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Demoralization comprises multiple dimensions. Among them, Subjective Incompetence (SI) is the perception of being incapable of appropriate action in demanding circumstances. SI may be an early sign of demoralization preceding hopelessness, thus we aimed at integrating items related to Subjective Incompetence into the clinical assessment of demoralization. We assessed 414 subjects from the general population with the Demoralization Scale, 24 items (DS24) and the Subjective Incompetence Scale, 12 items (SIS12). We used multiple approaches to detect the optimal number of factors and their item structure, then conducted Bayesian Item Response Theory analyses to study item psychometric properties. Item Response Theory models were used to extrapolate latent severity ratings of clinical dimensions. We modelled the DS24 with five factors (Disheartenment, Sense of Failure, Helplessness, Irritability, Loss of Purpose) and the SIS12 with three (Subjective Incompetence, Inability to plan, Inability to Deal). The more complex IRT model had the best predictive value and helped to identify the items with better discrimination properties across the different dimensions. Twenty items were retained and used to develop the combined Demoralization and Subjective Incompetence Scale (DSIS20), which maintained high correlation with raw and latent trait scores of the longer versions. We combined selected items of the DS24 and the SIS12 to develop the DSIS20, a shorter assessment instrument that includes Subjective Incompetence as well as other clinical dimensions of demoralization. Further study may clarify if DSIS20 may be helpful for the early detection of demoralization. [ABSTRACT FROM AUTHOR]

Physical symptoms play an important role in late-life depression and may contribute to residual symptomatology after antidepressant treatment. In this exploratory study, we examined the role of specific bodily dimensions including movement, respiratory functions, fear of falling, cognition, and physical weakness in older people with depression. Clinically stable older patients with major depression within a Psychiatric Consultation-Liaison program for Primary Care underwent comprehensive assessment of depressive symptoms, instrumental movement analysis, dyspnea, weakness, activity limitations, cognitive function, and fear of falling. Network analysis was performed to explore the unique adjusted associations between clinical dimensions. Sadness was associated with worse turning and walking ability and movement transitions from walking to sitting, as well as with worse general cognitive abilities. Sadness was also connected with dyspnea, while neurovegetative depressive burden was connected with activity limitations. Limitations of motor and cognitive function, dyspnea, and weakness may contribute to the persistence of residual symptoms of late-life depression. [ABSTRACT FROM AUTHOR]

Novel ceramic foams loaded with Fe and Fe/Mn oxides were developed via geopolymerization process as catalysts for tar removal in syngas cleaning operations. The foams were realized through polymer scaffold template replica, by impregnating polyurethane or cellulose foams with a metakaolin based geopolymer slurry loaded with 19 wt% powdered Fe 2 O 3 and Mn 2 O 3 metal oxides. A thermal treatment up to 900 °C was applied to vitrify and partially crystallize into leucite the geopolymer binder. Foams from cellulose showed better structural properties compared to those from polyurethane. Preliminary test in real gasification conditions were carried out on a lab scale double fixed bed reactor. In working conditions, vitrified phases derived from geopolymer binder promoted the formation of mixed phases of (Fe, Mn) oxides and silicates, beneficial for improving the catalytic activity. Furthermore, foams loaded with mixed Fe-Mn oxides were more effective than granules in reducing the produced tar. [ABSTRACT FROM AUTHOR]

The aim of the study was to build a machine learning-based predictive model to discriminate between hospitalized patients at low risk and high risk of bloodstream infection (BSI). A Data Mart including all patients hospitalized between January 2016 and December 2019 with suspected BSI was built. Multivariate logistic regression was applied to develop a clinically interpretable machine learning predictive model. The model was trained on 2016–2018 data and tested on 2019 data. A feature selection based on a univariate logistic regression first selected candidate predictors of BSI. A multivariate logistic regression with stepwise feature selection in five-fold cross-validation was applied to express the risk of BSI. A total of 5660 hospitalizations (4026 and 1634 in the training and the validation subsets, respectively) were included. Eleven predictors of BSI were identified. The performance of the model in terms of AUROC was 0.74. Based on the interquartile predicted risk score, 508 (31.1%) patients were defined as being at low risk, 776 (47.5%) at medium risk, and 350 (21.4%) at high risk of BSI. Of them, 14.2% (72/508), 30.8% (239/776), and 64% (224/350) had a BSI, respectively. The performance of the predictive model of BSI is promising. Computational infrastructure and machine learning models can help clinicians identify people at low risk for BSI, ultimately supporting an antibiotic stewardship approach. [ABSTRACT FROM AUTHOR]

Single sided deafness (SSD) is characterized by significant sensorineural hearing loss, severe or profound, in only one ear. SSD adversely affects various aspects of auditory perception, including causing impairment in sound localization, difficulties with speech comprehension in noisy environments, and decreased spatial awareness, resulting in a significant decline in overall quality of life (QoL). Several treatment options are available for SSD, including cochlear implants (CI), contralateral routing of signal (CROS), and bone conduction devices (BCD). The lack of consensus on outcome domains and measurement tools complicates treatment comparisons and decision-making. This narrative overview aims to summarize the treatment options available for SSD in adult and pediatric populations, discussing their respective advantages and disadvantages. Rerouting devices (CROS and BCD) attenuate the effects of head shadow and improve sound awareness and signal-to-noise ratio in the affected ear; however, they cannot restore binaural hearing. CROS devices, being non-implantable, are the least invasive option. Cochlear implantation is the only strategy that can restore binaural hearing, delivering significant improvements in speech perception, spatial localization, tinnitus control, and overall QoL. Comprehensive preoperative counseling, including a discussion of alternative technologies, implications of no treatment, expectations, and auditory training, is critical to optimizing therapeutic outcomes. [ABSTRACT FROM AUTHOR]

A 33-year-old woman with a prior history of small-incision lenticule extraction (SMILE) presented with gradual deterioration of vision in her right eye since the surgery. She had undergone bilateral SMILE for myopic correction ((7.00 diopters [D] in the right eye and (6.00 D in the left eye) 3 weeks prior. SMILE was performed with a Zeiss VisuMax femtosecond laser system, with a cap thickness of 120 µm, a cap diameter of 7.50 mm, and a lenticule diameter of 6.50 mm. At the completion of the surgery, loose epithelium was noted at the SMILE incision bilaterally, and bandage contact lenses were placed in both eyes. On the first postoperative day, the patient’s uncorrected distance visual acuity (UDVA) was 20/40 in both eyes. The bandage lenses were removed from both eyes, with the epithelium intact. At the first-week postoperative visit, her visual acuity was recorded as 20/30 in the right eye and 20/20 in the left eye. She noticed her vision in the right eye was not as sharp as that in her left eye. She denied experiencing any pain, redness, or ocular surface irritations. She was advised to return to the clinic for a 1-month postoperative visit and continue with aggressive lubrication in both eyes. However, a week later, the patient returned for an emergency visit, citing significant central visual distortion in the right eye and difficulty working on the computer. At this visit, her UDVA and corrected distance visual acuity (CDVA) was 20/50 in the right eye and 20/15 in the left eye at both near and far distances. A slitlamp examination revealed mild central changes in the right eye. She once again denied any pain, redness, or irritation. She was advised to continue with artificial tears and return to the office in 1 week for further observation of the central distortion in her right eye. Upon returning to the clinic at the third postoperative week, the patient still complained of central visual changes in the right eye, with a visual acuity of 20/70. Further slitlamp examination revealed a nonspecific central haze in the same eye, but there was no corneal staining or signs of epithelial defects. Anterior segment ocular coherence tomography (AS-OCT) and NIDEK topography were performed, showing the same central distortion in the right eye (Figures 1 and 2). Based on the examination and images provided, what is your working medical diagnosis? What other medical conditions are in your differential diagnosis? What medical and/or surgical interventions would you recommend, if any? [ABSTRACT FROM AUTHOR]

