Search

Snow cover variability has significant effects on local and global climate evolution. By changing surface energy fluxes and hydrological conditions, changes in snow cover can alter atmospheric circulation and lead to remote climate effects. To document such multi-scale climate effects, atmospheric reanalysis and derived products offer the opportunity to analyze snow variability in great detail far back to the early 20th century. So far only little is know about their quality. Comparing snow depth in four long-term reanalysis datasets with Russian in situ snow depth data, we find a moderately high daily correlation (around 0.6–0.7), which is comparable to correlations for the recent era (1981–2010), and a good representation of sub-decadal variability. However, the representation of pre-1950 inter-decadal snow variability is questionable, since reanalysis products divert towards different base states. Limited availability of independent long-term snow data makes it difficult to assess the exact cause for this bifurcation in snow states, but initial investigations point towards representation of the atmosphere rather than differences in assimilated data or snow schemes. This study demonstrates the ability of long-term reanalysis to reproduce snow variability accordingly.

Observations from the Odin/Sub-Millimetre Radiometer (SMR) instrument have been assimilated into the DIAMOND model (Dynamic Isentropic Assimilation Model for OdiN Data), in order to estimate the chemical ozone (O3) loss in the stratosphere. This data assimilation technique is described in Sagi and Murtagh (2016), in which it was used to study the inter-annual variability in ozone depletion during the entire Odin operational time and in both hemispheres. Our study focuses on the Arctic region, where two O3 destruction mechanisms play an important role, involving halogen and nitrogen chemical families (i.e. NOx = NO and NO2), respectively. The temporal evolution and geographical distribution of O3 loss in the low and middle stratosphere have been investigated between 2002 and 2013. For the first time, this has been done based on the study of a series of winter–spring seasons over more than a decade, spanning very different dynamical conditions. The chemical mechanisms involved in O3 depletion are very sensitive to thermal conditions and dynamical activity, which are extremely variable in the Arctic stratosphere. We have focused our analysis on particularly cold and warm winters, in order to study the influence this has on ozone loss. The winter 2010/11 is considered as an example for cold conditions. This case, which has been the subject of many studies, was characterised by a very stable vortex associated with particularly low temperatures, which led to an important halogen-induced O3 loss occurring inside the vortex in the lower stratosphere. We found a loss of 2.1 ppmv at an altitude of 450 K in the end of March 2011, which corresponds to the largest ozone depletion in the Northern Hemisphere observed during the last decade. This result is consistent with other studies. A similar situation was observed during the winters 2004/05 and 2007/08, although the amplitude of the O3 destruction was lower. To study the opposite situation, corresponding to a warm and unstable winter in the stratosphere, we performed a composite calculation of four selected cases, 2003/04, 2005/06, 2008/09 and 2012/13, which were all affected by a major mid-winter sudden stratospheric warming event, related to particularly high dynamical activity. We have shown that such conditions were associated with low O3 loss below 500 K (approximately 20 km), while O3 depletion in the middle stratosphere, where the role of NOx-induced destruction processes prevails, was particularly important. This can mainly be explained by the horizontal mixing of NOx-rich air from lower latitudes with vortex air that takes place in case of strongly disturbed dynamical situation. In this manuscript, we show that the relative contribution of O3 depletion mechanisms occurring in the lower or in the middle stratosphere is significantly influenced by dynamical and thermal conditions. We provide confirmation that the O3 loss driven by nitrogen oxides and triggered by stratospheric warmings can outweigh the effects of halogens in the case of a dynamically unstable Arctic winter. This is the first time that such a study has been performed over a long period of time, covering more than 10 years of observations.

The critical spread and dissemination of novel psychoactive substances (NPS), particularly among the most vulnerable youngsters, may pose a further concern about the psychotic trajectories related to the intake of new synthetic drugs. The psychopathological pattern of the “new psychoses” appears to be extremely different from the classical presentation. Therefore, clinicians need more data on these new synthetic psychoses and recommendations on how to manage them. The present mini-review aims at deepening both the clinical, psychopathological features of synthetic/chemical NPS-induced psychoses and their therapeutic strategies, according to the different NPS classes implicated, by underlining the main differences with the “classical” psychoses. A comprehensive review was conducted using the PubMed/Medline database by combining the search strategy of free-text terms and exploding a range of MESH headings relating to the topics of novel psychoactive substances and synthetic/chemical psychoses as follows: {(Novel Psychoactive Substances[Title/Abstract]) AND Psychosis[Title/Abstract])} and for each NPS categories as well, focusing on synthetic cannabinoids and cathinones, without time and/or language restrictions. Finally, an overview of the main clinical and psychopathological features between classical versus NPS-induced chemical/synthetic psychoses is provided for clinicians working with dual disorders and addiction psychiatry. Further insight is given here on therapeutic strategies and practical guidelines for managing patients affected with synthetic/chemical NPS-induced psychoses.

