The superior colliculus: New insights into an evolutionarily ancient structure.

The superior colliculus is a structure located in the dorsal midbrain with well conserved function and connectivity across species. Essential for survival, the superior colliculus has evolved to trigger rapid orientation and avoidance movements in response to external stimuli. The increasing recognition of the widespread connectivity of the superior colliculus, not only with brainstem and spinal cord, but also with virtually all brain structures, has rekindled the interest on this structure and revealed novel roles in the past few years.

Evaluation of the risk of occupational exposure to antineoplastic drugs in healthcare sector: part II - the application of the FMECA method to compare manual vs automated preparation.

Healthcare workers handling antineoplastic drugs (ADs) in preparation units run the risk of occupational exposure to contaminated surfaces and associated mutagenic, teratogenic, and oncogenic effects of those drugs. To minimise this risk, automated compounding systems, mainly robots, have been replacing manual preparation of intravenous drugs for the last 20 years now, and their number is on the rise. To evaluate contamination risk and the quality of the working environment for healthcare workers preparing ADs, we applied the Failure Mode Effects and Criticality Analysis (FMECA) method to compare the acceptable risk level (ARL), based on the risk priority number (RPN) calculated from five identified failure modes, with the measured risk level (MRL).

Aberrant survival of hippocampal Cajal-Retzius cells leads to memory deficits, gamma rhythmopathies and susceptibility to seizures in adult mice.

Cajal-Retzius cells (CRs) are transient neurons, disappearing almost completely in the postnatal neocortex by programmed cell death (PCD), with a percentage surviving up to adulthood in the hippocampus. Here, we evaluate CR's role in the establishment of adult neuronal and cognitive function using a mouse model preventing Bax-dependent PCD. CRs abnormal survival resulted in impairment of hippocampus-dependent memory, associated in vivo with attenuated theta oscillations and enhanced gamma activity in the dorsal CA1.

Evaluation of the efficiency of hyaluronic acid, PRP and I-PRF intra-articular injections in the treatment of internal derangement of the temporomandibular joint: A prospective study.

This study aimed to evaluate the clinical effects of hyaluronic acid (HA), platelet-rich plasma (PRP), and platelet-rich fibrin (I-PRF) injections in the internal derangement of the temporomandibular joint. Adult patients who had failed to respond to nonsurgical treatment were were included in the study. The patients were divided into three treatment groups according to the given substance: 1) HA administration three times in a row on a weekly basis, 2) a single dose of PRP, or 3) a single dose of I-PRF.

[Healing of periodontal intrabony defects following treatment with a new-generation platelet-rich fibrin].

Összefoglaló. Az autológ vérlemezke-koncentrátumok az orvoslás egyre több területén kerülnek alkalmazásra. A vérlemezkében gazdag fibrin, ebben a kategóriában, az adott terápiás lehetőségek közül a legaktuálisabb.

Histological Examination of Retrieved ePTFE Membranes Following Regenerative Surgery of Intrabony Defects Treated with Platelet-rich Plasma and Bone Substitutes.

Purpose: Regenerative periodontal therapy using platelet-rich plasma (PRP) and bone substitutes with guided tissue regeneration (GTR) have been proposed as a therapeutic method to enhance the outcome of regenerative surgery. This includes light microscopic evaluation of retrieved ePTFE membranes to assess formation of new connective tissue attachment, and following the regeneration process. The objectives of this study were to evaluate the histological findings of retrieved ePTFE membranes using PRP and bone substitutes, the effect of PRP on graft materials, and the correlation of the findings with the clinical outcomes.

Efficacy of a new-generation platelet-rich fibrin in the treatment of periodontal intrabony defects: a randomized clinical trial.

Background: The aim of the study was to clinically evaluate the healing of intrabony defects after treatment with a new generation of platelet-rich fibrin (A-PRF+) respect to enamel matrix derivative (EMD).

Methods: Thirty (30) intrabony defects of 18 patients (9 males, 9 females) were randomly treated with A-PRF+ (test, n = 15) or EMD (control, n = 15). The following clinical parameters were recorded at baseline and 6 months after surgery: pocket depth (PD), gingival recession (GR) and clinical attachment level (CAL).

[Lean, work and psychological well-being.].

Many studies have confirmed the existence of a close relationship between job satisfaction and health. The Siena University Hospital introduced the Lean approach to support personnel development/empowerment and promote a constant improvement in work organization, with the aim of creating value for patients, professionals and the whole organization. The purpose of this study was to examine whether the introduction and the development of this improvement approach in healthcare could contribute to the enhancement of psychological wellbeing and employee satisfaction, with a positive value in preventing related stress work.

