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Fibromyalgia is a widespread condition which is currently underdiagnosed, therefore we conceived this study in order to assess whether a diagnostic suspicion may be assumed during widespread screening procedures, so that patients for which a reasonable diagnostic suspicion exist may be redirected towards rheumatologic evaluation. We analyzed a sample of 1060 patients, all of whom were female and undergoing standard breast cancer screening procedures, and proceeded to evaluate the level of pain they endured during mammographic exam. We also acquired a range of other information which we related to the level of pain endured, we suggested a rheumatologic examination for those patients who endured the highest level of pain and then we evaluated how many patients in this subgroup were actually diagnosed with fibromyalgia. Out of the 1060 patients who participated to our study, 139 presented level 4 pain intensity, One patient did not go for rheumatologic examination, the remaining 138 underwent rheumatologic evaluation, and 50 (36%, 28–44, 95% CI) were diagnosed with fibromyalgia. Our study shows that assessing the level of pain endured by patients during standard widespread screening procedures may be an effective asset in deciding whether or not to suggest specialist rheumatologic evaluation for fibromyalgia.

Respiratory distress syndrome (RDS) is a leading cause of morbidity and mortality in preterm infants due to primary surfactant deficiency. Surfactant replacement has greatly improved the short and long term prognosis of RDS but its administration criteria remain uncertain. Lung ultrasound has been recently shown as a non-invasive, repeatable, bedside tool to estimate parenchymal aeration using a semiquantitative score (LUS). The objective of this systematic review and meta-analysis is to evaluate the accuracy of LUS, assessed on the first day of life, to predict surfactant replacement. Methods will follow the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guidelines and the protocol has been registered in PROSPERO database (registration number: CRD42021247888). Primary outcome: in a population of preterm infants, LUS will be compared in neonates who received surfactant replacement versus those who did not. Secondary outcome will be the accuracy of lung ultrasound score to predict the need for ≥ 2 doses of surfactant.

When people receive a diagnosis of chronic or non-communicable disease, they need to reorganize their lives to understand and accommodate the changes associated with the new health condition. This reorganization, which involves the activation of a process through which meaning is given to the illness, could be fostered by narrative methods also in the context of Primary Care. The Sense of Grip on Disease (SoGoD) model intends to focus on the role of sense-meaning-making processes in the psychological adjustment to non-communicable illness, emphasizing the patients’ role in managing their own health condition. In this study, the authors propose a mixed-method research method which implies the adaptation of the narrative interview on the Sense of Grip on Disease. The interview was administered to 31 adults suffering from non-communicable diseases and has been analyzed with a theory-driven approach, which aims to explore the modalities of five narrative functions: organization of temporality, integration of illness, expression of emotions, social sharing and orientation to action. Through a Multiple Correspondence Analysis and a Cluster Analysis, the authors have identified two different ‘Grip Profiles’, called “Dynamic Profile” and “Compliant Profile”, representative of different degrees of flexibility, integration and adjustment to disease.

The aim of this prospective multicenter study was to compare antibiotic therapy and appendectomy as treatment for patients with uncomplicated appendicitis confirmed by ultrasound and/or computed tomography.The study was conducted from January 2017 to January 2018. Data regarding all patients discharged from the participating centers with a diagnosis of uncomplicated appendicitis were collected prospectively.Of the 318 patients enrolled in the study, 27.4% underwent antibiotic-first therapy, and 72.6% underwent appendectomy. The matched group was composed of 87 patients in both study arms. Of the 87 patients available of 1-year follow-up in the antibiotic-first group, 64 (73.6%) did not require appendectomy. The complication-free treatment success in the antibiotic-first group was 64.4%. A statistically significant higher complication-free treatment success was found in the appendectomy group: 81.8% in the pre-matching sample and 83.9% in the post-matching sample. Patients in the antibiotic-first group reported lower VAS scores compared to those treated with an appendectomy, both at discharge (2.0 ± 1.7 vs 3.6 ± 2.3) and at 30-day follow-up (0.3 ± 0.6 vs 2.1 ± 1.7). The mean of the days of absence from work was higher in the appendectomy group (β 0.63; 95% CI 0.08-1.18).Although laparoscopic appendectomy remains the gold standard of treatment for uncomplicated appendicitis, conservative treatment with antibiotics is a safe option in most cases. Approximately 65% of patients treated with antibiotics are symptom-free at 1 year, without increased risk of adverse events should symptoms recur, and better outcomes in terms of less pain and shorter period of absence from work compared to patients undergoing an appendectomy.Clinicaltrials.gov identifier (NCT number): NCT03080103.

