Search

Background: Immersive Virtual Reality (IVR) has shown promise in the assessment, understanding, and treatment of eating disorders (EDs), providing a dynamic platform for clinical innovation. This scoping review aims to synthesize the recent advancements and applications of IVR in addressing these complex psychological disorders. Methods: This review followed the Preferred Reporting Items for Systematic Reviews and Meta-analysis Protocols, focusing on studies published in the past five years. It included peer-reviewed papers that used IVR for ED assessment, examination, or treatment. A comprehensive database search provided a selection of relevant articles, which were then methodically screened and analyzed. Results: Twenty studies met the inclusion criteria, with a primary focus on Anorexia Nervosa (AN), Bulimia Nervosa (BN), and Binge Eating Disorder (BED). The application of IVR was categorized into three areas: assessment, understanding, and treatment. IVR was found to be an effective tool in assessing body image distortions and emotional responses to food, providing insights that are less accessible through traditional methods. Furthermore, IVR offers innovative treatment approaches by facilitating exposure therapy, modifying body-related biases, and enabling emotional regulation through embodied experiences. The studies demonstrate IVR's potential to improve body image accuracy, reduce food-related anxieties, and support behavioral changes in ED patients. Conclusion: IVR stands out as a transformative technology in the field of EDs, offering comprehensive benefits across diagnostic, therapeutic, and experiential domains. The IVR's ability to simulate the brain's predictive coding mechanisms provides a powerful avenue for delivering embodied, experiential interventions that can help recalibrate distorted body representations and dysfunctional affective predictive models implicated in EDs. Future research should continue to refine these applications, ensuring consistent methodologies and wider clinical trials to fully harness IVR's potential in clinical settings. [ABSTRACT FROM AUTHOR]

The brain dynamics underlying working memory (WM) unroll via transient frequency-specific large-scale brain networks. This multidimensionality (time, space, and frequency) challenges traditional analyses. Through an unsupervised technique, the time delay embedded-hidden Markov model (TDE-HMM), we pursue a functional network analysis of magnetoencephalographic data from 38 healthy subjects acquired during an n-back task. Here we show that this model inferred task-specific networks with unique temporal (activation), spectral (phase-coupling connections), and spatial (power spectral density distribution) profiles. A theta frontoparietal network exerts attentional control and encodes the stimulus, an alpha temporo-occipital network rehearses the verbal information, and a broad-band frontoparietal network with a P300-like temporal profile leads the retrieval process and motor response. Therefore, this work provides a unified and integrated description of the multidimensional working memory dynamics that can be interpreted within the neuropsychological multi-component model of WM, improving the overall neurophysiological and neuropsychological comprehension of WM functioning. The TDE-HMM infers spectrally defined brain networks underpinning the executive, maintenance, and retrieval functions in a working memory WM task. This integrated description improves the neurophysiological and neuropsychological understanding of WM. [ABSTRACT FROM AUTHOR]

Introduction: Obesity is not only an important modifiable cardiovascular risk factor but also a chronic disease with relevant consequences on morbidity and mortality in the general population. According to European guidelines, cardiologists must recognize and treat it properly. Aims: To assess perception of obesity as a modifiable pathological condition and the importance to treat it in a real-world sample of cardiologists and residents in cardiology. Methods: A nationwide, web-based, epidemiological survey on the perception of obesity as a disease and as a modifiable cardiovascular risk factors was conducted in 137 medical doctors (cardiologists and residents in cardiology). Participants filled with their answers a questionnaire of 31 questions about perception of obesity and strategies on cardiovascular disease prevention in clinical practice. Results: Of 137 individuals enrolled in our survey only 5 (3.6%) reported to measure waist circumference in their clinical practice and only 3 (2.2%) reported to measure waist-to-hip ratio. One-hundred-twenty participants (87.6%) would not prescribe an anti-obesity drug to a patient with grade II obesity. Sixty-eight (49.6%) participants have never read or heard of a clinical trial on obesity. On the other hand, 134 (97.8%) routinely measured blood pressure in their clinical practice, 129 (94.2%) would prescribe a statin for a hypercholesterolemic patient and 132 (96.4%) subjects have read/heard a clinical trial on type 2 diabetes in their life. Conclusions: Although obesity is a chronic disease and an important modifiable cardiovascular risk factor such as arterial hypertension, hypercholesterolemia, cigarette smoke and diabetes, cardiologists and residents in cardiology substantially underestimate it ignoring that it should be treated as a proper disease. [ABSTRACT FROM AUTHOR]