The Workplace Health Promotion (WHP) programme in an Italian University Hospital.

Introduction: Description of the lifestyles of employees of the Siena University Hospital (Azienda Ospedaliera Universitaria Senese: AOUS), as assessed through a Workplace Health Promotion (WHP) project in the two-year period 2017-18; assessment of possible short-term effects of integrated health promotion interventions in the workplace, within the framework of the Tuscany WHP network, as applied in the AOUS and involving about 1,000 workers.

Methods: A cross-sectional study and a pre-post evaluation of data collected by means of anonymous questionnaires in two phases: before the beginning of the programme and after 12 months.

Results: Twelve months after the start of the programme regarding diet (consumption of fruit and vegetables) and physical activity, the positive effects that emerged were not statistically significant.

Bacterial Contamination of ePTFE Membranes Following Regenerative Surgery of Intrabony Defects Treated with Platelet-rich Plasma and Natural Bone Mineral.

Purpose: The rationale of using platelet-rich plasma (PRP) in reconstructive periodontal surgery is to amplify or accelerate the wound healing through the growth factors contained in platelets. On the other hand, bacterial colonisation of membranes may negatively affect the healing process. The aim of this study was to evaluate bacterial contamination of non-bio-resorbable membranes (ePTFE) used for regenerative periodontal therapy of intrabony defects and the clinical attachment level (CAL) gain with or without PRP.

Effects of platelet rich plasma (PRP) on human gingival fibroblast, osteoblast and periodontal ligament cell behaviour.

Background: The use of platelet rich plasma (PRP, GLO) has been used as an adjunct to various regenerative dental procedures. The aim of the present study was to characterize the influence of PRP on human gingival fibroblasts, periodontal ligament (PDL) cells and osteoblast cell behavior in vitro.

Methods: Human gingival fibroblasts, PDL cells and osteoblasts were cultured with conditioned media from PRP and investigated for cell migration, proliferation and collagen1 (COL1) immunostaining.

Microarchitectural study of the augmented bone following ridge preservation with a porcine xenograft and a collagen membrane: preliminary report of a prospective clinical, histological, and micro-computed tomography analysis.

Socket preservation using a combination of porcine xenograft and collagen membrane maintains the vertical and horizontal dimensions of the ridge. The aim of this study was to evaluate the microarchitecture of the grafted area by histological analysis and micro-computed tomography. Patients in the test group (group 1; nine patients) underwent socket preservation, while the sockets in the control group (group 2; eight patients) were allowed to heal without preservation.

Integrated HTA-FMEA/FMECA methodology for the evaluation of robotic system in urology and general surgery.

Objectives: The following study proposes and tests an integrated methodology involving Health Technology Assessment (HTA) and Failure Modes, Effects and Criticality Analysis (FMECA) for the assessment of specific aspects related to robotic surgery involving safety, process and technology.

Methods: The integrated methodology consists of the application of specific techniques coming from the HTA joined to the aid of the most typical models from reliability engineering such as FMEA/FMECA. The study has also included in-site data collection and interviews to medical personnel.

Development of a web based monitoring system for safety and activity analysis in operating theatres.

Background: The management and the monitoring of the operating rooms on the part of the general management have the objective of optimizing their use and maximizing the internal safety. The expenses owed to their safe use represent, besides reimbursements coming from the surgical activity, important factors for the analysis of the medical facility.

Objective: Given that it is not possible to reduce the safety, it is necessary to develop supporting systems with the aim to enhance and optimize the use of the rooms.

Hospital-based expert model for health technology procurement planning in hospitals.

Although in the last years technology innovation in healthcare brought big improvements in care level and patient quality of life, hospital complexity and management cost became higher. For this reason, necessity of planning for medical equipment procurement within hospitals is getting more and more important in order to sustainable provide appropriate technology for both routine activity and innovative procedures. In order to support hospital decision makers for technology procurement planning, an expert model was designed as reported in the following paper.

Development of sustainable models for technology evaluation in hospital.

Background: This paper reports the development of standard techniques for technology evaluation in hospital carried out at the Florence Teaching Hospital Careggi (AOUC), where, as a complex system, the technological evaluation is a strategic and essential element for the maintenance of high-quality clinical activity and maximization of available resources.