Rheumatoid arthritis (RA) is associated with higher risk of heart failure. Several studies report that left ventricular (LV) diastolic dysfunction (LVDD), a silent precursor of heart failure, is widely present in RA patients. Very little is known about the factors related to the development of LVDD in this disease. In this study we assessed the incidence and the predictors of new-onset LVDD in RA patients. Two-hundred-ninety-five adults with RA without overt cardiac disease were prospectively analyzed from March 2014 to March 2015 by Doppler echocardiography. Among the 295 subjects evaluated, 217 (73.6%) had normal LV diastolic function and represented the final study population. At 1-year follow-up, 53 of 217 patients (24%) developed LVDD, which was of degree I (mild dysfunction) in all of them. By multivariate logistic regression analysis, lower E/A ratio of transmitral flow (ratio between the peak velocity of early diastolic “E” wave and late diastolic “A” wave of transmitral flow) was independently associated with new-onset LVDD [OR 0.17 (CI 0.09-0.57)], together with older age and higher systolic blood pressure. In a clinical predictive model derived from multivariate analysis, the new-onset LVDD rate event ranged from 0% (patients without any factor) to 75% (patients in whom the three predictors coexisted). A significant portion of patients with RA without overt cardiac disease develop LVDD at 1-year follow-up. This condition can be predicted by a simple clinical model which could improve the clinical management and the prognostic stratification of patients with RA.

The decision made in the year 2004 by the U.S. Food and Drug Administration (FDA) to require a boxed warning on antidepressants regarding the risk of suicidality in young adults still represents a matter of controversy. The FDA warning was grounded on industry-sponsored trials carried one decade ago or earlier. However, within the past decade, an increasing number of reports have questioned the actual validity of the FDA warning, especially considering a decline in the prescription of the antidepressant drugs associated with an increase in the rate of suicidal events among people with severe depression. The present report provides an overview of the FDA black box warning, also documenting two Major Depressive Disorder patients whose refusal to undergo a pharmacological antidepressant treatment possibly led to an increased risk for suicidal behaviors. The concerns raised by the FDA black box warning need to be considered in real-world clinical practice, stating the associated clinical and public health implications.

El 10 de diciembre del año 1948, la Asamblea General de Naciones Unidas, mediante Resolución 217 A(III), aprobó la Declaración Universal de los Derechos Humanos, incorporando todos los derechos básicos del ser humano, a excepción -curiosamente- de su derecho al agua potable. Fue necesario esperar más de 60 años, para que el 28 de julio del año 2010, a través de la Resolución 64/292, la Asamblea General de las Naciones Unidas reconociera explícitamente el derecho humano al agua y al saneamiento. También escuchamos en los últimos años -en particular en oportunidad de actos eleccionarios- discursos políticos que incorporaban elegantes expresiones reafirmando el derecho el agua, aunque sin aportar siquiera una propuesta “rápida” de cómo garantizar tal derecho, y mucho menos de las herramientas jurídicas para su protección. En el presente trabajo, se hace mención a los riesgos de las enfermedades hídricas; a las referencias históricas de los derechos humanos, y en particular, del derecho al agua y al saneamiento en la provincia de Santa Fe; y la histórica ausencia de una política en tal sentido; al agua para consumo humano como principal objetivo de la Política Hídrica propuesta; las garantías del derecho al agua, y una propuesta básica de Ordenamiento Jurídico para contar con tales garantías.