Purpose: Accurate evaluation of breast cancer on bioptic samples is of fundamental importance to guide therapeutic decisions, especially in the neoadjuvant or metastatic setting. We aimed to assess concordance for oestrogen receptor (ER), progesterone receptor (PR), c-erbB2/HER2 and Ki-67. We also reviewed the current literature to evaluate our results in the context of the data available at present. Methods: We included patients who underwent both biopsy and surgical resection for breast cancer at San Matteo Hospital, Pavia, Italy, between January 2014 and December 2020. ER, PR, c-erbB2, and Ki-67 immunohistochemistry concordance between biopsy and surgical specimen was evaluated. ER was further analysed to include the recently defined ER-low-positive in our analysis. Results: We evaluated 923 patients. Concordance between biopsy and surgical specimen for ER, ER-low-positive, PR, c-erbB2 and Ki-67 was, respectively, 97.83, 47.8, 94.26, 68 and 86.13%. Cohen's κ for interobserver agreement was very good for ER and good for PR, c-erbB2 and Ki-67. Concordance was especially low (37%) in the c-erbB2 1 + category. Conclusion: Oestrogen and progesterone receptor status can be safely assessed on preoperative samples. The results of this study advise caution in interpreting biopsy results regarding ER-low-positive, c-erbB2/HER and Ki-67 results due to a still suboptimal concordance. The low concordance for c-erbB2 1 + cases underlines the importance of further training in this area, in the light of the future therapeutic perspectives. [ABSTRACT FROM AUTHOR]

Purpose: Breast lesions classified as of "uncertain malignant potential" represent a heterogeneous group of abnormalities with an increased risk of associated malignancy. Clinical management of B3 lesions diagnosed on vacuum-assisted breast biopsy (VABB) is still challenging: surgical excision is no longer the only available treatment and VABB may be sufficient for therapeutic excision. The aim of the present study is to evaluate the positive predictive value (PPV) for malignancy in B3 lesions that underwent surgical excision, identifying possible upgrading predictive factors and characterizing the malignant lesions eventually diagnosed. These results are compared with a subset of patients with B3 lesions who underwent follow-up. Methods: A total of 1250 VABBs were performed between January 2006 and December 2017 at our center. In total, 150 B3 cases were diagnosed and 68 of them underwent surgical excision. VABB findings were correlated with excision histology. A PPV for malignancy for each B3 subtype was derived. Results: The overall PPV rate was 28%, with the highest upgrade rate for atypical ductal hyperplasia (41%), followed by classical lobular neoplasia (29%) and flat epithelial atypia (11%). Only two cases of carcinoma were detected in the follow-up cohort, both associated with atypical ductal hyperplasia at VABB. Conclusion: Open surgery is recommended in case of atypical ductal hyperplasia while, for other B3 lesions, excision with VABB only may be an acceptable alternative if radio-pathological correlation is assessed, if all microcalcifications have been removed by VABB, and if the lesion lacks high-risk cytological features. Key Points: • Surgical treatment is strongly recommended in case of ADH, while the upgrade rate in case of pure FEA, especially following complete microcalcification removal by VABB, may be sufficiently low to advice surveillance as a management strategy. • The use of 11-G- or 8-G-needle VABB, resulting in possible complete diagnostic excision of the lesion, can be an acceptable alternative in case of RS, considering open surgery only for selected high-risk patients. • LN management is more controversial: surgical excision may be recommended following classical LN diagnosis on breast biopsy if an additional B3 lesion is concurrently detected while in the presence of isolated LN with adequate radiological-pathological correlation follow-up alone could be an acceptable option. [ABSTRACT FROM AUTHOR]

