Martina Andellini

Test-retest reliability of graph metrics of resting state MRI functional brain networks: A review.

The employment of graph theory to analyze spontaneous fluctuations in resting state BOLD fMRI data has become a dominant theme in brain imaging studies and neuroscience. Analysis of resting state functional brain networks based on graph theory has proven to be a powerful tool to quantitatively characterize functional architecture of the brain and it has provided a new platform to explore the overall structure of local and global functional connectivity in the brain. Due to its increased use and possible expansion to clinical use, it is essential that the reliability of such a technique is very strongly assessed. In this review, we explore the outcome of recent studies in network reliability which apply graph theory to analyze connectome resting state networks. Therefore, we investigate which preprocessing steps may affect reproducibility the most. In order to investigate network reliability, we compared the test-retest (TRT) reliability of functional data of published neuroimaging studies with different preprocessing steps. In particular we tested influence of global signal regression, correlation metric choice, binary versus weighted link definition, frequency band selection and length of time-series. Statistical analysis shows that only frequency band selection and length of time-series seem to affect TRT reliability. Our results highlight the importance of the choice of the preprocessing steps to achieve more reproducible measurements.

Experimental application of Business Process Management technology to manage clinical pathways: a pediatric kidney transplantation follow up case

BackgroundTo test the application of Business Process Management technology to manage clinical pathways, using a pediatric kidney transplantation as case study, and to identify the benefits obtained from using this technology.MethodsUsing a Business Process Management platform, we implemented a specific application to manage the clinical pathway of pediatric patients, and monitored the activities of the coordinator in charge of the case management during a 6-month period (from June 2015 to November 2015) using two methodologies: the traditional procedure and the one under study.ResultsThe application helped physicians and nurses to optimize the amount of time and resources devoted to management purposes. In particular, time reduction was close to 60%. In addition, the reduction of data duplication, the integrated event management and the efficient data collection improved the quality of the service.ConclusionsThe use of Business Process Management technology, usually related to well-defined processes with high management costs, is an established procedure in multiple environments; its use in healthcare, however, is innovative. The use of already accepted clinical pathways is known to improve outcomes. The combination of these two techniques, well established in their respective areas of application, could represent a revolution in clinical pathway management. The study has demonstrated that the use of this technology in a clinical environment, using a proper architecture and identifying a well-defined process, leads to real benefits in terms of resources optimization and quality improvement.

Neurometabolic Profiling of Ketamine: Changes in Neurotransmitter Pools

Abstract The need for understanding the mechanisms of ketamine action in the brain has pushed research to measure the effect of ketamine on neurotransmitters. In fact, ketamine binds to a variety of receptors, but principally acts at the N-methyl- D -aspartate receptor (NMDAR) thus being responsible for NMDAR blockade and/or hypofunction. This hypofunction can explain connectional and oscillatory abnormalities considered as a consequence of a weakened excitation of inhibitory gamma-aminobutyric acidergic interneurons that synchronize cortical networks and disinhibition of principal cells. The chapter reviews the studies that have investigated about the changes on the neurotransmitter pools until now to provide robust evidences of the most recent theory of the action of ketamine on human and animal brain.