Task- and stimulus-based neuroimaging studies have begun to unveil the central autonomic network which modulates autonomic nervous system activity. In the present study, we aimed to evaluate the central autonomic network without the bias constituted by the use of a task. Additionally, we assessed whether this circuitry presents signs of dysregulation in the early stages of Parkinson's disease (PD), a condition which may be associated with dysautonomia. We combined heart-rate-variability based methods for time-varying assessments of the autonomic nervous system outflow with resting-state fMRI in 14 healthy controls and 14 de novo PD patients, evaluating the correlations between fMRI time-series and the instantaneous high-frequency component of the heart-rate-variability power spectrum, a marker of parasympathetic outflow. In control subjects, the high-frequency component of the heart-rate-variability power spectrum was significantly anti-correlated with fMRI time-series in several cortical, subcortical and brainstem regions. This complex central network was not detectable in PD patients. In between-group analysis, we found that in healthy controls the brain activation related to the high-frequency component of the heart-rate-variability power spectrum was significantly less than in PD patients in the mid and anterior cingulum, sensorimotor cortex and supplementary motor area, insula and temporal lobe, prefrontal cortex, hippocampus and in a region encompassing posterior cingulum, precuneus and parieto-occipital cortex. Our results indicate that the complex central network which modulates parasympathetic outflow in the resting state is impaired in the early clinical stages of PD.

Background. The tyrosine kinase inhibitors (TKIs) are indicated for the treatment of locally advanced or metastatic progressive thyroid carcinoma (CDT), refractory to radioactive iodine. The following report describes the efficacy of lenvatinib administered through a nose-gastric tube (SNG) in a patient affected with a poorly differentiated thyroid carcinoma (PDTC) which determined a stenosis of the esophagus. Material and Methods. A patient was followed up for papillary thyroid carcinoma follicular variant (T3NxMx), subjected to total thyroidectomy and treated with iodine-131 radio metabolic therapy. Two years after surgery, following the onset of dysphonia and dysphagia, patient was submitted to a computed tomography (CT) scan of the neck that showed the presence of a lesion of 6 × 2.5 × 3.5 cm, which determined trachea deviation and cervical esophagus compression. The biopsy indicated the presence of PDTC, triggering tracheal lumen reduction and sub-stenosis of the cervical esophagus for an ab-extrinsic compression. A nose-gastric tube (SNG) was placed and lenvatinib was started at a dose of 20 mg/day, administered via this probe after opening the capsules and diluting the drug in 10 ml of saline solution. Results. One month later, CT showed a significant cervical lesion reduction. Bronchoscopy confirmed tracheal infiltration, but the residual caliber was improved from 50% to 75%. At the esophagogastroduodenoscopy (EGDS), the sub stenosis of the cervical esophagus was no longer appreciated; however, a double perforation of the esophagus was found, without fistula. Conclusion. Lenvatinib therapy is effective also when administered via SNG. Our result is of particular relevance in the management of thyroid cancer patients, especially in the presence of subjects unable to swallow. Further studies are needed to validate the administration of lenvatinib by SNG, in order to extend the indications to this alternative administration way, beside the oral one.

Introduction: Arterial stiffness is known to be associated with atherosclerosis, cardiac remodelling and cardiovascular diseases. In recent studies, common carotid artery rigidity was seen to better predict cardiac morphology and function if compared to aortic parameters. The aim of the study was to determine the relation between carotid/aortic stiffness indices and the main echocardiographic measures in patients with rheumatological disease. Methods: 208 participants were evaluated (57,4 ± 11,4 yr; males = 36,1%); 65,9% were previously diagnosed with rheumatoid arthritis, 20,2% with psoriatic arthritis and 13,9% with ankylosing spondylitis. In each subjects medical history, use of drugs and glico-metabolic status was assessed. Echocardiography, blood pressure (BP) measurement and carotid ultrasonography were performed. Carotid Distensibility (CD) and Aortic Stiffness (AoS) were measured as indices of arterial stiffness. Results: Mean Left Ventricular Mass indexed by body surface area (LVM/BSA) and Relative Wall Thickness (RWT) were 98,8 ± 20,7 g/m2 and 0,46 ± 0,06, respectively. In multiple regression analysis, DC was correlated with age (β = 0,325, p < 0,0001) and mean BP (β = 0,502, p < 0,0001) while AoS was not associated with any anthropometric, anamnestic and vascular parameters. DC has been seen to inversely correlate with LVM/BSA (r = −0,20, p = 0,005), Intraventricular Septum and Posterior Wall Thickenss; a direct correlation between AoS and left E/e’ (a diastolic function indicator) has emerged (r = 0,191, p = 0,007). Conclusion: Results are consistent with a possible predictive role of DC assessment in left cardiac hypertrophy and remodelling and a direct link between AoS and left ventricular diastolic function.

