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Background Acute kidney injury (AKI) represents a frequent complication after orthotopic liver transplantation (OLT). This study aimed to evaluate early postoperative AKI incidence during the first 72 h after OLT, perioperative risk factors, and AKI impact on survival. Methods From January 2011 to December 2013) 1681 patients underwent OLT in 19 centers and were enrolled in this prospective cohort study. Results According to RIFLE criteria, AKI occurred in 367 patients, 21.8% (R: 5.8%, I: 6.4%, F: 4.8%, L: 4.8%). Based on multivariate analysis, intraoperative risk factors for AKI were: administration of 5-10 RBCs (OR 1.8, 95%CI 1.3-2.7), dopamine use (OR 1.6, 95%CI 1.2-2.3), post-reperfusion syndrome (OR 1.5, 95%CI 1.0-2.3), surgical complications (OR 2.0, 95% CI 1.3-3.0), and cardiological complications (OR 2.2, 95%CI 1.2-4.0). Postoperative risk factors were: norepinephrine (OR 1.4, 95%CI 1.0-2.0), furosemide (OR 4.2, 95% CI 3.0-5.9), more than 10 RBCs transfusion, (OR 3.7, 95%CI 1.4-10.5), platelets administration (OR 1.6, 95% CI 1.1-2.4), fibrinogen administration (OR 3.0, 95%CI, 1.5-6.2), hepatic complications (OR 4.6, 95%CI 2.9-7.5), neurological complications (OR 2.4, 95%CI 1.5-3.7), and infectious complications (OR 2.7, 95%CI 1.8-4.3). NO-AKI patients' 5 years survival rate was higher than AKI patients (68.06, 95% CI 62.7-72.7 and 81.2, 95% CI 78.9-83.3, p Conclusions AKI still remains an important risk factor for morbidity and mortality after OLT. Further researches to develop new strategies aimed at preventing or minimizing post-OLT AKI are needed.

Knowledge about the role of empathy, emotional self-efficacy, and loneliness on early adolescents’ depressive symptoms is scarce. The main aims of the study were to investigate the following: (a) the role of empathy and emotional self-efficacy (additive and interactive) on loneliness and depressive symptoms, taking into account gender differences and (b) the possible mediating role of loneliness in the relationship between emotional predictors and depressive symptoms. Three hundred forty-eight Italian early adolescents (48% girls; mean age, 13; SD = 0.3) completed an anonymous self-report questionnaire at two time points (1 year apart). Structural equation modeling (SEM) was used to analyze data. Results indicated the following: (a) high empathy and low emotional self-efficacy were related to higher subsequent loneliness and depressive symptoms; (b) emotional self-efficacy moderated the relationship between empathy and loneliness and, only for girls, between empathy and depressive symptoms; (c) no mediation role of loneliness between emotional predictors (empathy and emotional self-efficacy) and depressive symptoms was found. Results are discussed in relation to preventive interventions targeting early adolescents.

Background Children with dyslexia often show second-language reading and writing difficulties, but the cognitive mechanisms connected to this impairment need to be clarified. Aims The present study examined the neuropsychological mechanisms underlying learning English as a foreign language in 4th- to the 8th-grade Italian students showing reading difficulties (RD) or typical development (TD). For this purpose, screening involving 901 students was carried out to select children with RD. Sample Ninety students with RD were compared with 90 typically developing (TD) children matched for non-verbal IQ, grade, and gender. Methods The two groups were compared on different measures to understand the relationships between reading skills in their mother tongue and in English as a second-language (L2). Subsequently, their phonological and memory skills were investigated to understand the potential role of these variables in learning L2 English. Results Students with RD obtained worse results than TD students for phonological awareness and working memory, which are both crucial to L2 learning. Conclusions The results suggest that memory mainly influences accuracy in English writing and, together with phonological skills, plays an important role in reading accuracy. Socio-economic status also plays an important role in L2 learning.