New inorganic nanostructured matrices for fiber-reinforced composites with enhanced high-temperature stability were developed from alkali aluminosilicate polymers doped with different ultra-high-temperature ceramic (UHTC) particles. The alkali aluminosilicate matrices were synthesized at room temperature with a high SiO2:Al2O3 ratio and then further functionalized by doping with 4–5 wt % of micrometric SiC, ZrB2, ZrC, and HfC powders and finally thermally stabilized as glass–ceramics at 750 °C. The different UHTC-doped matrices were characterized according to their dimensional and microstructural changes after thermal cycling in air flux at 1000 °C. The first results showed that carbide-based UHTC powders improved the thermal stability of the matrices, preventing the excessive swelling of the material and the formation of detrimental voids that might result in the lack of adhesion with reinforcing fibers. Contrarily, the addition of ZrB2 resulted in an excessive matrix swelling at high temperature, thus proving no efficacy compared to the undoped matrix. Impregnation tests carried out on C-fiber fabrics showed good processability, adhesion to the fibers, and fracture pull-out, especially for carbide-based matrices. [ABSTRACT FROM AUTHOR]

Aim: To estimate the treated incidence of individuals with first‐episode psychosis (FEP) who contacted the Emilia‐Romagna public mental healthcare system (Italy); to examine the variability of incidence and user characteristics across centres and years. Methods: We computed the raw treated incidence in 2013–2019, based on FEP users aged 18–35, seen within or outside the regional program for FEP. We modelled FEP incidence across 10 catchment areas and 7 years using Bayesian Poisson and Negative Binomial Generalized Linear Models of varying complexity. We explored associations between user characteristics, study centre and year comparing variables and socioclinical clusters of subjects. Results: Thousand three hundred and eighteen individuals were treated for FEP (raw incidence: 25.3 / 100.000 inhabitant year, IQR: 15.3). A Negative Binomial location‐scale model with area, population density and year as predictors found that incidence and its variability changed across centres (Bologna: 36.55; 95% CrI: 30.39–43.86; Imola: 3.07; 95% CrI: 1.61–4.99) but did not follow linear temporal trends or density. Centers were associated with different user age, gender, migrant status, occupation, living conditions and cluster distribution. Year was associated negatively with HoNOS score (R = −0.09, p <.001), duration of untreated psychosis (R = −0.12, p <.001) and referral type. Conclusions: The Emilia‐Romagna region presents a relatively high but variable incidence of FEP across areas, but not in time. More granular information on social, ethnic and cultural factors may increase the level of explanation and prediction of FEP incidence and characteristics, shedding light on social and healthcare factors influencing FEP. [ABSTRACT FROM AUTHOR]

Simple Summary: Operation Phalco is an experimental training protocol for breast cancer survivors implemented through a network of oncologists, sports medicine physicians and kinesiologists. The aim of this research is to evaluate the effects of an online adapted physical activity protocol with respect to a usual care on functional capacity, fatigue and quality of life of breast cancer patients. The protocol was structured by taking into account both cancer-related issues and the presence of comorbidities detected in the enrolled patients. For this reason, the patients recruited in the oncology centers of Rome and Verona were divided into three risk levels based on the risk stratification carried out by a sports medicine physician during a medical examination. The results evidenced the positive impact of a well-adapted physical activity on breast cancer patients' quality of life, suggesting that this program should be included as early as possible in the cancer patient's care process. The international literature emphasizes the importance of physical activity (PA) in the first steps after cancer surgery. The regular practice of physical exercise causes positive adaptations on several functional capacities, with positive consequences on patients' quality of life. This project aims to evaluate the effect of a post-operative training protocol, structured by taking into account both cancer-related issues and the presence of comorbidities, on functional capacities and quality of life of breast cancer survivors. Therefore, it was necessary to create a synergy between oncologists (referring physicians), sport medicine physicians (risk stratification and exercise prescription) and kinesiologists (trainers). Thirty-five post-surgery BC patients decided on a voluntary basis to attend an online Adapted PA (APA) protocol for 4 months, twice a week (APA Group) or Usual Care Group (UC Group). Functional capacity of the APA Group significantly increased, by 13.1% (p = 0.000), whereas perceived exertion decreased by 19.7% (p = 0.020). In the same group, the general health evaluated through the questionnaire EORTC-QLQ-C30 increased (p = 0.050). No differences were found in the UC Group. Operation Phalco, creating a network between oncologists, sports medicine physicians and kinesiologists, confirms the importance of structuring a post-operative path where APA should be included as early as possible in the cancer patient care. [ABSTRACT FROM AUTHOR]

In many natural and technological systems the rule that governs the system’s dynamics changes over time. In such switched systems the system’s switching can be a significant source of instability. Here we give a simple sufficient criterium to determine if an i.i.d. stochastically switched system is stable in expectation. This method extends recent results for linear switched systems to nonlinear switched systems. It also extends results known for general switched systems giving improved results for systems with i.i.d. stochastic switching. The paper also considers the effects of time-delays on the stability of switched systems. Such time delays, which are intrinsic to any real-world system, can also have a destabilising effect on the system’s dynamics. Previously, it has been shown that if a dynamical system is intrinsically stable, which is a stronger form of global stability, then it maintains its stability even when time-delays are introduced into the system. Here we extend this notion to stochastically switched systems. We refer to this type of stability as patient stability and give a simple sufficient criterium under which such systems are patiently stable, i.e. cannot be destabilised by time delays. Both criteria introduced in this paper side step the need to use Lyapunov, linear matrix inequalities, and semi-definite programming-type methods. Our examples in this paper demonstrate the simplicity of these criteria. [ABSTRACT FROM AUTHOR]