Attention deficit hyperactivity disorder (ADHD) is a condition that usually has its onset in childhood. Although the disorder persists into adulthood in half of cases, adult ADHD is often not recognized due to different psychopathological characteristics, quite often overlapping with other diagnoses such as mood, anxiety and personality disorders. This is especially true for bipolar disorder (BD), which shares several symptoms with adult ADHD. Moreover, besides an overlapping clinical presentation, BD is often co-occurring in adults with ADHD, with comorbidity figures as high as 20%. This review will focus on the comorbidity between ADHD and BD by exploring the magnitude of the phenomenon and evaluating the clinical and functional characteristics associated with ADHD–BD comorbidity in adults. Finally, the review will address the implications of pharmacologically treating the ADHD–BD comorbidity, providing suggestions in how to treat these complex patients and addressing the issue of treatment-induced manic switch with the use of stimulants and other medications for ADHD.

The stratospheric, tropospheric and surface impacts from the 11 year ultraviolet solar spectral irradiance (SSI) variability have been extensively studied using climate models and observations. Here, we demonstrate using idealized model simulations that the Pacific Decadal Oscillation (PDO), which has been shown to impact the tropospheric and stratospheric circulation from sub-decadal to multi-decadal timescales, strongly modulates the solar-induced atmospheric response. To this end, we use a high-top version of the coupled ocean–atmosphere Norwegian Climate Prediction Model forced by the SSI dataset recommended for Coupled Model Intercomparison Project 6. We perform a 24-member ensemble experiment over the solar cycle 23 in an idealized framework. To assess the PDO modulation of the solar signal, we divide the model data into the two PDO phases, PDO+ and PDO−, for each solar (maximum or minimum) phase. By compositing and combining the four categories, we hence determine the component of the solar signal that is independent of the PDO and the modulation of the solar signal by the PDO, along with the solar signal in each PDO phase. Reciprocally, we determine the PDO effect in each solar phase. Our results show that the intensification of the polar vortex under solar maximum is much stronger in the PDO− phase. This signal is transferred into the troposphere, where we find a correspondingly stronger polar jet and weaker Aleutian Low. We further show that the amplification of the solar signal by the PDO− phase is driven by anomalous meridional advection of solar-induced temperature anomalies over northern North America and the North Pacific, which contributes to a decreased meridional eddy heat flux and hence to a decreased vertical planetary wave flux into the stratosphere.

We show how factorial regression can be used to analyse numerical model experiments, testing the effect of different model settings. We analysed results from a coupled atmosphere–ocean model to explore how the different choices in the experimental set-up influence the seasonal predictions. These choices included a representation of the sea ice and the height of top of the atmosphere, and the results suggested that the simulated monthly mean air temperatures poleward of the mid-latitudes were highly sensitivity to the specification of the top of the atmosphere, interpreted as the presence or absence of a stratosphere. The seasonal forecasts for the mid-latitudes to high latitudes were also sensitive to whether the model set-up included a dynamic or non-dynamic sea-ice representation, although this effect was somewhat less important than the role of the stratosphere. The air temperature in the tropics was insensitive to these choices.

RESUMO Objetivo: Avaliar a biocompatibilidade da Nanoskin para reposição de volume em cavidades enucleadas ou evisceradas de coelhos. Métodos: Estudo experimental, utilizando implantes de Nanoskin (Innovatecs®, São Carlos, Brasil), celulose bacteriana produzida pela bactéria Acetobacter xylinum tendo como substrato o chá-verde. Implantes de 10mm de diâmetro/5mm de espessura foram colocados em cavidades enucleadas (G1) ou evisceradas (G2) de 21 coelhos, avaliados clinicamente todos os dias, sacrificados aos 7, 30 e 90 dias após a cirurgia. O material foi removido e preparado para exame de microscopia óptica. Resultados: Sinais flogísticos discretos no pósoperatório imediato, não tendo sido evidenciados sinais infecciosos ou extrusão de nenhum implante. Houve aparente redução do volume ao longo do período experimental. Histologicamente ambos os grupos foram muito semelhantes, apresentando aos 7 dias células inflamatórias (predominantemente monócitos e neutrófilos), rede de fibrina e hemácias. A Nanoskin apresentava-se como pequenas esferas, de cor rósea, com pequenos espaços entre elas, permeados por escassas células inflamatórias. As células inflamatórias se modificaram ao longo de período experimental, sendo possível observar aos 30 dias células gigantes multinucleadas e fibroblastos maduros permeando o implante. Aos 90 dias, a estrutura do implante apresentava-se desorganizada, amorfa, com restos necróticos e com áreas ovoides, revestidas por fina membrana rósea, que pareciam se agrupar, vazias ou preenchidas por material acelular, róseo ou acinzentado. Conclusão: A Nanoskin provocou reação inflamatória que levou à reabsorção e redução do volume do implante. Novas formulações devem ser estudadas a fim de ter um produto que seja permanente para reparo da cavidade anoftálmica.

