Lamberti (Italy)

Cognitive impairment is a common and disabling feature of multiple sclerosis (MS), but a precise characterization of cognitive phenotypes in patients with MS is lacking. To identify cognitive phenotypes in a clinical cohort of patients with MS and to characterize their clinical and magnetic resonance imaging (MRI) features. This multicenter cross-sectional study consecutively screened clinically stable patients with MS and healthy control individuals at 8 MS centers in Italy from January 1, 2010, to October 31, 2019. Patients with MS and healthy control individuals who were not using psychoactive drugs and had no history of other neurological or medical disorders, learning disability, severe head trauma, and alcohol or drug abuse were enrolled. Participants underwent a neurological examination and a cognitive evaluation with the Rao Brief Repeatable Battery and Stroop Color and Word Test. A subgroup of participants also underwent a brain MRI examination. Latent profile analysis was used on cognitive test z scores to identify cognitive phenotypes. Linear regression and mixed-effects models were used to define clinical and MRI features of each phenotype. A total of 1212 patients with MS (mean [SD] age, 41.1 [11.1] years; 784 women [64.7%]) and 196 healthy control individuals (mean [SD] age, 40.4 [8.6] years; 130 women [66.3%]) were analyzed in this study. Five cognitive phenotypes were identified: preserved cognition (n = 235 patients [19.4%]), mild-verbal memory/semantic fluency (n = 362 patients [29.9%]), mild-multidomain (n = 236 patients [19.5%]), severe-executive/attention (n = 167 patients [13.8%]), and severe-multidomain (n = 212 patients [17.5%]) involvement. Patients with preserved cognition and mild-verbal memory/semantic fluency were younger (mean [SD] age, 36.5 [9.8] years and 38.2 [11.1] years) and had shorter disease duration (mean [SD] 8.0 [7.3] years and 8.3 [7.6] years) compared with patients with mild-multidomain (mean [SD] age, 42.6 [11.2] years; mean [SD] disease duration, 12.8 [9.6] years; P < .001), severe-executive/attention (mean [SD] age, 42.9 [11.7] years; mean [SD] disease duration, 12.2 [9.5] years; P < .001), and severe-multidomain (mean [SD] age, 44.0 [11.0] years; mean [SD] disease duration, 13.3 [10.2] years; P < .001) phenotypes. Severe cognitive phenotypes prevailed in patients with progressive MS. At MRI evaluation, compared with those with preserved cognition, patients with mild-verbal memory/semantic fluency exhibited decreased mean (SE) hippocampal volume (5.42 [0.68] mL vs 5.13 [0.68] mL; P = .04), patients with the mild-multidomain phenotype had decreased mean (SE) cortical gray matter volume (687.69 [35.40] mL vs 662.59 [35.48] mL; P = .02), patients with severe-executive/attention had higher mean (SE) T2-hyperintense lesion volume (51.33 [31.15] mL vs 99.69 [34.07] mL; P = .04), and patients with the severe-multidomain phenotype had extensive brain damage, with decreased volume in all the brain structures explored, except for nucleus pallidus, amygdala and caudate nucleus. This study found that by defining homogeneous and clinically meaningful phenotypes, the limitations of the traditional dichotomous classification in MS can be overcome. These phenotypes can represent a more meaningful measure of the cognitive status of patients with MS and can help define clinical disability, support clinicians in treatment choices, and tailor cognitive rehabilitation strategies.

Background: Patients with paediatric-onset multiple sclerosis (POMS) could be at an increased risk for cognitive impairment (CI), given the potential harmful effects of disease activity in neurodevelopment. However, there is scarce information on their long-term cognitive outcomes. Objective: To compare the prevalence and profile of CI between adults with a history of POMS and those with classic, adult-onset multiple sclerosis (AOMS). Methods: Cognitive performance was assessed through the Brief Repeatable Battery (BRB) and the Stroop Test in consecutive patients referred to six Italian MS centres. CI was defined as impairment in ⩾2 cognitive domains. Results: In all, 119 patients with POMS and 712 with AOMS were included in this analysis. The prevalence of CI was 48.0% in AOMS, 44.5% in POMS; with similar neuropsychological profile between the two groups. However, when adjusting for current age, we found a significantly increased risk for CI (odds ratio (OR) = 1.71; p = 0.02) and for impairment in information processing speed (OR = 1.86; p < 0.01) in patients with POMS. A higher Expanded Disability Status Scale (EDSS) was also identified in POMS (p = 0.03) compared with AOMS patients. Conclusion: Patients with a history of POMS appear to be at higher risk of physical and cognitive disability than AOMS patients, after correcting for age effects, with particular involvement of information processing speed.

OBJECTIVES: to evaluate the effect of age, sex and onset symptoms on the risk of the second clinical attack in a cohort of pediatric patients with a clinically isolated syndrome suggestive of MS (pCIS). BACKGROUND: Pediatric onset occurs in 5-10[percnt] of Multiple Sclerosis (MS) patients. Due to its rare incidence limited epidemiological data are available. METHODS: Demographic and clinical data of a cohort of patients with pCIS and onset <= 15 years were extracted from the Italian iMedWeb registry and from the MSBase platform. A Cox-model adjusted for age at onset, sex and onset symptom(s) was performed to evaluate the time to a second clinical attack during the follow-up. Proportions of patients with different onset symptom(s) (optic, spinal, supratentorial, brainstem/cerebellum and multifocal) were calculated and compared between children (age at onset < 12 years) and adolescents (age at onset > 12) (chi-square test). RESULTS: a total of 1357 of pCIS patients with onset before 15 years was extracted. A shorter time to a second clinical attack was found in female pCIS (male vs female: HR= 0.82; p< 0.02) and in pCIS with an age at onset > 12 years (HR = 1.32; 95[percnt] CI: 1.13-1.54; p=0.0006). Brainstem onset was found to be more frequent in pCIS with an age at onset < 12 years in comparison to pCIS with an age at onset > 12 years (35.93 vs 26.43[percnt]; p=0.0019). CONCLUSIONS: the results indicate that the most significant factors influencing the time to reach a clinically definite MS diagnosis in pCIS are the female sex and an age at onset > 12 years. Moreover the results confirm that brainstem symptoms at onset are more frequent in children than in adolescents.