Visual neglect is a frequent and disabling consequence of right brain damage. Traditional paper-and- pencil tests of neglect have limitations in sensitivity and ecological validity. The Baking Tray Task (BTT), instead, approaches real-life situations, because it requires participants to place 16 physical objects on a board. The number of objects placed on the left and right portions of the board provides a clinical index of visual neglect. Here we present E-TAN, a technology-enhanced platform which allows patients to perform an enhanced version of the BTT (E-BTT). This platform automatically determines the object locations on the board, and also records the sequence and timing of their placement. We used E-BTT to test 9 patients with right hemisphere damage, and compared their performance with that obtained by 115 healthy participants. To this end, we developed a new method of analysis of participants’ performance, based on the use of the convex hull described by the objects on the board. This measure provides an estimate of the portion of space processed by each participant, and can effectively discriminate neglect patients from patients without neglect. E-TAN allows clinicians to assess visuospatial performance by using a convenient, fast, and relatively automatized procedure, that patients can even perform at home to follow-up the effects of rehabilitation.

Purpose: The aim of this prospective multicenter study was to compare antibiotic therapy and appendectomy as treatment for patients with uncomplicated appendicitis confirmed by ultrasound and/or computed tomography. Methods: The study was conducted from January 2017 to January 2018. Data regarding all patients discharged from the participating centers with a diagnosis of uncomplicated appendicitis were collected prospectively. Results: Of the 318 patients enrolled in the study, 27.4% underwent antibiotic-first therapy, and 72.6% underwent appendectomy. The matched group was composed of 87 patients in both study arms. Of the 87 patients available of 1-year follow-up in the antibiotic-first group, 64 (73.6%) did not require appendectomy. The complication-free treatment success in the antibiotic-first group was 64.4%. A statistically significant higher complication-free treatment success was found in the appendectomy group: 81.8% in the pre-matching sample and 83.9% in the post-matching sample. Patients in the antibiotic-first group reported lower VAS scores compared to those treated with an appendectomy, both at discharge (2.0 ± 1.7 vs 3.6 ± 2.3) and at 30-day follow-up (0.3 ± 0.6 vs 2.1 ± 1.7). The mean of the days of absence from work was higher in the appendectomy group (β 0.63; 95% CI 0.08-1.18). Conclusion: Although laparoscopic appendectomy remains the gold standard of treatment for uncomplicated appendicitis, conservative treatment with antibiotics is a safe option in most cases. Approximately 65% of patients treated with antibiotics are symptom-free at 1 year, without increased risk of adverse events should symptoms recur, and better outcomes in terms of less pain and shorter period of absence from work compared to patients undergoing an appendectomy. Trial registration: Clinicaltrials.gov identifier (NCT number): NCT03080103.

Objectives: The aim of our study was to assess the frequency distribution of relevant and incidental vascular events in a retrospective cohort of 42 COVID-19 patients. Methods: All patients were studied by whole-body CT angiography.Twenty-three out of 42 patients were admitted to the intensive care unit (ICU). Results: Relevant vascular events were recorded in the 71.4% of the whole study population. Pulmonary embolism was the most frequent one both in ICU and no-ICU cases (56.5% vs10.5%, p=0.002). Ischemic infarction of other organs was affecting with an increasing prevalence the gut, the spleen, the liver, the brain and the kidney, with a simultaneous ischemic occurrence in some cases. Multi-focal venous thrombosis was also represented especially in ICU patients (p=0.005). Among incidental findings, splanchnic vessels little-size aneurysms were reported in the 40% of the whole population, with relative frequencies similarly distributed in ICU and no-ICU patients.Conclusions: Vascular involvement is not negligible in COVID-19 and should be carefully investigated as may significantly affect disease behavior and prognosis.