RESUMO Objetivo: Observar a frequência de ocorrência das afecções que acometem os anexos oculares e o olho externo, assim como descrever o perfil demográfico dos portadores, na região centro oeste do estado de São Paulo. Métodos: Estudo prospectivo, populacional e aleatorizado, no qual foram avaliadas 11.000 pessoas da região centro-oeste do Estado de São Paulo, nos anos de 2004/2005, por meio de consultas oftalmológicas e utilizando uma unidade móvel. Foi realizado exame oftalmológico completo. Os dados foram transferidos para tabela Excel, utilizando-se para o presente estudo dados referentes aos anexos e doenças do olho externo. A frequência de ocorrência dos problemas detectados foi analisada estatisticamente. Resultados: Foram detectadas 1.581 (14,6%) afecções de anexos ou do olho externo, sendo as mais frequentes o pterígio (9,4%), o hordéolo (0,8%) e as alterações do posicionamento palpebral (1,7%) (ectrópio, ptose e triquíase). Trauma, ectrópio e pterígio foram estatisticamente mais frequentes na população masculina. Conclusão: Das afecções pesquisadas, a de maior ocorrência na população foi o pterígio, seguido das alterações inflamatórias e do posicionamento palpebral.

Well-tuned emotional regulation is fundamental for human life and psychological well-being. Negative physiological emotions are counterbalanced by positive ones, and this equilibrium is the mainstay of human physiological affective states. However, this mechanism may sometimes become dysfunctional when negative emotions are not correctly counterbalanced, causing maladaptive behaviors, especially during adolescence. A very interesting review by Young et al. was recently published (Brain Sci.2019, 9(4), 76) and stimulated us to reflect on this topic. The screening for emotional disturbances and dysregulation in adolescents must be included in all the preventive and interventional programs aimed to achieve both physical and psychological well-being of the population and early intervention should be provided in order to avoid progression toward clinically relevant psychiatric disorders in late adolescence and adulthood.

Currently different classes of psychoactive substances are easily available for abuse, including several hundred novel psychoactive substances (NPS). Some of these drugs occur naturally in plants and animals or are chemically modified from plant or animal compounds and have been abused by humans over millennia. Recently, the occurrence of a new “drug culture” (e.g., psychonauts) who consume a great variety of NPS with hallucinogenic/psychedelic properties, facilitated the development of a new “psychedelic trend” toward the consumption of substances contained in some species of animals (“psychedelic fauna”). The present review aims at providing an overview of the most commonly abused “psychedelic animals,” by combining a dual search strategy coming from online psychonauts' experiences and English literature searches on the PubMed/Medline Google Scholar databases. A multilingual qualitative assessment on a range of websites and online resources was performed in order to identify a list of animals who possess some psychoactive properties and could be abused by humans for recreational purposes. Several species are implicated (i.e., ants, amphibians, fish). Routes of administration depend on the animal, substance included, metabolism, toxicity and individual, social and cultural variability. Online purchase and access are easy through tourism-related search strategies (“frog trip,” “help of charmer snake,” “religious trip”).

Antimicrobial resistance in Gram-negative bacteria, particularly Enterobacteriaceae, has become a leading cause of morbidity and mortality and a serious public health concern. Gram-negative bacteria carrying extended-spectrum beta-lactamase (ESBL) enzymes now represent a significant proportion of all bacteria isolated from different countries worldwide. Furthermore, the increasing number of isolates carrying carbapenemases in recent years includes multidrug-resistant (MDR), extensively drug-resistant (XDR), and pandrug-resistant (PDR) bacteria. Here, we describe what, to our knowledge, is the first case of a patient with a prosthetic joint infection from carbapenemase-resistant Klebsiella pneumoniae (CRKP) successfully treated with ceftazidime-avibactam in Italy.

Necrotizing fasciitis (NF) is a soft tissue infection affecting subcutaneous tissue and the muscular fascia without involvement of the muscle and can be either monomicrobial or polymicrobial. Monomicrobial infections are usually caused by group A streptococci, while infections caused by anaerobic germs usually affect immunodepressed patients. We report a rare case of NF caused by two anaerobic bacteria in an immunocompetent patient.

