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The goal of the present study is to explore the perception of the relationship with parental figures, traumatic experiences, personality traits and psychosocial characteristics of the participant sibling caregivers. The sample was composed of 30 sibling caregivers recruited at psychiatric facilities in Italy, and of 30 control siblings. The battery of instruments administered included Parental Bonding Instrument (PBI), Minnesota Multiphasic Personality Inventory 2 (MMPI-2), and The Inventory of Traumatic Experiences (TEC). This research found that sibling caregivers of patients with severe psychiatric pathologies are distinctly different from the siblings of the control group with respect to the perception of their relationship with parental figures more frequently regarded as dysfunctional, and were also characterized by a higher presence of traumatic experiences. The problematic relationship with parental figures, some traumatic experiences, and the burden of taking care of a sibling with psychiatric disorders are probably important variables with regards to the individual’s overall psychological condition.

Introduction: Indications for transcatheter aortic valve replacement (TAVR) are progressively extending to younger and lower risk patients. In this scenario, minimizing periprocedural complications and optimizing procedural result are both crucial to achieve an excellent long-term outcome. Areas covered: In this review, we summarize the main strategies that can be adopted before, during, and after TAVR to predict and prevent complications, to optimize procedural results and ultimately improve outcomes, with an emphasis on more recent evidence, new devices, and new techniques. Expert opinion: In the next future TAVR will probably represent the first treatment option for patients affected by aortic valve stenosis who are candidates to receive a biological valve. Continuous refinement of TAVR devices has been key to allow safer and most effective procedures and further progress is expected. Development of new techniques and devices, such as ultrasound-guided puncture and intravascular lithotripsy, will expand safety and eligibility to transfemoral procedures. Effective preemptive measures for coronary occlusion have been developed. Open issues include cerebral protection, re-access to coronary arteries, post-procedural management, and therapy.

Although conscious aspects of attachment representations can be effectively assessed in middle childhood, the few available self-reports are based on different operationalizations of attachment and do not always show adequate psychometric properties. The current study aimed to develop and evaluate the psychometric properties of the Attachment in Middle Childhood Questionnaire (AMCQ). Using three independent samples of Italian children ( Mage = 10 years, 52% = girls), in three interrelated studies we (1) selected a pool of items from existing questionnaires, adapted them to the same response format, and subjected them to exploratory factor analysis; (2) performed confirmatory factor analyses on the retained items; and (3) used structural equation modeling to assess the factor structure, external validity, and invariance across gender and age groups. The final 15-item questionnaire comprised two dimensions (anxiety and avoidance) and a supplementary scale (security). Overall, results supported the reliability and validity of the AMCQ for Italian children.

This study explored attachment networks in committed couples who differed in parenting choice and relationship status. Attachment networks were defined in terms of attachment functions, attachment strength, the presence of a primary figure, and full-blown attachments. Participants were 198 couples, married or cohabiting, either expecting their first child or childless-by-choice. Results indicated that participants relied most strongly on partners for all attachment functions except secure base, for which they relied on mothers to a similar extent. Furthermore, expectant women reported more proximity seeking and stronger attachments to mothers, while expectant men relied more on fathers for safe haven. Married participants indicated less proximity seeking to partners than cohabiting couples, and married women reported less reliance on partners for safe haven than married men and cohabiting women. This study supports previous findings underlining the particular importance of partners for members of committed couples. Further, it extends past research by showing the robustness of this finding across parenting choice, and by revealing gender differences in the attachment networks of committed couples.

Self-report questionnaires based on Harter’s response format (“Some kids . . . but other kids . . . ”) are commonly used in developmental and clinical research settings, but the reliability and validity of this format in middle childhood are still under debate. The current study aimed to test the psychometric proprieties of Harter versus Likert response formats as applied to two attachment questionnaires in a sample of 410 Italian children aged 8 to 10 years. Participants completed the Experiences in Close Relationships–Revised Child version ( n = 102, 4-point Likert-type scale; n = 104, adapted Harter version) and the Security Scale ( n = 95, Harter’s format; n = 109 adapted 4-point Likert version). Results of multigroup confirmatory factor analyses indicated that the two response formats exhibited comparable reliability and factorial validity, although a slight superiority of Harter’s format emerged for the Security Scale. External validity was supported for both answer formats. Implications for developmental theory and practice are discussed.