Chitosan-based coatings and films have been widely studied, demonstrating to be an efficient and eco-friendly approach to extend the shelf life of food products. The effect of incorporating Thymus capitatus essential oil (TCEO) at different concentrations (0.5, 1.0, and 1.5% w/w) on physical, mechanical and antimicrobial properties of chitosan films was studied. The antimicrobial activity of the films was evaluated by agar diffusion method, against 23 spoiling microorganisms isolated from tuna and swordfish (ten Shewanella baltica, one S. morhuae, one S. putrefaciens, two Pseudomonas fluorescens, two P. fragi, five Serratia spp., one Aeromonas molluscorum, and one Acinetobacter radioresistens) and Shewanella putrefaciens ATCC 49138. The films exerted antimicrobial activity against all the tested strain, although not proportional to increasing TCEO concentration. In particular, S. baltica was the most sensitive species and the inhibition was stable after 72 h. In general, TCEO incorporation in chitosan films, significantly (p < 0.05) decreased the water permeability (from 0.577 ± 0.060 gmm/kPahm2 at 61% R.U. for chitosan to 0.487 ± 0.037 gmm/kPahm2 for the film with 1.5% TCEO), the elongation at brake (from 27.322 ± 2.35% for chitosan to 14.695 ± 3.99% for the film with 1.5% TCEO) and increased the tensile strength (from 1.697 ± 0.16% for chitosan to 19.480 ± 2.86% for the film with 1.5% TCEO). Moisture content and water contact angle of the films also showed a similar trend with TCEO introduction, because of crosslinking reaction among the polymer chains and TCEO components. Scanning electron microscopy confirmed structure-properties relationships. These results suggest chitosan films incorporated with TCEO as an alternative treatment to inhibit the growth of degradative bacteria with potential application in the fish industry. The importance of testing more than one strain of the same bacteria species to evaluate the effectiveness of chitosan-essential oils coatings was also demonstrated. [ABSTRACT FROM AUTHOR]

Aims: Obesity-induced nephropathy is an established clinical entity arising from a 'maladaptive' response to lipid accumulation at the nephron level. Bariatric surgery positively affects renal function, reducing or increasing glomerular filtration rate (GFR) in subjects with hyperfiltration and renal impairment, respectively. The effect of this surgery in patients with normal estimated GFR (eGFR) is less clear. Methods: A complete clinical and biochemical assessment of 135 severely obese, otherwise healthy subjects, was obtained before Roux-en-Y gastric bypass (RYGB). All subjects underwent an OGTT with plasma glucose and insulin determinations. Follow-up data were recorded at 6, 12, 24 and 48 months after intervention. Results: Baseline eGFR was 98.2 ± 13.6 ml/min/1.73 m; hyperfiltration (>120 ml/min/1.73 m) was present in 7% of the cohort. No eGFR variation over the follow-up emerged, except at the last visit (−3.6 ± 1.4 ml/min/1.73 m at month 48, p = 0.01 vs baseline). In the univariate analysis, the renal performance at 48 months was inversely related to baseline eGFR ( r = −0.17, p = 0.04) and plasma triglycerides ( r = −0.04, p = 0.05). Fasting and OGTT-derived variables did not impact eGFR. By multiple regression analysis, eGFR time course was independently predicted only by baseline eGFR ( p = 0.03). Interestingly, patients having a baseline eGFR >100 ml/min/1.73 m (median value) showed, after 48 months, an average loss of −8.3 ± 2.2 ml/min/1.73 m, while those with eGFR <100 exhibited a slight increase (+1.8 ± 2.3 ml/min/1.73 m, p < 0.01). Conclusions: Long-term data confirm the safety of RYGB on renal function. Interestingly, a subtle hyperfiltration, i.e., occurring in high-normal range of eGFR, is attenuated by surgical procedure. Lastly, high serum triglycerides may track an unfavorable renal outcome. [ABSTRACT FROM AUTHOR]

Background: Several patients encompass a scarce weight loss after Roux-en-Y gastric bypass (RYGB). As such event is not related to surgical complications, finding markers able to identify 'well responders' and to predict weight loss outcome is clinically relevant. Ghrelin regulates appetite and energy balance. Common single nucleotide polymorphisms (SNPs) in its encoding genes have been associated with body weight regulation. Other peptides involved in satiety modulation, like the CD40/CD40L complex, are less explored. Methods: One hundred, otherwise healthy, obese subjects (aged 45 ± 11 years, 65 females, BMI 48.0 ± 0.7 kg/m) were sequentially enrolled in years 2014-2015. SNPs rs2241766 for adiponectin gene, rs490683 for ghrelin receptor, rs696217 and rs27647 for the preproghrelin/ghrelin gene, and rs1126535 for the CD40L gene were determined on DNA extracted from circulating lymphomonocytes. Patients were reevaluated at 6 ( n = 100), 26 ( n = 91), and 52 weeks ( n = 79) after RYGB. Results: Subjects carrying the rs696217 T allele encompassed a significantly greater reduction in BMI 52 weeks after surgery (GG vs GT 30.5 ± 1.1 vs 38.1 ± 2.1 %; p < 0.001). Carrying the rs1126535 C allele in the CD40L gene was associated with a significantly lower BMI reduction at week 52 (TT vs CT 33.2 ± 1.1 vs 28.1 ± 2.3 %, p = 0.049). rs490683 and rs27647 SNPs of ghrelin and rs2241766 for adiponectin gene did not show any difference between carriers and non-carriers of the mutant allele. Conclusion: Carrying a G to T substitution in rs696217 (preproghrelin gene) seems to mark a successful weight loss outcome; we also report for the first time that the rs1126535 C allele (CD40L gene) may predict a worse response to bariatric surgery. [ABSTRACT FROM AUTHOR]