Unsorted Construction and Demolition Waste (CDW) from residential building was tested as solid precursor for obtaining eco-sustainable alkali activated materials with potential applications in the building industry. Suitable reactive systems for material consolidation were tested, including alkaline solutions of sodium hydroxides and/or silicates at different concentrations. Metakaolin (MK) was also tested as an additional precursor together with CDW in different ratios to optimize geopolymerization. An MK/CDW weight ratio of 40/60 and sodium silicate as alkaline activator allowed the production of a well-reacted and cohesive material, with a bulk density of 1.35 g/cm3, a monomodal mesoporosity with a modal pore size of 0.0214 µm (open porosity ∼42 vol%), and a compressive strength of 25 MPa, thus showing similar features to those of pure metakaolin based-geopolymers. Thermal characterization was performed up to 1000°C showing that the material can exhibit thermal stability up to 650°C. Above that temperature a shrinkage due to viscous flow occurred, followed by an expansion over 750°C with the formation of macropores and dense struts. Based on these results, the developed CDW-based geopolymer has the potential for use in green building applications, with adequate thermal stability up to medium-high temperatures. • Unsorted CDW was used as solid precursor for eco-sustainable AAMs. • Several alkaline solutions and CDW/metakaolin ratios were tested for consolidation. • Effects of relevant parameters and microstructural properties were investigated. • The thermal behavior of CDW/MK-based geopolymer was investigated up to 1000°C. • The optimized geopolymer exhibited a 28-days compressive strength of 25 MPa and thermal stability up to 650°C. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic rapidly spread through Europe in the first months of 2020. On the 9th of March 2020, the Italian government ordered a national lock-down. The study's objectives were: to investigate the effect of lockdown on CI users; and to detect the difference in the perception of discomfort existing between unilateral cochlear implant (UCI) users and bilateral cochlear implant (BCI) users, due to the lockdown experience. Methods: A 17-item, web-based, anonymous online survey was administered to 57 CI users, exploring hearing performance, emotions, practical issues, behavior, and tinnitus. Participation in the study was voluntary. Results: all CI users obtained an abnormal score in all questionnaire themes. For the emotion theme and the practical issue theme, the age range 61–90 showed a significant difference between UCI and BCI users in favor of BCI users (emotion theme: UCI mean = 3.9, BCI mean = 2.3, p = 0.0138; practical issues: UCI mean = 4, BCI mean = 3, p = 0.0031). Conclusions: CI users experienced the lockdown negatively as regards behavior, emotions, hearing performance, and in practical issues. CI subjects with UCI in old age suffered more from the experience of lockdown than subjects with BCI in the same age, with regards to emotions and practical issues. [ABSTRACT FROM AUTHOR]

Introduction Bone anchored hearing solutions are a well-known option for patients with a conductive, mixed conductive-sensorineural hearing loss and those with singlesided deafness. Objective The aim of the present study was to evaluate the Ponto bone-anchored hearing system in terms of behavioral performance and self-reported outcomes, by comparing unaided and aided performance (softband and abutment), as well as aided performance with the sound processor on softband (preoperatively) versus abutment (postoperatively). Methods Fourteen adult bone-anchored candidates, with either a bilateral (n = 12) or unilateral (n = 2) conductive or mixed hearing loss, participated in the present study. Sound-field hearing thresholds were evaluated unaided and aided (softband and abutment). A speech-in-noise test was also performed unaided and aided for two spatial configurations (S0N90; implanted side; S0N90; nonimplanted side). The Glasgow Health Status Inventory and the Speech, Spatial and Quality of sound questionnaires were administered pre- and postsurgery to compare quality of life and perceived unaided and aided performance. Skin reaction (Holgers scores) was evaluated at 15 days, 6 weeks, and 10 weeks after surgery. Results Significant improvements postoperatively relative to unaided were obtained for sound-field thresholds at all tested frequencies. Additionally, sound-field thresholds were significantly improved with the sound processor on abutment relative to the softband at frequencies > 1 kHz. Improved performance postoperatively relative to unaided was also obtained in the speech-in-noise test and in self-reported outcomes. Conclusions Improvements in behavioral performance and self-reported outcomes were obtained with the sound processor mounted on abutment. [ABSTRACT FROM AUTHOR]

Simple Summary: Breast cancer is one of the most common cancers worldwide and the leading cause of cancer death in women. Screening, early diagnosis, and surgical techniques might increase patients' survival, leading to a rise in the health-related consequences of anti-neoplastic therapies, such as cardiotoxicity following anthracycline treatments. Alongside conventional therapies, physical activity seems to reduce treatment side effects, improving quality of life either after a breast cancer diagnosis or in the early steps post-surgery. This review offers a general framework for the role of anthracycline in the physio-pathological mechanisms of cardiotoxicity and the effect of exercise on cancer treatment side effects. Moreover, we propose the type and the timing of exercise to better assist patients and reduce the pressure on the health care system in breast cancer patients undergoing anthracycline. The increase in breast cancer (BC) survival has determined a growing survivor population that seems to develop several comorbidities and, specifically, treatment-induced cardiovascular disease (CVD), especially those patients treated with anthracyclines. Indeed, it is known that these compounds act through the induction of supraphysiological production of reactive oxygen species (ROS), which appear to be central mediators of numerous direct and indirect cardiac adverse consequences. Evidence suggests that physical exercise (PE) practised before, during or after BC treatments could represent a viable non-pharmacological strategy as it increases heart tolerance against many cardiotoxic agents, and therefore improves several functional, subclinical, and clinical parameters. At molecular level, the cardioprotective effects are mainly associated with an exercise-induced increase of stress response proteins (HSP60 and HSP70) and antioxidant (SOD activity, GSH), as well as a decrease in lipid peroxidation, and pro-apoptotic proteins such as Bax, Bax-to-Bcl-2 ratio. Moreover, this protection can potentially be explained by a preservation of myosin heavy chain (MHC) isoform distribution. Despite this knowledge, it is not clear which type of exercise should be suggested in BC patient undergoing anthracycline treatment. This highlights the lack of special guidelines on how affected patients should be managed more efficiently. This review offers a general framework for the role of anthracyclines in the physio-pathological mechanisms of cardiotoxicity and the potential protective role of PE. Finally, potential exercise-based strategies are discussed on the basis of scientific findings. [ABSTRACT FROM AUTHOR]

We discuss difficulties of evaluating partisan gerrymandering in the congressional districts in Utah and the failure of many common metrics in Utah. We explain why the Republican vote share in the least-Republican district (LRVS) is a good indicator of the advantage or disadvantage each party has in the Utah congressional districts. Although the LRVS only makes sense in settings with at most one competitive district, in that setting it directly captures the extent to which a given redistricting plan gives advantage or disadvantage to the Republican and Democratic parties. We use the LRVS to evaluate the most common measures of partisan gerrymandering in the context of Utah's 2011 congressional districts. We do this by generating large ensembles of alternative redistricting plans using Markov chain Monte Carlo methods. We also discuss the implications of this new metric and our results on the question of whether the 2011 Utah congressional plan was gerrymandered. [ABSTRACT FROM AUTHOR]

Aim: To examine the incidence of with first‐episode psychosis (FEP) in the Integrated Department of Mental Health and Pathological Addictions in Ferrara, Italy, and to examine the association between the Duration of Untreated Psychosis (DUP) and the clinical course. Methods: Participants recruited in 2013–2019 were assessed with the Health of the Nation Outcome Scale (HoNOS) every 6 months for 24 months. Hierarchical growth models analysed changes of global severity (HoNOS total scores) and symptom dimensions. Regression modelled factors associated with remission (HoNOS < 8) and clinical improvement (<12). Results: The incidence of FEP was 21.5 (95%CI: 21.2–21.9) cases per 100 000 person year. Among participants (n = 86, mean age 23, 76% males), baseline HoNOS scores were higher for those with a longer DUP. More than half subjects reached clinical remission (61.6%) or improvement (82.6%), while very few (2.3%) were re‐hospitalized. HoNOS total scores decayed with a mixed linear/quadratic trend, with a slower decay among migrants. A longer DUP was associated with reduced improvements of positive symptoms and lower likelihood of clinical improvement (OR: 0.84; 95%CI: 0.73–0.96). Conclusions: Patients from the FEP program of Ferrara reached good clinical outcomes. Nonetheless, individuals with a longer DUP may need additional clinical attention. Systematic monitoring of clinical outcomes may be an optimal strategy to improve the outcomes of FEP in the real world. [ABSTRACT FROM AUTHOR]