Background Flash glucose monitoring system (FGMS; FreeStyle Libre) was recently validated for use in diabetic dogs (DD). It is not known if this system is clinically useful in monitoring DD. Objective To compare the clinical utility of FGMS against blood glucose curves (BGCs) obtained with a portable blood glucose meter (PBGM) in monitoring DD. Animals Twenty dogs with diabetes mellitus. Methods Prospective study. Dogs with diabetes mellitus on insulin treatment for at least 1 month were included. Comparisons of insulin dose recommendations based on the in-hospital GCs acquired using FGMS and a PBGM, consecutive-day interstitial GCs (IGCs) acquired at home using the FGMS, and consecutive-day, home vs hospital IGCs acquired using the FGMS were made using concordance analysis. Results There was good concordance between insulin dose recommendations based on FGMS and PBGM generated GCs and IGCs obtained in the 2 different environments on 2 consecutive days, but almost absent concordance between IGCs obtained on 2 consecutive days at home. Glucose nadirs were detected in 34/43 (79%) of Ambulatory Glucose Profile (AGP) reports of the FGMS. In comparison, concordant glucose nadirs were identified in 14/34 (41%) BGCs using PBGM. The individual FGMS scans and PBGM identified 60% and 9% of low IG/hypoglycemic episodes, respectively. Conclusions and clinical importance Insulin dose adjustments based on BGCs can be suboptimal. The FGMS allows a more accurate identification of the glucose nadirs and hypoglycemic episodes compared to the use of a PBGM and assessment of day-to-day variations in glycemic control.

Background The Fear of Pain Questionnaire-III (FPQ-III) is a self-report instrument developed to assess fear of different stimuli usually causing pain. The present study aimed to construct an Italian version of the FPQ-III and examine its psychometric properties in a heterogeneous sample of Italian healthy individuals. Methods The questionnaire was translated following the forward-backward method and completed by 511 Italian adults who met the inclusion criteria. Within 2 months of the first assessment, a subgroup of participants (n = 164) was re-tested. The factorial structure of the FPQ-III was assessed by confirmatory factor analysis (CFA). To better comprehend the FPQ-III’s factorial structure, a CFA was also performed for each of the two reduced versions of the FPQ-III, namely the FPQ-Short Form and the FPQ-9. Divergent validity, test-retest reliability, and gender/age measurement invariance were also evaluated. Results The results of the CFA revealed that the original three-factor model poorly fitted the data, but it became satisfactory after allowing correlated error terms. Concerning divergent validity, correlations between FPQ-III scores and pain intensity, depression, and anxiety were found to be positive but weak in magnitude (< .20). FPQ-III subscales and total scores showed good internal consistency and time reliability. Finally, scalar invariance was only partially obtained, whereas all the other types of invariance were fully respected both for gender and age. Conclusions The current findings indicate that the Italian version of the FPQ-III provides valid and reliable scores for the assessment of fear of pain in the Italian population.

The aim of this study was to estimate preferences related to quality of life attributes in people with multiple sclerosis, by keeping heterogeneity of patient preference in mind, using the latent class approach. A discrete choice experiment survey was developed using the following attributes: activities of daily living, instrumental activities of daily living, pain/fatigue, anxiety/depression and attention/concentration. Choice sets were presented as pairs of hypothetical health status, based upon a fractional factorial design. The latent class logit model estimated on 152 patients identified three subpopulations, which, respectively, attached more importance to: (1) the physical dimension; (2) pain/fatigue and anxiety/depression; and (3) instrumental activities of daily living impairments, anxiety/depression and attention/concentration. A posterior analysis suggests that the latent class membership may be related to an individual’s age to some extent, or to diagnosis and treatment, while apart from energy dimension, no significant difference exists between latent groups, with regard to Multiple Sclerosis Quality of Life-54 scales. A quality of life preference-based utility measure for people with multiple sclerosis was developed. These utility values allow identification of a hierarchic priority among different aspects of quality of life and may allow physicians to develop a care programme tailored to patient needs.