Supplemental material, Supplemental_material_final for Development and Psychometric Properties of a New Self-Report Questionnaire Measuring Attachment in School-Age Children: The Attachment in Middle Childhood Questionnaire (AMCQ) by Tatiana Marci, Ughetta Moscardino, Alessandra Santona, Francesca Lionetti, Massimiliano Pastore and Gianmarco Altoé in Assessment

Dental pulp regeneration: An overview of the current approaches. Regenerative Endodontic Procedures (REPs) are biologically based procedures aimed at restoring the damaged structures and physiological functions of the pulp-dentine complex. Clinically, two strategies have been proposed so far to induce REP: cell transplantation and cell homing. REPs success relies primarily on the clinical and biological conditions of the tooth; therefore, cell homing strategies will not be consistently successful in every condition. Root canal treatment remains the standard of care for mature teeth with necrotic pulps and closed apex.

Background Triple Negative breast cancer (TNBC) includes a heterogeneous group of tumors with different clinico-pathological features, molecular alterations and treatment responsivity. Our aim was to evaluate the clinico-pathological heterogeneity and prognostic significance of TNBC histologic variants, comparing “special types” to high-grade invasive breast carcinomas of no special type (IBC-NST). Methods This study was performed on data obtained from TNBC Database, including pathological features and clinical records of 1009 TNBCs patients diagnosed between 1994 and 2015 in the four most important Oncology Units located in different hospitals in Sardinia, Italy. Kaplan-Meier analysis, log-rank test and multivariate Cox proportional-hazards regression were applied for overall survival (OS) and disease free survival (DFS) according to TNBC histologic types. Results TNBC “special types” showed significant differences for several clinico-pathological features when compared to IBC-NST. We observed that in apocrine carcinomas as tumor size increased, the number of metastatic lymph nodes manifestly increased. Adenoid cystic carcinoma showed the smallest tumor size relative to IBC-NST. At five-year follow-up, OS was 92.1, 100.0, and 94.5% for patients with apocrine, adenoid cystic and medullary carcinoma, respectively; patients with lobular and metaplastic carcinoma showed the worst OS, with 79.7 and 84.3%, respectively. At ten-years, patients with adenoid cystic (100.0%) and medullary (94.5%) carcinoma showed a favourable prognosis, whereas patients with lobular carcinoma showed the worst prognosis (73.8%). TNBC medullary type was an independent prognostic factor for DFS compared to IBC-NST. Conclusions Our study confirms that an accurate and reliable histopathologic definition of TNBC subtypes has a significant clinical utility and is effective in the therapeutic decision-making process, with the aim to develop innovative and personalized treatments.

Introduction: Imported parasitosis, which do not require an invertebrate vector, are extremely dangerous and can lead to the occurrence of disease in currently parasite free areas. In the present study we report a case of multi-parasitic infection in a young immigrant from Ghana to Italy caused by filaria, Schistosoma sp. and Strongyloides sp. Case presentation: A 27-year-old Ghanaian man attended the Hospital of Nuoro (Sardinia), Italy, at the end of August 2015, claiming pain to the kidney and hypertensive crisis; the patient presented with dyspnea and epistaxis, chronic itchy skin of the back, shoulders, arms and legs, anuria and high creatinine, metabolic acidosis and hypereosinophilic syndrome. Serological test for parasitic infections were done, and showed a marked positivity for filaria, Schistosoma sp. and Strongyloides sp. The patient started the treatment immediately with two doses per day of Bassado Antibiotic (tetracycline) for twenty days and then with a single dose of 3 mg of ivermectin that was repeated after 3 months. Conclusions: Immigrant patients from endemic areas who show clinical signs, such as a general itching on the back, shoulders and arms and legs, should have a thorough history in order to make early diagnosis and prevent further complications. Therefore, general practitioners and doctors in Europe and in other parasitosis non-endemic countries, should consider to test for parasites in any immigrant from endemic countries to aid in establishing the final diagnosis and prevent further complications.

Our understanding of the source of methane (CH4) in freshwater ecosystems is being revised because CH4 production in oxic water columns, a hitherto inconceivable process of methanogenesis, has been discovered for lake ecosystems. The present study surveyed nine Japanese deep freshwater lakes to show the pattern and mechanisms of such aerobic CH4 production and subsurface methane maximum (SMM) formation. The field survey observed the development of SMM around the metalimnion in all the study lakes. Generalized linear model (GLM) analyses showed a strong negative nonlinear relationship between dissolved organic carbon (DOC) and dissolved inorganic nitrogen (DIN), as well as a similar curvilinear relationship between DIN and dissolved CH4, suggesting that the availability of organic carbon controls N accumulation in lake waters thereby influences the CH4 production process. The microbial community analyses revealed that the distribution of picocyanobacteria (i.e., Synechococcus), which produce CH4 in oxic conditions, was closely related to the vertical distribution of dissolved CH4 and SMM formation. Moreover, a cross-lake comparison showed that lakes with a more abundant Synechococcus population exhibited a greater development of the SMM, suggesting that these microorganisms are the most likely cause of methane production. Thus, we conclude that the stoichiometric balance between DOC and DIN might cause the cascading responses of biogeochemical processes, from N depletion to picocyanobacterial domination, and subsequently influence SMM formation in lake ecosystems.