Background Calgranulin-C (S100A12) is a new faecal marker of inflammation that is potentially more specific for Inflammatory Bowel Disease (IBD) than calprotectin, since it is only released by activated granulocytes. In recent years it has been confirmed that the S100A12 has comparable sensitivity and specificity to fecal calprotectin (FC) in adult patients with IBD. The aim of our study was to evaluate concentration of faecal S100A12 and calprotectin (FC) to see which of the two tests best correlated to inflammation in IBD children. Methods Between September 2019 and March 2020, we prospectively enrolled all IBD pediatric patients, both Crohn’s Disease (CD) and Ulcerative Colitis (UC). Blood and faecal samples were collected in order to evaluate serological markers of inflammation, faecal S100A12A and FC. S100A12 and FC were determined by enzyme-linked immunosorbent assay (ELISA). Results One hundred seventeen consecutive children, 46 (39%) with CD and 71 (61%) with UC were enrolled in the study. The mean age was 14.6 years (range:5–18), 44% female. Twenty three children were in clinical relapse (20%). No significant differences in S100 A12A levels were found between the UC and the CD groups (mean ±ds 25 ±32mcg/ml vs 34 ±27 mcg/ml respectively, p=0.22).In the UC group we found a statistically significant correlation of both calprotectin and S100A12 with CRP (r=0.253, p=0.044 and r=0.252, p=0.040, respectively). In CD group we found that both calprotectin and S100A12 correlated with hemoglobin (r= -0.343, p=0,024; r=-0.401, p 0.008 respectively), hematocrit (r=-0.361, p=0,046; r=-0.434, p=0.015, respectively), fibrinogen (r=0.499, p< 0,001; r=0.325, p =0.038, respectively), and white blood cells count (r=0.309, p=0.044; r=0.394, p=0.021, respectively). Moreover, in CD group, FC correlated with CRP (r=0.431, p=0.004) and erythrocyte sedimentation rate (r=0.430, p=0.004). Finally, S100A12 correlated with platelet count both in CD and UC group (r=0.351, p=0.021and r=0.254, p=0.038, respectively) IBD children in clinical relapse had higher values ​​of S100A12 and FC than patients in remission (66±47 mcg/ml vs 43±42 mcg/ml, p=0.05 and 260±192 mg/Kg vs 166±169 mg/Kg, p=0.046, respectively) Conclusion Our preliminary data show that both faecal S100A12 and FC are useful non-invasive biomarkers which reflect inflammatory activity of IBD children. Our future aim is to evaluate the correlation of S100A12 and endoscopic finding in order to further clarify its role in the diagnosis and the management of pediatric IBD.