Objects: This study aimed to evaluate the Executive Function (EF) domains in a group of profoundly deaf children treated with cochlear implant (CI) in comparison to normal hearing (NH) children. The secondary aim was to evaluate the influence exerted by the age at cochlear implant activation on EFs. Materials and Methods: 32 children were enrolled into two groups: group A of 17 CI users with a mean age of 8.78 years and group B of 15 NH subjects with a mean age of 7.99 years (SD + 2.3). All subjects were tested using the following tests: the subtests for working memory of the neuropsychological evaluation battery for the developmental age (Batteria di valutazione neuropsicologica per l'età evolutive), inhibition and control of the impulsive response--CAF, and the tower of London test. Results: No children with CIs scored within the normal range in the tests administered for the evaluation of EF domains. The same scores were significantly lower when compared with scores obtained by NH children. Children with younger age at CI activation showed better executive performances in planning, working memory (backward digit span), and cognitive flexibility (categorical fluency). Conclusion: The results of this study highlight that cochlear implantation plays a role in improving hearing and consequently influences the development of EFs in deaf children. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic is impressively challenging the healthcare system. Several prognostic models have been validated but few of them are implemented in daily practice. The objective of the study was to validate a machine-learning risk prediction model using easy-to-obtain parameters to help to identify patients with COVID-19 who are at higher risk of death. The training cohort included all patients admitted to Fondazione Policlinico Gemelli with COVID-19 from March 5, 2020, to November 5, 2020. Afterward, the model was tested on all patients admitted to the same hospital with COVID-19 from November 6, 2020, to February 5, 2021. The primary outcome was in-hospital case-fatality risk. The out-of-sample performance of the model was estimated from the training set in terms of Area under the Receiving Operator Curve (AUROC) and classification matrix statistics by averaging the results of fivefold cross validation repeated 3-times and comparing the results with those obtained on the test set. An explanation analysis of the model, based on the SHapley Additive exPlanations (SHAP), is also presented. To assess the subsequent time evolution, the change in paO2/FiO2 (P/F) at 48 h after the baseline measurement was plotted against its baseline value. Among the 921 patients included in the training cohort, 120 died (13%). Variables selected for the model were age, platelet count, SpO2, blood urea nitrogen (BUN), hemoglobin, C-reactive protein, neutrophil count, and sodium. The results of the fivefold cross-validation repeated 3-times gave AUROC of 0.87, and statistics of the classification matrix to the Youden index as follows: sensitivity 0.840, specificity 0.774, negative predictive value 0.971. Then, the model was tested on a new population (n = 1463) in which the case-fatality rate was 22.6%. The test model showed AUROC 0.818, sensitivity 0.813, specificity 0.650, negative predictive value 0.922. Considering the first quartile of the predicted risk score (low-risk score group), the case-fatality rate was 1.6%, 17.8% in the second and third quartile (high-risk score group) and 53.5% in the fourth quartile (very high-risk score group). The three risk score groups showed good discrimination for the P/F value at admission, and a positive correlation was found for the low-risk class to P/F at 48 h after admission (adjusted R-squared = 0.48). We developed a predictive model of death for people with SARS-CoV-2 infection by including only easy-to-obtain variables (abnormal blood count, BUN, C-reactive protein, sodium and lower SpO2). It demonstrated good accuracy and high power of discrimination. The simplicity of the model makes the risk prediction applicable for patients in the Emergency Department, or during hospitalization. Although it is reasonable to assume that the model is also applicable in not-hospitalized persons, only appropriate studies can assess the accuracy of the model also for persons at home. [ABSTRACT FROM AUTHOR]

Very few studies have focused on the relationship between cognitive functions and clinical features in borderline personality disorder (BPD). Subjects with BPD and healthy controls were administered the Repeatable Battery for the Assessment of Neuropsychological Status, Trail Making Test A and B, and the Wisconsin Card Sorting Test. The Brief Symptom Inventory (BSI-53) was used to assess the severity of current symptoms. Attachment style was assessed with the Experiences in Close Relationship Questionnaire, identity integration with the Personality Structure Questionnaire, and other domains of personality dysfunction with the RUDE Scale for Personality Dysfunction. Patients with BPD performed significantly worse than healthy controls in all cognitive domains. Cognitive functions, particularly delayed memory and visuospatial abilities, displayed meaningful associations with trait-like clinical features, above the effect of global cognition and state psychopathology. These findings highlight the need to evaluate effects of cognitive rehabilitation on trait features among individuals with BPD. [ABSTRACT FROM AUTHOR]

Very few studies have focused on the relationship between cognitive functions and clinical features in borderline personality disorder (BPD). Subjects with BPD and healthy controls were administered the Repeatable Battery for the Assessment of Neuropsychological Status, Trail Making Test A and B, and the Wisconsin Card Sorting Test. The Brief Symptom Inventory (BSI-53) was used to assess the severity of current symptoms. Attachment style was assessed with the Experiences in Close Relationship Questionnaire, identity integration with the Personality Structure Questionnaire, and other domains of personality dysfunction with the RUDE Scale for Personality Dysfunction. Patients with BPD performed significantly worse than healthy controls in all cognitive domains. Cognitive functions, particularly delayed memory and visuospatial abilities, displayed meaningful associations with trait-like clinical features, above the effect of global cognition and state psychopathology. These findings highlight the need to evaluate effects of cognitive rehabilitation on trait features among individuals with BPD. [ABSTRACT FROM AUTHOR]

Rutile is often found as inclusions in garnet, quartz, and several other rock-forming minerals, and it is also a common accessory phase in high-pressure metamorphic rocks. Its relatively simple structure, chemistry, broad P-T stability field, and its wide occurrence in nature makes it a candidate for the application of elastic geobarometry. However, thermodynamic studies coupled with observations on natural samples predict that rutile inclusions in garnets should exhibit zero residual pressure. This implies that the rutile inclusions are detached from the inclusion walls in the host garnet after entrapment. We determined the elastic and vibrational properties of rutile via ab initio hybrid Hartree-Fock/ Density Functional Theory simulations under different strain states. Our results confirmed the thermodynamic behavior of rutile in garnet and allowed us to determine for the first time the components of the phonon-mode Grüneisen tensors of rutile. We demonstrated that pure rutile inclusions in garnets from metamorphic rocks exhibit no residual strain or stress, consistent with thermodynamic modeling. Nevertheless, there are rutile inclusions in garnet surrounded by optical birefringence haloes, which are indicative of residual inclusion pressures. Careful examination of these show that they contain significant amounts of amphibole, which reduce the elastic moduli of the composite inclusion to less than that of the garnet hosts. A calculation method for the residual pressures of multi-phase inclusions is described. [ABSTRACT FROM AUTHOR]

This retrospective analysis at a major Italian university hospital (January 2018–September 2022) assessed the prognostic significance of fever in patients with bloodstream infections (BSIs). Of the 1299 patients with positive blood cultures, a comparison between febrile and afebrile patients at emergency department admission was conducted. This study particularly focused on the mortality rates associated with these two groups. Notably, afebrile patients exhibited a higher mortality rate. The odds ratio for mortality in afebrile patients was significantly higher compared to febrile patients. This suggests that the absence of fever might be an indicator of increased mortality risk, highlighting the complexity of diagnosing bloodstream infections based on fever presence. This study contributes to the understanding of fever as a diagnostic marker in emergency settings. [ABSTRACT FROM AUTHOR]

