionephrology)

Kidney is mainly involved in fluid and electrolytes homeostasis, as well as in toxins knockout. Kidney function seems to be strictly related to heart and cardiovascular asset and ‘cardiorenal syndrome’ is now used to identify clinical correlation between heart and kidney disease. Chronic heart failure (CHF) represent first cause of hospitalization in western countries; CHF patients often present with mild to severe chronic kidney disease (CKD). Many physiological and pathophysiological pathways are postulated to explain how CKD can affect CHF prognosis and vice-versa. cGMP and NO - cGMP axis could be involved in pathogenesis of CHF in CKD patients together with natriuretic peptides (ANP and BNP) and phosphodiesterases control. Patients with CHF need to be treated for their chronic volume overload. First choice therapy is undoubtedly diuretic therapy, often with association between different kinds of drugs (such as thiazides and loop diuretics). Ultrafiltration excorporeal treatments are usually indicated in those patients not responding to massive diuretic treatments and they are often employed as complementary treatment in patients with refractory CHF.  (Cardionephrology), Il rene è coinvolto, in prima battuta, nel mantenimento dell'omeostasi dei fluidi e dell'equilibrio idro-elettrolitico ed acido-base, nonché nell'eliminazione delle scorie tossiche. La funzione renale sembra essere strettamente collegata a quella cardiovascolare e, negli ultimi anni, il termine di ‘sindrome Cardio-Renale’ è stato utilizzato per spiegare le correlazioni cliniche tra patologia renale e cardiaca. Lo scompenso cardiaco congestizio (SCC) rappresenta la prima causa di ospedalizzazione nei Paesi occidentali e i pazienti affetti presentano spesso, in associazione, un quadro di malattia renale cronica (MRC) di grado variabile. Sono stati considerati diversi modelli fisiologici e fisiopatologici per spiegare come una condizione di malattia renale cronica possa influenzare lo stato di insufficienza cardiaca. Sicuramente la via metabolica del guanosin monofosfato ciclico (cGMP) e quello dell'ossido nitrico (NO) giocano un ruolo fondamentale di concerto con l'azione dei peptidi natriuretici atrial natriuretic peptide (ANP) e brain natriuretic peptide (BNP) sotto il controllo del sistema delle fosfodiesterasi sieriche. I pazienti con sovraccarico di circolo necessitano di terapie farmacologiche specifiche. La terapia diuretica, spesso in associazione (vedi tiazidici + diuretici d'ansa), rappresenta ancora quella di prima scelta ma, nei pazienti, refrattari alla terapia diuretica a dosi massimali, l'impiego di metodiche extracorporee, quali l'ultrafiltrazione (nelle sue diverse modalità d'impiego), può essere di grande aiuto per il paziente scompensato dal punto di vista cardiologico.  (Cardionephrology)

Cardio-renal syndrome is well – known clinical syndrome, describing both negative effects of impaired renal function on heart and circulation and, on the other hand, those of heart failure on renal function. Many author have investigated the usefulness of serological markers in identify and eventually follow this syndrome. Natriuretic peptides levels are not only directly associated with severity of heart failure, but on the other hand they can help to detect renal dysfunction before creatinine serum levels raise up. NGAL, Cystatin C, NAG, KIM-1 and IL-18 represent interesting biomarkers for early detection of acute kidney injury (AKI), while urinary KIM-1 and urinary IL-18 seems to be appropriate only for differential diagnosis of established AKI. (Cardionephrology), La sindrome cardio-renale (SCR) è una sindrome clinica ben nota, che descrive tanto gli effetti negativi dell'insufficienza renale sull'equilibrio cardio-circolatorio quanto quelli dell'insufficienza cardiaca sulla funzione renale. Molti autori hanno studiato l'utilità di marcatori sierologici ai fini dell'identificazione e del monitoraggio ambulatoriale delle varie forme di questa sindrome. L'analisi dei livelli sierici dei peptidi natriuretici è, al momento, quella maggiormente utilizzata, in quanto essi stessi non sono solo direttamente associati alla gravità delhinsufficienza cardiaca, ma anche capaci di rilevare precocemente la disfunzione renale, certamente prima che sia possible osservare un incremento nei livelli sierici di creatinina. NGAL, cistatina C, NAG, KIM-1 e IL-18 rappresentano interessanti biomarcatori per la diagnosi precoce di danno renale acuto (AKI), e quindi per la diagnosi precoce delle forme renocardiache acute, mentre il loro utilizzo in altre forme di SCR non appare codificato. Al contrario, la valutazione di KIM-1 e IL-18 sembra più utile per cercare una diagnostica differenziale tra forme diverse di insufficienza renale acuta. (Cardionephrology)

financial disputes rarely go into arbitration. The contribution indicates reasons for this and possible developments for the future. Investment arbitration is also reported

the institution of amicus curiae permits the consideration of interests and stakeholders that are excluded from the proceedings. This might give rise to a new consideration of third parties interests in disputes and in international assessment of rights