The anionic polymerization of ε‐caprolactam in the bulk is now enriched by a new member belonging to the family of very fast activators, represented by blocked (triethoxysilyl)propylisocyanate. The activator is able to allow polymerization completion in a few tens of seconds in quasi‐adiabatic conditions starting from ca. 150°C. The most relevant and unexpected feature of its role in ε‐caprolactam activated anionic polymerization arises from the observation that the resultant APA 6 is extensively crosslinked in situ up to ca. 80% despite the isocyanate monofunctionality of the activator. Comparison with the behavior of a commercial trifunctional activator/crosslinker is carried out and possible explanation of (triethoxysilyl)propylisocyanate role as a crosslinker is put forward. Optimization of the procedure to properly evaluate the degree of APA 6 crosslinking in comparison with a literature method is established. Other tested silane derivatives do not behave similarly in the same experimental conditions of synthesis. The strong adhesion, due to the triethoxysilyl group, to glass fibers introduced in the polymerizing medium is a relevant additional advantage of the quoted activator. Possible industrial applications can be foreseen. Copyright © 2015 John Wiley &amp; Sons, Ltd.

Background. Although physical exercise improves motor aspects of Parkinson’s disease (PD), it is not clear whether it may also have a neuroprotective effect. Objective. In this 2-year follow-up study, we determined whether intensive exercise in the early stages of the disease slows down PD progression. Methods. Forty newly diagnosed patients with PD were treated with rasagiline and randomly assigned to 2 groups: MIRT Group (two 28-day multidisciplinary intensive rehabilitation treatments [MIRT], at 1-year interval) and Control Group (only drug). In both groups, Unified Parkinson’s Disease Rating Scale Section II (UPDRS II), UPDRS III, 6-minute walking test (6MWT), Timed Up-and-Go test (TUG); PD Disability Scale (PDDS), and l-dopa equivalents were assessed at baseline (T0), 6 months (T1), 1 year (T2), 18 months (T3), and 2 years (T4) later. Results. Over 2 years, UPDRS II, UPDRS III, TUG, and PDDS differentially progressed in the 2 groups: In the MIRT Group, all scores at T4 were better than at T0 (all Ps < .03). No changes were noted in the Control Group. l-dopa equivalent dosages increased significantly only in the Control Group (P = .0015), with a decrease in the percentages of patients in monotherapy (T1 40%; T2, T3, and T4 20%). In the MIRT Group, the percentages of such patients remained higher (T1 and T2 100%; T3 89%; T4 75%). Conclusions. These results suggest that MIRT might slow down the progression of motor decay, it might delay the need for increasing drug treatment, and thus, it might have a neuroprotective effect.

We wish to report an unusual presentation of bovine papular stomatitis virus (BPSV) infection of a single cow’s teat, which was the only clinically detected manifestation of this infection in a dairy herd. The affected animal was a five-year-old Holstein in its third lactation with an average

Abstract Three difunctional cleavable photoinitiators based on the α‐hydroxyketone structure were tested in photopolymerization reactions with Fourier transform infrared spectroscopy. The excited‐state processes were investigated with time‐resolved laser absorption spectroscopy and laser‐induced photocalorimetry, which allowed the cleavage quantum yields to be determined and estimates of the triplet‐state lifetimes and interaction rate constants with a methacrylate monomer to be given. Modeling calculations helped to describe the ground‐state properties and showed that the difunctional photoinitiators exhibited different chromophoric groups than the corresponding monofunctional photoinitiator. An examination of the photochemical reactivity versus the practical efficiency observed in the polymerization showed that these difunctional photoinitiators exhibited better efficiency than the parent molecule, mainly because of their increased absorption properties. Their practical efficiency appeared to be better because of better light absorption when standard polychromatic light sources were used. © 2007 Wiley Periodicals, Inc. J Appl Polym Sci, 2008

Abstract Ever more stringent environmental regulations make it increasingly difficult to obtain satisfactory corrosion inhibitors which are effective while being compatible with marine life. Toxicity towards aquatic organisms is a major concern and environmental constraints have been imposed on the types of compositions used in the North Sea in order to protect marine organisms. Many available inhibitors cannot meet the environmental criteria while maintaining effective corrosion inhibition. For sweet / carbon dioxide corrosion, imidazoline based inhibitors are traditionally effective but they have an imperfect environmental profile. Here we describe how the environmental properties have now been improved by alkoxylation of a traditional inhibitor. This not only improves the environmental aspects but also increases the hydrophilicity of the inhibitor making it more suitable for water based applications and increasing its solubility in the water phase where corrosion usually takes place. Organic phosphate esters are also effective corrosion inhibitors with a broad field of application in sweet and sour corrosion. Here we describe laboratory-based corrosion testing on an innovative range of mixed imidazoline / oligophosphate ester inhibitors which show synergy in corrosion inhibition ability, especially at low dosages. The alkoxyimidazoline protects the cathode of the electrochemical cell and the oligophosphate protects the anode – this dual mechanism promotes synergy and increases confidence that the inhibitor will continue to give corrosion protection even in extreme situations where one of the components might have failed. These mixed corrosion inhibitors are therefore applicable to a wide range of water based systems used in the oil and gas industry.