We have recently shown that homologs of mammalian hair keratins are expressed in the claws of the green anole lizard, Anolis carolinensis. To test whether reptilian hair keratin homologs are functionally associated with claws, we investigated the conservation of the prototypical reptilian hair keratin homolog, hard acidic keratin 1 (HA1), in representative species from all main clades of reptiles. A complete cDNA of HA1 was cloned from the claw-forming epidermis of the lacertid lizard Podarcis sicula, and partial HA1 gene sequences could be amplified from genomic DNA of tuatara, lizards, gekkos, turtles, and crocodiles. In contrast, the HA1 gene of the limbless slow worm, Anguis fragilis, and of two species of turtles contained at least one deleterious mutation. Moreover, an HA1 gene was undetectable in the softshell turtle, snakes, and birds. Mapping the presence and absence of HA1 onto the phylogenetic tree of sauropsids suggested that the HA1 gene has been lost independently in several lineages of reptiles. The species distribution of HA1 is compatible with the hypothesis of a primary function of HA1 in claws but also shows that the formation of reptilian claws does not strictly depend on this keratin. [ABSTRACT FROM AUTHOR]

Background, aim and scope: This paper presents a preliminary study of the water profile with reference to microbiological parameters, required by Directive 2006/07/EC (European Community ) concerning the management of bathing water quality, in the coastal belt of the Province of Venice (Italy, Northern Adriatic Sea). A historical database has been implemented with monitoring data for the period 2000-2006 (data on rivers, bathing and marine coastal waters and on the characterization of Wastewater Treatment Plant (WWTP) discharges) from the institutional activity of Veneto Regional Environmental Prevention and Protection Agency (ARPAV). An integrated areal analysis for the microbiological investigation of homogeneous stretches along the coast of the Province of Venice was performed for a preliminary characterization of the bathing water profile considering water quality status and existing pressure sources. Materials and methods: ARPAV is the institutional body responsible for environmental monitoring and control activities. Data were produced from monitoring and controls made available by the Regional Environmental Informative System and extracted and elaborated for the period of interest (2000−2006). Sampling and analysis of microbiological parameters were executed following the official Italian methods in accordance with international procedures (APHA et al. ). For the purpose of this study, the coast was divided into eight stretches, which were considered to be homogeneous according to their physical and geographical characteristics. An ANOVA statistical assessment has been performed on stretches I, V and VIII. Results and discussion: From the integrated areal analysis of microbiological parameters in the homogeneous stretches along the coast of all the investigated matrices, high mean levels of faecal contamination were found in some cases. The most critical situation amongst the stretches evaluated is to be found in stretch VIII-Ca' Roman, Sottomarina and Isola Verde shores (Southern part of the Province). These results can be widely attributed to pressure sources from the Brenta and Adige rivers, rather than to local contributions. Stretches VI and VII, which correspond to the area from Punta Sabbioni (Cavallino shore N-E) to the Pellestrina shore (S-W), present the best conditions for faecal contamination parameters (low pollution levels). These situations can probably be explained given that WWTPs 7 and 8 have two submarine outfalls at a distance of about 4 km from the coastline and therefore a discharge point which is distant from the bathing and marine coastal monitoring stations; there are also no river mouths in these two stretches. Due to lack of data, it was not possible to implement seasonal assessments. Conclusions: This study aimed to develop an integrated areal analysis for biological parameters along the coast over the period 2000-2006 for the identified homogeneous stretches in order to develop a preliminary approach for the characterization of the water profile, as requested by directive 2006/7/EC. From the integrated analysis of the stretches, it is evident that in some cases there are high levels of faecal contamination along the coast which can be caused by river flows which heavily condition the quality of coastal waters as verified with the statistical assessment. Recommendations and perspectives: From the preliminary analysis, the submarine outfalls seem to be the best solution to guarantee good bathing water quality on the coast. Nevertheless, it must be observed that this solution cannot overlook the possible impact of the discharges on seawaters intended for a specific use, such as mussel farms with reference to coastal hydrodynamics. Therefore, a sound wastewater dispersion analysis on the discharges of the WWTPs for the identification of the interested area and the level of contamination must be performed; a modelling study on pollution dispersion is complementary to this study (Scroccaro et al. ). This analysis highlights the critical stretches as being numbers II and, above all, VIII with particular correlation with the main river mouths. Thus, it is evident that the issue of microbiological impact must be studied following a river basin approach according to the influence of river loads on coastal areas. [ABSTRACT FROM AUTHOR]