This study investigates the effect of stratospheric sudden warmings (SSWs) on planetary wave (PW) activity in the mesosphere–lower thermosphere (MLT). PW activity near 95 km is derived from meteor wind data using a chain of eight SuperDARN radars at high northern latitudes that span longitudes from 150° W to 25° E and latitudes from 51 to 66° N. Zonal wave number 1 and 2 components were extracted from the meridional wind for the years 2000–2008. The observed wintertime PW activity shows common features associated with the stratospheric wind reversals and the accompanying stratospheric warming events. Onset dates for seven SSW events accompanied by an elevated stratopause (ES) were identified during this time period using the Specified Dynamics Whole Atmosphere Community Climate Model (SD-WACCM). For the seven events, a significant enhancement in wave number 1 and 2 PW amplitudes near 95 km was found to occur after the wind reversed at 50 km, with amplitudes maximizing approximately 5 days after the onset of the wind reversal. This PW enhancement in the MLT after the event was confirmed using SD-WACCM. When all cases of polar cap wind reversals at 50 km were considered, a significant, albeit moderate, correlation of 0.4 was found between PW amplitudes near 95 km and westward polar-cap stratospheric winds at 50 km, with the maximum correlation occurring ∼ 3 days after the maximum westward wind. These results indicate that the enhancement of PW amplitudes near 95 km is a common feature of SSWs irrespective of the strength of the wind reversal.

Golimumab is an anti-TNF monoclonal antibody administred subcutaneously once a month and produced with an innovative technology that minimizes immunogenicity. This paper reviews and updates the main studies on the efficacy, safety and pharmacoeconomic aspects of treatment with golimumab of psoriatic arthritis, ankylosing spondylitis and rheumatoid arthritis.

Hallucinogen-persisting perception disorder (HPPD) is a syndrome characterized by prolonged or reoccurring perceptual symptoms, reminiscent of acute hallucinogen effects. HPPD was associated with a broader range of LSD (lysergic acid diethylamide)-like substances, cannabis, methylenedioxymethamphetamine (MDMA), psilocybin, mescaline, and psychostimulants. The recent emergence of novel psychoactive substances (NPS) posed a critical concern regarding the new onset of psychiatric symptoms/syndromes, including cases of HPPD. Symptomatology mainly comprises visual disorders (i.e., geometric pseudo-hallucinations, haloes, flashes of colors/lights, motion-perception deficits, afterimages, micropsia, more acute awareness of floaters, etc.), even though depressive symptoms and thought disorders may be comorbidly present. Although HPPD was first described in 1954, it was just established as a fully syndrome in 2000, with the revised fourth version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR). HPPD neural substrates, risk factors, and aetiopathogenesys still largely remain unknown and under investigation, and many questions about its pharmacological targets remain unanswered too. A critical mini review on psychopathological bases, etiological hypothesis, and psychopharmacological approaches toward HPPD, including the association with some novel substances, are provided here, by means of a literature search on PubMed/Medline, Google Scholar, and Scopus databases without time restrictions, by using a specific set of keywords. Pharmacological and clinical issues are considered, and practical psychopharmacological recommendations and clinical guidelines are suggested.

It is well known that alexithymic individuals may show significantly higher levels of anxiety, depression, and psychological suffering than non-alexithymics. There is an increasing evidence that alexithymia may be considered a risk factor for suicide, even simply increasing the risk of development of depressive symptoms or per se. Therefore, the purpose of this narrative mini-review was to elucidate a possible relationship between alexithymia and suicide risk. The majority of reviewed studies pointed out a relationship between alexithymia and an increased suicide risk. In several studies, this relationship was mediated by depressive symptoms. In conclusion, the importance of alexithymia screening in everyday clinical practice and the evaluation of clinical correlates of alexithymic traits should be integral parts of all disease management programs and, especially, of suicide prevention plans and interventions. However, limitations of studies are discussed and must be considered.

A sample of 170 Italian children was assessed for reading accuracy, reading speed, text comprehension and spelling in Grades 1 and 3 in order to investigate the concurrent and longitudinal relationships among literacy skills. Main results from multivariate analyses (regression, discriminant and path analyses) indicated that reading speed was the best predictor of later literacy and that spelling was the most stable measure and influenced text comprehension and reading speed. An asymmetry was also observed in the longitudinal relationship between reading and spelling errors, with reading errors predicting later spelling errors and a non-significant result in the opposite direction. (Contains 5 tables and 2 figures.)