Aim: The fully implantable middle ear implant (C-FI-MEI) is designed for patients with moderate-to-severe sensorineural hearing loss or those with mixed hearing loss. To analyze the audiological post-operative results of subjects bilaterally implanted with C-FI-MEI. Materials and methods: Retrospective study: 14 patients with bilateral, moderate-to-severe, sensorineural or mixed hearing loss were treated. This clinical sample included 14 cases bilaterally implanted (13 sequentially, 1 simultaneously). The evaluation at each follow-up after surgery included otologic examination, a structured interview, and different audiological tests composed of pure tone audiometry, speech in quiet and in noise test, and localization task. The mean follow-up was 67.2 ± 33 months. Results: There were no significant differences between pre and post-operative pure tone averages. The patients showed no significant differences between pre-operatively aided and C-FI-MEI implant-aided conditions in terms of word recognition score. Speech perception in noise under different loudspeaker arrangements and localization tests demonstrated a binaural advantage in bilaterally implanted patients. The mean daily use time was 17.4 and 16.7 h, respectively, for right and left side. Conclusion: The results for the 14 patients, bilaterally implanted with C-FI-MEI, suggest that bilateral implantation of fully implantable middle ear hearing devices is an effective procedure. Level of evidence: 4. [ABSTRACT FROM AUTHOR]

Sensory processing is a fundamental aspect of  human experience, and varies significantly between individuals, potentially affecting individual functioning, behaviour, and mental health. This study investigated the associations between sensory processing and psychopathology in a sample of the general population. Participants responded to a general psychiatric screening tool (DSM-5 Self-Rated Level 1 Cross-Cutting Symptom Measure-Adult) and to the Adolescent/Adult Sensory Profile (AASP) questionnaire. The sample comprised 1108 young adults (77.25% females, mean age 22.6). Data were analysed using item response theory and Bayesian network analyses, revealing specific associations between sensory profiles and psychopathological dimensions. Specifically, we detected associations between the low registration sensory profile and the dimensions of psychosis, substance use, and mania. Sensation seeking was associated with mania. Sensory sensitivity was related to depression and mania, while sensation avoiding was inversely correlated with mania. These findings suggest that reduced external sensory awareness may be linked to a predisposition to psychosis, while a multifaceted sensory processing pattern may indicate vulnerability to mood disorders. Assessing sensory processing could yield crucial insights into individual susceptibilities to mental disorders and help identify targeted preventive and therapeutic strategies [ABSTRACT FROM AUTHOR]

Objective: In the present study, we aimed to assess hostility and to examine its association with formal psychiatric diagnosis, coping, cancer worries, and quality of life in cancer patients.Methods: The World Health Organization (WHO) Composite International Diagnostic Interview (CIDI) to make an ICD-10 (International Classification of Disease) psychiatric diagnosis was applied to 516 cancer outpatients. The patients also completed the Brief Symptom Inventory-53 to assess hostility (BSI-HOS), and the Mini-Mental Adjustment to cancer scale (Mini-MAC). A subset of patients completed the Cancer Worries Inventory (CWI), the Openness Scale, and the Quality of Life Index.Results: By analyzing the distribution of the responses 25% of the patients had moderate and 11% high levels of hostility, with about 20% being BSI-HOS "cases." Hostility was higher in patients with a formal ICD-10 psychiatric diagnosis (mainly major depression, other depressive disorders, anxiety disorders) than patients without ICD-10 diagnosis. However, about 25% of ICD-10-non cases also had moderate-to-high hostility levels. Hostility was associated with Mini-MAC hopelessness and anxious preoccupation, poorer quality of life, worries (mainly problems sin interpersonal relationships), and inability to openly discuss these problems within the family.Conclusions: Hostility and its components should be considered as dimensions to be more carefully explored in screening for distress in cancer clinical settings for its implications in negatively impacting on quality of life, coping and relationships with the family, and possibly the health care system. [ABSTRACT FROM AUTHOR]

• Mortality due to bloodstream infections is increased in geriatric patients. • Elderly and oldest old show different susceptibility to distinct pathogens. • MRSA and Enterococcus spp strongly affect survival in oldest old patients. Bloodstream infections (BSIs) are a major cause of mortality in elderly. Objective of the study is to identify factors predictive of mortality in old and oldest old patients. This is a single centre retrospective observational study, including all patients admitted to Fondazione Policlinico A. Gemelli university hospital and diagnosed with BSI. Patients were stratified into three groups according to age: adult (A), younger than 65; old (O), aged between 65 and 80; oldest old (OO), older than 80. Primary outcome was 30-day in-hospital mortality. Secondary outcomes were duration of antimicrobial therapy (DOT) and length of hospital stay (LOS). Of the 1034 patients included in the study, 346 were in group A, 447 in group O and 241 in group OO. The rate of 30-day mortality raised from 6.9% (24/346) in group A to 10.8% (84/447) in group O and 33.2% (80/241) in group OO (p<0.01), while DOT and LOS significantly decreased moving from adults to oldest old (p<0.01). Methicillin-resistant Staphylococcus aureus (MRSA) and Enterococcus spp were both independently correlated to an increased 30-day mortality risk selectively in patients older than 80 (MRSA: HR 2.37, p=0.03; Enterococcus spp: HR 2.44, p=0.01). BSIs have a high impact on survival in old and oldest old patients. BSIs by gram-positive pathogens, in particular MRSA and Enterococcus spp, should be a wake-up call for physicians, who should focus efforts on adequate and prompt antibiotic and support treatment. [ABSTRACT FROM AUTHOR]

Clinical use of topical ascorbic acid solution could have both the role as an adjunct to consolidated therapies and as an alternative to them, for the treatment of BCC and SCC of the skin. [ABSTRACT FROM AUTHOR]

Most diseases of oral mucosa are either autoimmune in nature or are the results of immunologically mediated events. The diseases with autoimmune pathogenesis are namely pemphigus and pemphigoid; the oral involvement is frequent or regularly observed in these diseases. The treatments with traditional drugs or biologic agents or combinations of these molecules are employed in clinical practice. New therapeutic targets aim to provide new treatment strategies that may go beyond nonspecific immunosuppression. [ABSTRACT FROM AUTHOR]

Background: The increasing availability of high-potency cannabis-derived compounds and the use of synthetic cannabinoids may be responsible for severe side effects like cognitive impairment, psychosis or self-injurious behaviours (SIB). In particular, SIB like non-suicidal self-injury (NSSI) and deliberate self-harm (DSH) raise growing concern as a possible consequence of cannabis use. However, the research to date has not addressed the relationship between cannabinoid use and SIB systematically.Methods: We conducted a systematic review on PubMed up to March 2020, using search terms related to cannabinoids and SIB.Results: The search yielded a total of 440 abstracts. Of those, 37 studies published between 1995 and 2020 were eligible for inclusion. Cannabinoid use was significantly associated with SIB at the cross-sectional (OR=1.569, 95%CI [1.167-2.108]) and longitudinal (OR=2.569, 95%CI [2.207-3.256]) level. Chronic use, presence of mental disorders, depressive symptoms, emotional dysregulation and impulsive traits might further increase the likelihood of self-harm in cannabis users. Synthetic cannabinoids may trigger highly destructive SIB mainly through the psychotomimetic properties of these compounds.Conclusion: Cannabinoid use was associated with an increased prevalence of self-injury and may act as a causative factor with a duration-dependent manner. Emotional regulation and behavioural impulsivity functions might crucially moderate this association. Future studies should further investigate the mechanisms underlying this association, while exploring potential therapeutic applications of substances modulating the endocannabinoid system. [ABSTRACT FROM AUTHOR]