Background Multiple pathways link Vitamin D status with the risk of development and the clinical course of Inflammatory Bowel Disease (IBD). However, limited studies have been conducted on the relationship between vitamin D and disease activity in IBD, especially in pediatric population and the results have been inconsistent. Moreover Vitamin D metabolites may provide a more precise assessment of sufficiency and mineral metabolism than total 25-hydroxyvitamin-D (25(OH)D). The aim of our study was to evaluate the concentrations of total25(OH)D, 24,25-dihydroxyvitamin D (24,25(OH)2D) and calcitriol (1,25-(OH)2D) to correlate these values with the disease activity markers. Methods We prospectively enrolled all IBD pediatric patients. Total 25(OH)D, 24,25(OH)2D and1,25-(OH)2D levels were measured by enzyme-linked immunosorbent assay (ELISA). In each patient with IBD, the activity scores of disease and the main inflammation markers were correlated to Vitamin D metabolites. We prospectively enrolled all IBD pediatric patients. Total 25(OH)D, 24,25(OH)2D and1,25-(OH)2D levels were measured by enzyme-linked immunosorbent assay (ELISA). In each patient with IBD, the activity scores of disease and the main inflammation markers were correlated to Vitamin D metabolites. Results One hundred twenty three consecutive IBD children were enrolled, 43% with Crohn Disease (CD),55% Ulcerative colitis (UC), 2% indeterminate colitis. No difference in 25(OH)D,24,25(OH)2D and 1,25-(OH)2D levels were found between CD and UC patients. A significant indirect correlation was found between C reactive protein and 1,25-(OH)2D levels in patients with IBD (r=-0.275, p=0.046) and in CD group (r=-0.477, p=0.039). Moreover, in patients with IBD and CD we found a significant indirect correlation between erythrocyte sedimentation rate(ESR) and 25(OH)D (r=-0.212, p=0.024 and and r=-0.282, p=0.047 respectively). Instead, in the UC group we found only a direct correlation for both fibrinogen and ESR with 1,25-(OH)2Dlevels (r=0.407, p 0.028 and r=0.446, p=0.013). Conclusion Our results suggest that both the active form and the total Vitamin D levels are inversely associated with disease activity especially in CD children. Further studies are needed to clarify the role of Vitamin D deficiency as a consequence or a cause of inflammation.

Interpersonal emotion regulation entails a wide array of strategies aimed at influencing others' emotions. Despite its importance for successful social interactions, only a few studies have evaluated interpersonal emotion regulation in children. In detail, the study of developmental changes in the use of emotion regulation strategies overlooked age, gender and cultural differences across different emotions. To address this gap, the present study used the serious game Emodiscovery, a simulation game targeted at 8-10-year-olds, which measures the strategies selected by children to improve the emotions of anger, sadness, and fear displayed by 3D virtual characters. One-hundred British (M = 9.10 years; 39% girls) and 108 Spanish (M = 9.04, 44% girls) 8-10-year-olds played 3 different levels or scenarios of the game. In each level, the character displayed a negative emotion (i.e., sadness, anger, and fear, respectively) and children were first asked to indicate what emotion the character was feeling and afterward to interact three times with the character to improve his or her mood. In each interaction, 4 possible regulation strategies (2 adaptive and 2 maladaptive) were displayed for children to select. Results showed that in the scenario where the character was displaying sadness, 8-year-olds chose significantly less adaptive strategies than 10-years-olds. In the scenario where the character was angry, boys who accurately recognized the emotion of anger chose more adaptive strategies than those who did not recognize the emotion. For the scenario depicting fear, boys chose less adaptive strategies than girls. The obtained results highlight the importance of looking at specific emotions when researching interpersonal emotion regulation. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Emotion regulation (ER) is key for children's development and it has recently been considered in many serious games and e-learning technologies. However, these tools have focused on children's efforts to change their own emotions (intrapersonal ER), overlooking how children may engage in modifying the emotions of others (interpersonal ER). To address this gap, we have developed a multiplatform online serious game, Emodiscovery, which evaluates whether children (8-11 year-olds) tend to use different adaptive and maladaptive regulation strategies to change others' negative emotions with the use of 3D animated characters. The game is organized into levels, each representing a different scenario, where the child is asked to interact with the character three times choosing an appropriate regulation strategy to cheer him or her up from four possible options, being two adaptive and two maladaptive strategies. To test the effectiveness of the game, a sample of English children played three scenarios depicting a character feeling sadness, anger, and fear, respectively. Results showed that most children chose adaptive strategies to improve the character's emotion across the different emotion scenarios. Furthermore, emotion recognition was not positively related to children's choices of regulation strategies. The implications and applications of the games are discussed.

We present a natural language processing model that allows automatic classification and prediction of the user’s negotiation style during the interaction with virtual humans in a 3D game. We collected the sentences used in the interactions of the users with virtual artificial agents and their associated negotiation style as measured by ROCI-II test. We analyzed the documents containing the sentences for each style applying text mining techniques and found statistical differences among the styles in agreement with their theoretical definitions. Finally, we trained two machine learning classifiers on the two datasets using pre-trained Word2Vec embeddings.