Ozone and methane are chemically active climate-forcing agents affected by climate–chemistry interactions in the atmosphere. Key chemical reactions and processes affecting ozone and methane are presented. It is shown that climate-chemistry interactions have a significant impact on the two compounds. Ozone, which is a secondary compound in the atmosphere, produced and broken down mainly in the troposphere and stratosphre through chemical reactions involving atomic oxygen (O), NOx compounds (NO, NO2), CO, hydrogen radicals (OH, HO2), volatile organic compounds (VOC) and chlorine (Cl, ClO) and bromine (Br, BrO). Ozone is broken down through changes in the atmospheric distribution of the afore mentioned compounds. Methane is a primary compound emitted from different sources (wetlands, rice production, livestock, mining, oil and gas production and landfills).Methane is broken down by the hydroxyl radical (OH). OH is significantly affected by methane emissions, defined by the feedback factor, currently estimated to be in the range 1.3 to 1.5, and increasing with increasing methane emission. Ozone and methane changes are affected by NOx emissions. While ozone in general increase with increases in NOx emission, methane is reduced, due to increases in OH. Several processes where current and future changes have implications for climate-chemistry interactions are identified. It is also shown that climatic changes through dynamic processes could have significant impact on the atmospheric chemical distribution of ozone and methane, as we can see through the impact of Quasi Biennial Oscillation (QBO). Modeling studies indicate that increases in ozone could be more pronounced toward the end of this century. Thawing permafrost could lead to important positive feedbacks in the climate system. Large amounts of organic material are stored in the upper layers of the permafrost in the yedoma deposits in Siberia, where 2 to 5% of the deposits could be organic material. During thawing of permafrost, parts of the organic material that is deposited could be converted to methane. Furthermore, methane stored in deposits under shallow waters in the Arctic have the potential to be released in a future warmer climate with enhanced climate impact on methane, ozone and stratospheric water vapor. Studies performed by several groups show that the transport sectors have the potential for significant impacts on climate-chemistry interactions. There are large uncertainties connected to ozone and methane changes from the transport sector, and to methane release and climate impact during permafrost thawing.

Background and Objectives: Post-traumatic stress disorder (PTSD) is a common psychiatric disorder resulting from a traumatic event, is manifested through hyperarousal, anxiety, depressive symptoms, and sleep disturbances. Despite several therapeutic approaches being available, both pharmacological and psychological, recently a growing interest has developed in using cannabis and synthetic cannabinoids stems from their consideration as more efficient and better tolerated alternatives for the treatment of this condition. The present paper aims to evaluate the clinical and therapeutic potentials of medical cannabis and synthetic cannabinoids in treating PTSD patients. Methods: A systematic electronic search was performed, including all papers published up to May 2019, using the following keywords (((cannabis[Title/Abstract]) OR (synthetic cannabinoids [Title/Abstract])) AND ((PTSD[Title/Abstract]) OR (Posttraumatic stress disorder[Title/Abstract]))) for the topics ‘Cannabis’, ‘Synthetic Cannabinoids’, ‘PTSD’, and MESH terms, on the PubMed, Cochrane Library, and Web of Science online databases. For data gathering purposes, PRISMA guidelines were followed. Results were organized into two groups, considering cannabis and synthetic cannabinoids as different therapeutic approaches for PTSD. Results: Present data show that cannabis and synthetic cannabinoids, both acting on the endocannabinoids system, may have a potential therapeutic use for improving PTSD symptoms, e.g., reducing anxiety, modulating memory-related processes, and improving sleep. Conclusions: Even though the current literature suggests that cannabis and synthetic cannabinoids may have a role in the treatment of PTSD, there is currently limited evidence regarding their safety and efficacy. Therefore, additional research is needed in order to better understand the effectiveness and therapeutic usage of these drug classes and monitor their safety.