Purpose: Appendicitis is the most frequent urgency in pediatric age; the aim of this study was to investigate the association of quarantine for severe acute respiratory syndrome coronavirus 2 pandemic and the incidence of pediatric appendicitis in a specific macro area. Methods: We retrospectively analyzed the medical records of consecutive patients who underwent surgical exploration for acute appendicitis in the period March-April since 2014. This specific quarantine period was divided into two phases as indicated by National government. Patient data, demographics, characteristics and outcomes were studied and evaluated comparing patients treated during quarantine especially phase 1 vs. phase 2 (March-April 2020). Results: After reviewing medical charts following the inclusion and exclusion criteria, 155 patients were studied; focusing on the final outcome, it is possible to show a decreased amount of appendicitis during phase 1 and a progressive increase during phase 2; respect to previous years, there was a statistical increase in severity of appendicitis during quarantine (gangrenous vs. phlegmonous appendicitis). Conclusion: During this specific quarantine there was a reduction in appendicitis and a progressive increase during phase 2. These results offer new perspective among disease incidences during lockdown. [ABSTRACT FROM AUTHOR]

Cognitive impairments have profound implications for the management of severe mental disorders; however, they are rarely assessed in everyday clinical practice due to constraints in time, resource and expertise. Novel and short instruments, such as the Screen for Cognitive Impairment in Psychiatry (SCIP), which overcome such limitations are greatly needed. The study aims to assess the validity and reliability, among healthy subjects, of the Italian translation of the SCIP, a brief, accessible tool to detect cognitive impairments among individuals suffering from mental disorders, as the first step to validate the instrument in clinical settings. One-hundred and twenty healthy subjects completed two of the three alternative forms of the SCIP. Cronbach Alpha (0.70) supported the reliability of the SCIP scores. Correlation coefficients supported the test–retest reliability of the tool. Learning effects were observed despite the use of alternative forms. Factor analysis indicated a two-factor solution explaining 55.4% of the total variance: the first factor ("memory") loading for VLT-I and VLT-D and less for WMT; the second factor ("executive function") loading for VFT and PST and less for WMT. The study proved the validity and reliability of the Italian version of the SCIP as a reliable and simple instrument to screen for cognitive impairment in the general population. [ABSTRACT FROM AUTHOR]

Introduction: Depression and demoralization are highly prevalent among individuals with physical illnesses but their relationship is still unclear.Objective: To examine the relationship between clinical features of depression and demoralization with the network approach to psychopathology.Methods: Participants were recruited from the medical wards of a University Hospital in Italy. The Demoralization Scale (DS) was used to assess demoralization, while the Patient Health Questionnaire-9 (PHQ-9) to assess depressive symptoms. The structure of the depression-demoralization symptom network was examined and complemented by the analysis of topological overlap and Exploratory Graph Analysis (EGA) to identify the most relevant groupings (communities) of symptoms and their connections. The stability of network models was estimated with bootstrap procedures and results were compared with factor analysis.Results: Life feeling pointless, low mood/discouragement, hopelessness and feeling trapped were among the most central features of the network. EGA identified four communities: (1) Neurovegetative Depression, (2) Loss of purpose, (3) Frustrated Isolation and (4) Low mood and morale. Loss of purpose and low mood/morale were largely connected with other communities through anhedonia, hopelessness and items related to isolation and lack of emotional control. Results from EGA displayed good stability and were comparable to those from factor analysis.Limitations: Cross-sectional design; sample heterogeneity CONCLUSIONS: Among general hospital inpatients, features of depression and demoralization are independent, with the exception of low mood and self-reproach. The identification of symptom groupings around entrapment and helplessness may provide a basis for a dimensional characterization of depressed/demoralized patients, with possible implications for treatment. [ABSTRACT FROM AUTHOR]

In the face of the rapid evolution of the COVID-19 pandemic, healthcare professionals on the frontline are in urgent need of frequent updates in the accomplishment of their practice. Hence, clinicians started to search for prompt, valid information on sources that are parallel to academic journals. Aim of this work is to investigate the extent of this phenomenon. We administered an anonymous online cross-sectional survey to 645 Italian clinicians. Target of the survey were all medical figures potentially involved in the management of COVID-19 cases. 369 questionnaires were returned. 19.5% (n = 72) of respondents were younger than 30 years-old; 49,3% (n = 182) worked in Infectious Diseases, Internal Medicine or Respiratory Medicine departments, 11.5% (n = 42) in Intensive Care Unit and 7.4% (n = 27) were general practitioner. 70% (n = 261) of respondents reported that their use of social media to seek medical information increased during the pandemic. 39.3% (n = 145) consistently consulted Facebook groups and 53.1% (n = 196) Whatsapp chats. 47% (n = 174) of respondents reported that information shared on social media had a consistent impact on their daily practice. In the present study, we found no difference in social media usage between age groups or medical specialties. Given the urgent need for scientific update during the present pandemic, these findings may help understanding how clinicians access new evidences and implement them in their daily practice. [ABSTRACT FROM AUTHOR]

Background: Neuropsychological performance has a strong impact on real-life functioning and clinical outcomes in psychosis. However, conducting lengthy cognitive assessments may not be feasible in routine clinical practice. Brief, reliable and cost-effective tools are highly needed, but few studies are available to guide clinician choice.Methods: The purpose of this study was to compare the performance of two widely used, short instruments: the Screen for Cognitive Impairment in Psychiatry (SCIP) and the Montreal Cognitive Assessment (MoCA). These instruments were validated in a sample of patients with psychotic disorders and healthy controls, using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and other instruments to assess executive functions, as comparators.Results: Patients fared worse than controls across almost all cognitive domains, with effect sizes ranging from 0 (MoCA naming) to 2.08 (SCIP total). Receiver Operator Curve analysis of patient and control performance suggested a better convergent validity for the SCIP (total score AUC: 0.85; 95%CI: 0.79-0.90; Se: 76%, Sp: 83%, PPV: 85%, NPV: 73%) than the MoCA (AUC: 0.78; 95%CI: 0.72-0.85; Se: 69%, Sp: 76%, PPV: 78.7%, NPV 66%).Conclusions: The Screen for Cognitive Impairment in Psychiatry seems to be a more sensitive and specific screening tool than the MoCA to identify cognitive impairment among patients with psychotic disorders. [ABSTRACT FROM AUTHOR]