Lung infections caused by Pseudomonas aeruginosa pose a serious threat to patients suffering from, among others, cystic fibrosis, chronic obstructive pulmonary disease, or bronchiectasis, often leading to life-threatening complications. The establishment of a chronic infection is substantially related to communication between bacteria via quorum-sensing networks. In this study, we aimed to assess the role of quorum-sensing signaling molecules of the Pseudomonas quinolone signal (PQS) and to investigate the viscoelastic properties of lung tissue homogenates of PA-infected mice in a prolonged acute murine infection model. Therefore, a murine infection model was successfully established via intra-tracheal infection with alginate-supplemented Pseudomonas aeruginosa NH57388A. Rheological properties of lung homogenates were analyzed with multiple particle tracking (MPT) and quorum-sensing molecules were quantified with LC–MS/MS. Statistical analysis of bacterial load and quorum-sensing molecules showed a strong correlation between these biomarkers in infected lungs. This was accompanied by noticeable changes in the consistency of lung homogenates with increasing infection severity. Furthermore, viscoelastic properties of the lung homogenates strongly correlated with bacterial load and quorum sensing molecules. Considering the strong correlation between the viscoelasticity of lung homogenates and the aforementioned biomarkers, the viscoelastic properties of infected lungs might serve as reliable new biomarker for the evaluation of the severity of P. aeruginosa infections in murine models. [ABSTRACT FROM AUTHOR]

An amendment to this paper has been published and can be accessed via a link at the top of the paper. [ABSTRACT FROM AUTHOR]

Somatic mutations of calreticulin (CALR) have been described in approximately 60–80% of JAK2 and MPL unmutated Essential Thrombocythemia and Primary Myelofibrosis patients. CALR is an endoplasmic reticulum (ER) chaperone responsible for proper protein folding and calcium retention. Recent data demonstrated that the TPO receptor (MPL) is essential for the development of CALR mutant-driven Myeloproliferative Neoplasms (MPNs). However, the precise mechanism of action of CALR mutants haven't been fully unraveled. In this study, we showed that CALR mutants impair the ability to respond to the ER stress and reduce the activation of the pro-apoptotic pathway of the unfolded protein response (UPR). Moreover, our data demonstrated that CALR mutations induce increased sensitivity to oxidative stress, leading to increase oxidative DNA damage. We finally demonstrated that the downmodulation of OXR1 in CALR-mutated cells could be one of the molecular mechanisms responsible for the increased sensitivity to oxidative stress mediated by mutant CALR. Altogether, our data identify novel mechanisms collaborating with MPL activation in CALR-mediated cellular transformation. CALR mutants negatively impact on the capability of cells to respond to oxidative stress leading to genomic instability and on the ability to react to ER stress, causing resistance to UPR-induced apoptosis. [ABSTRACT FROM AUTHOR]

Purpose: The objective of this work was to evaluate the potential of polymeric spherical and aspherical invasive nanocarriers, loaded with antibiotic, to access and treat intracellular bacterial infections.Methods: Aspherical nanocarriers were prepared by stretching of spherical precursors, and both aspherical and spherical nanocarriers were surface-functionalized with the invasive protein InvA497. The relative uptake of nanocarriers into HEp-2 epithelial cells was then assessed. Nanocarriers were subsequently loaded with a preparation of the non-permeable antibiotic gentamicin, and tested for their ability to treat HEp-2 cells infected with the enteroinvasive bacterium Shigella flexneri.Results: InvA497-functionalized nanocarriers of both spherical and aspherical shape showed a significantly improved rate and extent of uptake into HEp-2 cells in comparison to non-functionalized nanocarriers. Functionalized and antibiotic-loaded nanocarriers demonstrated a dose dependent killing of intracellular S. flexneri. A slight but significant enhancement of intracellular bacterial killing was also observed with aspherical as compared to spherical functionalized nanocarriers at the highest tested concentration.Conclusions: InvA497-functionalized, polymer-based nanocarriers were able to efficiently deliver a non-permeable antibiotic across host cell membranes to affect killing of intracellular bacteria. Functionalized nanocarriers with an aspherical shape showed an interesting future potential for intracellular infection therapy. [ABSTRACT FROM AUTHOR]