In this study we explored metaphor and idiom competencies in two clinical populations, children with autistic spectrum disorder (ASD) and children with Klinefelter syndrome (KS), (age range: 9–12), compared to typically developing (TD) children of the same age. These three groups were tested with two multiple-choice tests assessing idiom comprehension through iconic and verbal alternatives and a metaphor comprehension test composed of novel, physical-psychological metaphors, requesting verbal explanations. To these instruments, another test was added, assessing basic sentence comprehension. Performances on the different linguistic tasks were examined by means of discriminant analysis which showed that idiom comprehension had a very small weight in distinguishing children with ASD from TD controls, whereas metaphor explanation did distinguish them. This study suggests that figurative language comprehension is not a “core deficit” per se in individuals with ASD. Only when the task requires to explicitly construct and explain a semantic mapping between the two terms of a metaphor does the performance of children with ASD significantly deviate from the typical population. These results are interpreted in terms of a difficulty in children with ASD and KS with complex cognitive and linguistic processes and also in relation with clinical assessment.

In this study we explore the development of phonological and lexical reading in dyslexic children. We tested a group of 14 Italian children who have been diagnosed with dyslexia and whose reading age is end of grade 1. We compared this group with a group of 70 typically developing children who have been tested for reading at the end of grade 1. For each dyslexic child we also selected a participant who was attending the same grade, was close in age, and showed typical reading development when tested with a narrative passage reading task (Cornoldi, Colpo, & Gruppo MT, 1981) for correctness and reading speed. Children in this group are "same grade controls." We used a reading task consisting of 40 three syllables words. A qualitative and quantitative method of coding children's naming allowed us to distinguish several components of their reading performance: the grapheme and word recognition, the size of orthographic units involved in the aloud orthography-phonology conversion, the reading process used to recognize words. The comparison of the dyslexic group with the reading age and the same grade control groups reveals different trends of delayed reading processes. Considering dyslexic children's chronological age, lexical reading is greatly delayed. Considering dyslexic children's reading age, the type of reading process that is more deeply delayed is phonological reading. The rate of fragmented phonological reading (i.e., a type of syllabized phonological reading) is much higher in dyslexic children compared to the reading age group, suggesting that some factors undermine the possibility of internalizing the orthography-phonology conversion and the blending processes.

In this longitudinal study we analyse the early phases of reading development in Italian and explore the transition from phonological to lexical reading. A group of 28 Italian children was tested in four phases. Language and cognitive skills were first assessed in the preschool. Reading performance was then tested in three different sessions, in grade 1 and 2, using off-line naming tasks. To identify lexical reading we included in our test Italian words that have atypical stress assignment and can be pronounced with fluent prosody only by using lexical look up. Our findings show that phonological reading develops from aloud conversion of small orthographic units (e.g., single graphemes) to aloud conversion of whole strings. Such development underlies a systematic expansion of lexical reading. Children who deployed lexical reading for a low percentage of words at the end of grade 2 were likely to rely on grapheme by grapheme conversion still at the end of grade 1. Phonological, lexical, visual attention, and orthographic memory skills contribute to the systematic development of lexical reading. (Contains 2 footnotes, 4 tables, and 4 figures.)

Cesario Bellantuono, Francesca Bozzi, Laura Orsolini Psychiatric Unit and DEGRA Center, United Hospital and Academic Department of Experimental and Clinical Medicine, Polytechnic University of Marche, Ancona, Italy Background: The aim of this paper is to report maternal and neonatal outcomes in pregnant women treated with escitalopram during pregnancy and breastfeeding. Methods: Women enrolled in the DEGRA Database at the Clinic of Affective Disorders in Pregnancy and Postpartum in Italy, treated during pregnancy with escitalopram and followed up throughout pregnancy, were included in this study. All patients provided written informed consent and the study was approved by the local ethics committee. Psychiatric diagnoses were assessed using the Structured Clinical Interview for DSM-IV (Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition) Axis I Disorders and symptoms were assessed using the Hamilton Rating Scale for Depression (17 items) and Hamilton Rating Scale for Anxiety (14 items). Clinical and sociodemographic characteristics as well as maternal and neonatal outcomes were recorded. Results: The case histories of seven pregnant women treated for depression and/or anxiety disorders with escitalopram were reported. Four women were also treated with benzodiazepines. All pregnancies were full-term and all newborns had normal Apgar scores. There were no major malformations or miscarriages following exposure to escitalopram. Mild withdrawal syndrome was reported only in a newborn who was also exposed to a benzodiazepine. Two infants exposed to escitalopram during breastfeeding did not show any health problems. Conclusion: Our experience with use of escitalopram in pregnant women did not reveal any maternal or neonatal concerns. However, considering the few cases analyzed and the paucity of published literature, no conclusions can be drawn on its safety profile in pregnancy and breastfeeding. Keywords: escitalopram, pregnancy, breastfeeding, major malformations, perinatal complications