Background. Greater levels of insight may be linked with depressive symptoms among patients with schizophrenia, however, it would be useful to characterize this association at symptomlevel, in order to inform research on interventions. Methods. Data on depressive symptoms (Calgary Depression Scale for Schizophrenia) and insight (G12 item from the Positive and Negative Syndrome Scale) were obtained from 921 community-dwelling, clinically-stable individuals with a DSM-IV diagnosis of schizophrenia, recruited in a nationwidemulticenter study. Network analysis was used to explore the most relevant connections between insight and depressive symptoms, including potential confounders in the model (neurocognitive and social-cognitive functioning, positive, negative and disorganization symptoms, extrapyramidal symptoms, hostility, internalized stigma, and perceived discrimination). Bayesian network analysis was used to estimate a directed acyclic graph (DAG) while investigating the most likely direction of the putative causal association between insight and depression. Results. After adjusting for confounders, better levels of insight were associated with greater self-depreciation, pathological guilt, morning depression and suicidal ideation. No difference in global network structure was detected for socioeconomic status, service engagement or illness severity. The DAG confirmed the presence of an association between greater insight and self-depreciation, suggesting the more probable causal direction was frominsight to depressive symptoms. Conclusions. In schizophrenia, better levels of insight may cause self-depreciation and, possibly, other depressive symptoms. Person-centered and narrative psychotherapeutic approaches may be particularly fit to improve patient insight without dampening self-esteem. [ABSTRACT FROM AUTHOR]

Adolescence is marked by increased susceptibility to trauma-related disorders and substance and behavioral addictions (SBAs). Complex post-traumatic stress disorder (cPTSD) is a newly recognized condition characterized by specific features in addition to those of classic PTSD and is often associated with SBAs. This study adopted a psychopathology network approach to explore which post-traumatic symptoms were explicitly associated with SBAs in a sample of late adolescents. We hypothesized that cPTSD symptoms would be particularly relevant to explain the comorbidity between PTSD and SBAs. A sample of 1010 late adolescents provided measures of post-traumatic symptomatology, cannabis and alcohol abuse, problematic internet use, and gambling. We estimated the network structure of PTSD/cPTSD symptoms and SBAs and assessed their bridge centrality indices. The results suggest that the SBAs had the highest bridge connections with the cPTSD dimension of affective dysregulation, which reported the highest centrality indices. Problematic internet use was the most central cluster of addictive behaviors among SBAs. Therefore, adolescents struggling with affective dysregulation may look for alternative ways to suppress their intense emotions, and SBAs may be sought as a maladaptive coping mechanism. These findings should prompt further research on affective dysregulation as a therapeutic target among adolescents. [ABSTRACT FROM AUTHOR]

Organic compounds, such as the polycyclic aromatic hydrocarbons (PAHs), are among the major species responsible for the infrared spectral features characterising the cosmic background radiation. Similar to silicate dust, aggregates rich in carbon with micro- and nano-meter sizes are subjected to several weathering processes in various astrophysical environments that modify their chemistry and structure, thus contributing to the chemical richness of the cosmic environment. In particular, the study of the chemical and structural evolution of PAHs aggregates in the presence of water is relevant to understand the mechanism of formation of the prebiotic building blocks of life. Pulsed laser ablation of a water-dispersed nano-phase of rubrene (5,6,11,12-tetraphenyltetracene) is here performed to reproduce the high energy-density conditions occurring in shock events in the interstellar medium, while ensuring the presence of a water environment. We studied the structural and chemical evolution of the dispersed rubrene nanocrystals upon laser treatment, showing that rubrene undergoes a fragmentation process producing water soluble species. The results obtained demonstrate that the extreme conditions occurring in cosmic environments coupled with the presence of water are sufficient conditions for transforming PAHs into prebiotic molecules. [Display omitted] • Pulsed laser ablation in water on PAH to reproduce space weathering processes. • Laser processing of nano-phase rubrene to study its chemical and structural changes. • Production of soluble molecules via a redox-fragmentation process. [ABSTRACT FROM AUTHOR]

Background: Clostridioides difficile infection (CDI) is a risk factor for bloodstream infection (BSI). Fecal microbiota transplantation (FMT) is more effective than antibiotics in treating recurrent CDI, but its efficacy in preventing CDI-related BSI is uncertain.Objective: To assess incidence of primary BSI in patients with recurrent CDI treated with FMT versus antibiotics.Design: Prospective cohort study. Patients treated with FMT and those treated with antibiotics were matched on propensity score.Setting: Single academic medical center.Patients: 290 inpatients with recurrent CDI (57 patients per treatment in matched cohort).Intervention: FMT or antibiotics.Measurements: The primary outcome was primary BSI within 90 days. Secondary outcomes were length of hospitalization and overall survival (OS) at 90 days.Results: Of the 290 patients, 109 were treated with FMT and 181 received antibiotics. Five patients in the FMT group and 40 in the antibiotic group developed BSI. Because of differences in the patients treated with FMT versus antibiotics in many baseline characteristics, including number of recurrences and CDI severity, comparative analyses were limited to the matched cohort. Risk for BSI was 23 percentage points (95% CI, 10 to 35 percentage points) lower in the FMT group; the FMT group also had 14 fewer days of hospitalization (CI, 9 to 20 fewer days) and a 32-percentage point increase in OS (CI, 16 to 47 percentage points) compared with the antibiotic group.Limitation: Nonrandomized study with potential for unmeasured or residual confounding; limited generalizability of the propensity score-matched cohort.Conclusion: In a propensity score-matched cohort, patients with recurrent CDI treated with FMT were less likely to develop primary BSI.Primary Funding Source: None. [ABSTRACT FROM AUTHOR]

Structural and functional abnormalities of the cerebellum have been observed in schizophrenia since the first neuroimaging studies. More recently, the functions of the cerebellum have been extended beyond sensorimotor control to include participation in higher-level cognition and affective regulation. Consistently, the "cognitive dysmetria" theory posits that dysfunctions of cortical-subcortical-cerebellar circuitry may be crucial for the pathogenesis of different clinical features of schizophrenia. This conceptual framework offers a set of testable hypotheses, now that various tools to exert direct modulation of cerebellar activity are available. We conducted a systematic review of studies examining the effects of cerebellar modulation in schizophrenia. Two independent authors conducted a search within PubMed for articles published up to April 2019 and identified 10 studies (three randomized controlled trials, two open-label studies, two case reports, one preclinical study) describing the effects of cerebellar circuitry modulation in patients with schizophrenia or animal models. The majority of interventions were uncontrolled and used stimulation of the cerebellar vermis, using transcranial magnetic stimulation or transcranial direct-current stimulation. Most studies detected improvements after cerebellar modulation. Clinical changes mostly pertained the domains of negative symptoms, depressive symptoms and cognitive functions. In conclusion, few studies examined the effects of cerebellar modulation in schizophrenia but yielded promising results. This approach may hold therapeutic potential, pending further methodologically robust replication. [ABSTRACT FROM AUTHOR]

Background: Late Life Bipolar Disorder (LLBD) is associated with a high prevalence of cognitive impairments, but few studies have examined their risk factors and clinical correlates METHODS: Participants with bipolar disorder older than 60 (n = 86) were recruited from psychiatric outpatient and inpatients units. Patients were assessed with various instruments, including the Clinical Dementia Rating scale, the Montreal Cognitive Assessment and the Cumulative Illness Rating Scale. The distribution of disorder-specific and general risk factors was compared between patients with LLBD plus cognitive impairments (mild cognitive impairment or dementia) and those with LLBD but no cognitive impairment. Analyses were first conducted at the bivariate level, then using multiple regression. The association with disability, aggressive behavior and suicidal ideation was also explored.Results: Cognitive impairments in LLBD were associated with a diagnosis of type 1 bipolar disorder (OR = 6.40, 95%CI: 1.84 - 22.31, p = 0.004), fewer years of education (OR = 0.79, 95%CI: 0.69 - 0.91, p = 0.001) and higher severity of physical diseases (OR 26.54, 95%CI: 2.07 - 340.37, p = 0.01). Moreover, cognitive impairments were associated with an increased likelihood of disability and recent aggressive behavior, but not suicidal ideation.Limitations: retrospective design, conflation of MCI and dementia, not all subjects were in euthymia CONCLUSIONS: In LLBD, the presence of cognitive impairments was associated with a diagnosis of type I bipolar disorder, lower education and more severe physical comorbidities. In turn, MCI or dementia were associated with increased disability and aggressive behavior. These findings may aid the identification of patients at risk for cognitive deterioration in everyday clinical practice. [ABSTRACT FROM AUTHOR]