Background and Objectives Multiple sclerosis (MS) has a broad spectrum of physical, social, psychological effects and significant impact on quality of life (QoL). Several studies has showed the importance of self-efficacy as a predictor of QoL in patients with MS. This study aims at evaluating the robustness of the relationship between self-efficacy and QoL. Specifically it aims to test whether such relation will vanish under the following conditions: using a general measure of self-efficacy and controlling for level of impairment defined as a broad construct dealing with physical, social and working changes due to the illness condition. Methods One hundred-fifty five participants responded to a questionnaire, including QoL and general self-efficacy measures, socio demographic and clinical variables. Two nested structural equation models that differ for the presence or absence of the path connecting self-efficacy and QoL was estimated. Results and Conclusions The hypothesis of the vanishing of the relationship between self-efficacy and QoL had to be rejected. These results support the genuineness of this relation and emphasize the importance of interventions promoting self-efficacy to improve QoL in chronic diseases such as MS. From a methodological perspective this study is an example of the usefulness of formative indicators in QoL studies.

Background: The Multiple Sclerosis Quality of Life-54 (MSQOL-54, 52 items grouped in 12 subscales plus two single items) is the most used MS specific health related quality of life inventory. Objective: To develop a shortened version of the MSQOL-54. Methods: MSQOL-54 dimensionality and metric properties were investigated by confirmatory factor analysis (CFA) and Rasch modelling (Partial Credit Model, PCM) on MSQOL-54s completed by 473 MS patients. Their mean age was 41 years, 65% were women, and median Expanded Disability Status Scale (EDSS) score was 2.0 (range 0-9.5). Differential item functioning (DIF) was evaluated for gender, age and EDSS. Dimensionality of the resulting short version was assessed by exploratory factor analysis (EFA) and CFA. Cognitive debriefing of the short instrument (vs. the original) was then performed on 12 MS patients. Results: CFA of MSQOL-54 subscales showed that the data fitted the overall model well. Two subscales (Role Limitations-Physical, Role Limitations-Emotional) did not fit the PCM, and were removed; two other subscales (Health Perceptions, Social Function) did not fit the model, but were retained as single items. Sexual Satisfaction (single-item subscale) was also removed. The resulting MSQOL-29 consisted of 25 items grouped in 7 subscales, plus 4 single items. PCM fit statistics were within the acceptability range for all MSQOL-29 items except one which had significant DIF by age. EFA and CFA indicated adequate fit to the original two-factor (Physical and Mental Health Composites) hypothesis. Cognitive debriefing confirmed that MSQOL-29 was acceptable and had lost no key items. Conclusions: The proposed MSQOL-29 is 50% shorter than MSQOL-54, yet preserves key quality of life dimensions. Prospective validation on a large, independent MS patient sample is ongoing.

The present work aims to investigate the relation between appraisals, emotions, and emotion regulation strategies by creating a structural equation model which integrates these three aspects of the emotion process. To reach this aim, Italian students (N = 610) confronted with their high school diploma examination completed a questionnaire 3 weeks before the beginning of the exam. Results showed that they experienced primarily three types of emotions—anxiety/fear, frustration/powerlessness, positive emotions—which were related to specific appraisal profiles. Importantly, these appraisal profiles and emotions were associated with the use of different strategies for regulating emotions: anxiety/fear was associated with focusing on the exam, drug use, and an inability to distance oneself from the exam; frustration/powerlessness, with use of suppression, distancing, and drugs; positive emotion, with reappraisal and problem focused strategies. The effectiveness of these different strategies will be discussed.

The study explores the psychometric properties of a deviant behavior scale for adolescents based on Jessor’s problem behavior theory. The sample consisted of 2191 Italian adolescents aged between 13 and 24 years (M = 16.2, SD = 1.6) attending different types of secondary schools in Piemonte and Valle d’Aosta. The results demonstrate goodness of fit for a three interrelated factor model corresponding to the three most common deviant behaviors in adolescents – “physical aggression,” “theft and vandalism,” and “lying and disobedience.” Furthermore, the three dimensions prove to possess a satisfactory degree of reliability. Multigroup analyses show that the three-factor structure is substantially stable over age and gender subgroups.