Objective: The aim of this paper has been the development of a system of economically sustainable models for the implementation of HTA and HS analyses in the hospital environment as well as presenting, in addition to a valid scientific resilience, the methodological and temporary flexibility to satisfy needs of hospital decision-makers.

Methods: The evaluation models call for 3 main phases: an initial analysis of the in-hospital request, a collection of data, and finally a draft of a specific, easily usable set of reports.

Hospital-based health technology assessment on the use of mitral clips in the treatment of mitral regurgitation.

Background: This study, carried out at the Florence Teaching Hospital Careggi (AOUC), reports the technological evaluation, through the use of Health Technology Assessment (HTA), on the application of mitral clips in the treatment of mitral insufficiency.

Objective: The assessment, carried out by analyzing the clinical, technological, social, procedural, safety and economic elements, sought to answer the following research questions: Evaluation of the general technological status of the mitral clips in the treatment process of mitral regurgitation, with particular reference to traditional methods; and contextualisation of the analyses within the hospital structure, by identifying criticality issues and improvements.

Methods: The methodology was based on the following steps: technological description; areas of evaluation and the selection of Key Performance Indicators; research of scientific facts and the collection of expert opinions; evaluation and reporting of findings.

A queueing theory based model for business continuity in hospitals.

Clinical activities can be seen as results of precise and defined events' succession where every single phase is characterized by a waiting time which includes working duration and possible delay. Technology makes part of this process. For a proper business continuity management, planning the minimum number of devices according to the working load only is not enough.

HTA decision support system for sustainable business continuity management in hospitals. The case of surgical activity at the University Hospital in Florence.

Background: A fundamental element of the social and safety function of a health structure is the need to guarantee continuity of clinical activity through the continuity of technology.

Objective: This paper aims to design a Decision Support System (DSS) for medical technology evaluations based on the use of Key Performance Indicators (KPI) in order to provide a multi-disciplinary valuation of a technology in a health structure.

Methods: The methodology used in planning the DSS followed the following key steps: the definition of relevant KPIs, the development of a database to calculate the KPIs, the calculation of the defined KPIs and the resulting study report.

Five-year results evaluating the effects of platelet-rich plasma on the healing of intrabony defects treated with enamel matrix derivative and natural bone mineral.

Background: Regenerative periodontal surgery using the combination of enamel matrix derivative (EMD) and natural bone mineral (NBM) with and without addition of platelet-rich plasma (PRP) has been shown to result in substantial clinical improvements, but the long-term effects of this combination are unknown.

Methods: The goal of this study was to evaluate the long-term (5-year) outcomes after regenerative surgery of deep intrabony defects with either EMD + NBM + PRP or EMD + NBM. Twenty-four patients were included.

Ten-year results following treatment of intrabony defects with an enamel matrix protein derivative combined with either a natural bone mineral or a β-tricalcium phosphate.

Background: The purpose of the present study is to evaluate the 10-year results following treatment of intrabony defects treated with an enamel matrix protein derivative (EMD) combined with either a natural bone mineral (NBM) or β-tricalcium phosphate (β-TCP).

Methods: Twenty-two patients with advanced chronic periodontitis and displaying one deep intrabony defect were randomly treated with a combination of either EMD + NBM or EMD + β-TCP. Clinical evaluations were performed at baseline and at 1 and 10 years.

Design of a decision support system for preventive maintenance planning in health structures.

The appropriate maintenance of medical devices, including performance inspections and preventive maintenance, is fundamental in mitigating clinical risk caused by adverse events in health care. Although several models for managing and planning preventive maintenance have been developed, the problem is lacking in standard methodology and still presents an open challenge for today's health experts. This paper aims to provide and develop methodology together with support systems able to assist decision makers in constructing preventive maintenance and performance inspection plans, taking into account both the technical and economic needs of hospital clinical engineering departments.

A methodology aimed to guarantee technology continuity in health structures.

In healthcare the importance of clinical continuity is essential for both patients life and health organization activity. Since technology continuity is having more and more importance for the service continuity, a correct management of medical devices must be guided by criteria that ensure its safe, appropriate and economical use through a well planned purchase, appropriate preventive and corrective maintenance Indeed, the aim of health technology managers is to optimize the integration of external interventions assistance and internal technical service to guarantee an efficient and cost-effective maintenance system. This paper proposes an innovative carefully thought methodology which is aimed to provide technological and procedural actions which offer support to decision makers in technology management regarding the implementation of continuity in medical services and response to technology failures and emergency events.