The corneal endothelium plays an integral role in regulating corneal hydration and clarity. Endotheliitis, defined as inflammation of the corneal endothelium, may disrupt endothelial function and cause subsequent visual changes. Corneal endotheliitis is characterized by corneal edema, the presence of keratic precipitates, anterior chamber inflammation, and occasionally limbal injection, neovascularization, and co-existing or superimposed uveitis. The disorder is classified into four subgroups: linear, sectoral, disciform, and diffuse. Its etiology is extensive and, although commonly viral, may be medication-related, procedural, fungal, zoological, environmental, or systemic. Not all cases of endothelial dysfunction leading to corneal edema are inflammatory in nature. Therefore, it is imperative that practitioners consider a broad differential for patients presenting with possible endotheliitis, as well as familiarize themselves with appropriate diagnostic and therapeutic modalities. [ABSTRACT FROM AUTHOR]

The study of the effects of non-hydrostatic stresses on rock-forming minerals is fundamental for understanding how minerals respond to tectonic stresses in the Earth's interior. Larger deviatoric stresses of the order of GPa can arise from physical interaction between minerals (e.g. host–inclusion systems, compositional gradients) at the micrometric scale, even if at the large-scale large stresses are annealed by plastic flows. Thus, experimental data under hydrostatic pressure do not provide us access to all the possible modifications and structural changes experienced by minerals subjected to deviatoric stresses. Therefore, we carried out ab initio hybrid Hartree–Fock/Density Functional Theory simulations to determine the properties of alpha-quartz, since it is one of the most abundant minerals in the Earth's crust with a very simple chemistry and structure. We calculated its structure, elastic parameters and Raman-active vibrational modes as a function of different applied strains, which allow us to show how phonon frequencies and structural parameters (bond lengths and angles) are affected by deviatoric stress conditions rather than hydrostatic pressure. [ABSTRACT FROM AUTHOR]

Abstract Terrien marginal degeneration, a rare disease resulting in peripheral corneal thinning, commonly occurs in middle-aged males and usually manifests clinically with decreased visual acuity from increased corneal astigmatism. Although the exact etiology is unknown, hypotheses focus on possible degenerative and inflammatory origins. Histopathologic studies often reveal characteristic findings of innumerable intracellular and extracellular vacuoles in the affected stroma. Distinguishing Terrien marginal degeneration from other peripheral corneal diseases such as Mooren ulcer and pellucid marginal degeneration is important. Nonsurgical interventions include spectacles, rigid gas-permeable contact lenses, and scleral lenses; however, when the corneal thickness is ≤150 μm, surgical interventions including tectonic grafting and lamellar keratoplasty may be necessary. [ABSTRACT FROM AUTHOR]

The concept of the phonon-mode Grüneisen tensor is reviewed as method to determine the elastic strains across crystals from the changes in the wavenumbers of Raman-active phonon modes relative to an unstrained crystal. The symmetry constraints on the phonon-mode Grüneisen tensor are discussed and the consequences for which combinations of strains can be determined by this method are stated. A computer program for Windows, stRAinMAN, has been written to calculate strains from changes in Raman (or other phonon) mode wavenumbers, and vice-versa. It can be downloaded for free from www.rossangel.net. [ABSTRACT FROM AUTHOR]

The population of unilateral cochlear implant (CI) users with aidable residual hearing in the contralateral ear is continuously growing. Aiding the contralateral ear with a hearing aid has been shown to provide substantial benefit regarding speech intelligibility in quiet and in noise, sound quality, localization ability and listening effort. In this study, a dedicated hearing aid with the accompanying fitting prescription, tailored to the needs of bimodal listeners was evaluated in nine bimodal CI users. Speech intelligibility scores in noise revealed on-par performance of the dedicated bimodal fitting compared to the clinical standard prescription. 78% of the bimodal CI users preferred the dedicated bimodal fitting over the clinical standard. The minimal subject-specific fine-tuning effort required during the dedicated bimodal fitting process emphasizes the clinical efficiency. [ABSTRACT FROM AUTHOR]

Introduction: The primary objective was to show our initial surgical single-site experience with small incision lenticule extraction (SMILE) after the official enrollment in March 2017 following Food and Drug Administration (FDA) approval for simple myopia in late 2016 in the United States and, subsequently, compare our results to the earliest and most advanced generation of excimer platforms for laser-assisted in situ keratomileusis (LASIK) surgery.Methods: This was a retrospective single-site study of 68 eyes from 35 patients who had SMILE surgery. The patients’ preoperative and postoperative uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest sphere, manifest cylinder, intraoperative complications, and preoperative and postoperative visual symptoms were collected. We compared our findings to the results from the FDA SMILE study, and to the three earliest (1999-2000) and three of the most updated (2013-2016) platforms for LASIK.Results: The cumulative UDVA was 20/20 and 20/40 or better in 74% and 100% of patients, respectively. The intended target refraction was within ± 0.5 and ± 1.00 D in 80% and 93% of cases, respectively. The prevalence of dry eyes decreased by nearly half from 1-week to the 6-month postoperative interval. Patients noted improvement in glare (17%), halos (17%), fluctuation (25%), and depth perception (8%) at the 6-month interval compared to preoperative levels.Conclusions: This study’s findings are consistent with current SMILE reports. Notably, the results are superior to the earliest generation of LASIK, however inferior to the latest excimer platforms. SMILE does meet the efficacy and safety criteria met by FDA; however, there is a definite need for further improvement to reach the superior refractive outcomes produced by the latest generation of LASIK platforms. [ABSTRACT FROM AUTHOR]

Elastic geobarometry for host-inclusion systems can provide new constraints to assess the pressure and temperature conditions attained during metamorphism. Current experimental approaches and theory are developed only for crystals immersed in a hydrostatic stress field, whereas inclusions experience deviatoric stress. We have developed a method to determine the strains in quartz inclusions from Raman spectroscopy using the concept of the phonon-mode Grüneisen tensor. We used ab initio Hartree-Fock/Density Functional Theory to calculate the wavenumbers of the Raman-active modes as a function of different strain conditions. Least-squares fits of the phonon-wavenumber shifts against strains have been used to obtain the components of the mode Grüneisen tensor of quartz ( γ 1 m $ \begin{array} {} \gamma _1^{\rm{m}}\end{array} $ and γ 3 m $ \begin{array} {} \gamma _3^{\rm{m}}\end{array} $) that can be used to calculate the strains in inclusions directly from the measured Raman shifts. The concept is demonstrated with the example of a natural quartz inclusion in eclogitic garnet from Mir kimberlite and has been validated against direct X‑ray diffraction measurement of the strains in the same inclusion. [ABSTRACT FROM AUTHOR]