Virgin olive oil (VOO) provides an important source of healthy compounds. Its high concentrations of monounsaturated fatty acids and phenolic compounds contribute toward its nutritional, antioxidant, and antimicrobial properties. VOO is used in the preparation of many dishes worldwide and forms a staple of the Mediterranean diet; however, the antimicrobial activity of VOO in food matrices has been investigated very little to date. Considering this and the growing demand to reduce the use of synthetic antimicrobials and chemical food preservatives, especially in minimally processed foods, the aim of this work was to evaluate the antibacterial activity of VOOs obtained from 13 different Italian olive varieties. All olive varieties were harvested and processed in the same area (Oristano, Sardinia, Italy). The in vitro antimicrobial activities of the resulting VOOs were tested against: Listeria monocytogenes DSM 20600, Staphylococcus aureus DSM 20231, Escherichia coli DSM 30083, Salmonella bongori DSM13772, Lacticaseibacillus casei Shirota, Limosilactobacillus reuteri DSM 17938, Lacticaseibacillus casei RI4, and the yeast Candida albicans 3393. Orthogonal Projections to Latent Structures (OPLS) analysis showed a strong correlation between the content of certain phenolic compounds, the contact time of VOOs with the microbial cells, and the antimicrobial activity of the VOOs against the microorganisms tested. The VOOs showing the strongest antimicrobial activities (the Bosana and Sivigliana varieties) were then re-tested against L. monocytogenes DSM 20600 and S. bongori DSM 13772 in artificially contaminated commercial quick salad bags (QSB) of baby green leaf lettuces. The results show that antimicrobial activities of VOO depend on the target microbial species and the concentration of the inoculum. This study provides evidence supporting that VOOs with determinate polyphenols profiles might be used as antimicrobial ingredients in minimally processed foods to significantly reduce the presence of pathogenic bacteria.

Enterococcus faecium has become a globally disseminated nosocomial pathogen mainly because of acquisition and diffusion of virulence factors and multidrug resistance determinants, including glycopeptides, which are some of the last resort antimicrobials used to treat more serious infections common in high-risk patients. In this study we investigated and characterized hospital-associated (HA) E. faecium isolates collected at Hue Central Hospital, Vietnam. Our results highlighted the spread among hospital wards of a surprisingly heterogeneous multidrug-resistant E. faecium population comprising five different CC17-related sequence types (STs), of which 46% VREf carry the vanB gene. Whole genome sequencing of selected E. faecium isolates showed that VREf from different STs carried the same chromosomal integrated Tn1549-like transposon, with a highly mutated vanB2-operon, showing an increased level of vancomycin resistance (VanB phenotype) and able, in one isolate, to confer resistance to teicoplanin (VanA incongruent phenotype). Two unusual vanA/vanB2-type strains were detected within the vanB2-type ST17 population, harbouring a Tn1546-vanA-like transposon in pJEG40-like plasmids. Wg-SNPs-based analysis showed the genetic relatedness of VSEf/VREf of the same STs and indicated lateral exchange of the Tn1549-like element among isolates followed by clonal expansion. Microevolution among ST17 isolates, including the vanA/vanB2-type strains, and inter-wards VREf transmission, were highlighted. The use of teicoplanin is strongly discouraged in the study hospital because of the spreading of Tn1549–vanB2 associated to teicoplanin resistance. A rational use of glycopeptides and effective surveillance measures are required to reduce nosocomial VSEF/VREf spread and to avoid the rise of unusual and misleading VREf genotypes.

The olives are rich in microorganisms that, during the extraction process may persist in the oils and can influence their physicochemical and sensory characteristics. In this work, and for the first time, we isolated and identified microbial species, yeast and bacteria, present during the production process in four Sardinian (Italy) oleic ecosystems. Among these varieties, we found that Nera di Gonnos was associated to the highest microbial biodiversity, which was followed by Bosana, Nocellara del Belice and Semidana. Among the different microbial species isolated, some are specific of olive ecological niches, such as Cryptococcus spp and Serratia spp; and others to olive oils such as Candida spp and Saccharomyces. Some other species identified in this work were not found before in oleic ecosystems. The enzymatic analyses of yeast and bacteria showed that they have good β-glucosidase activity and yeast also showed good β-glucanase activity. The majority of bacteria presented lipolytic and catalase activities while in yeast were species-specific. Interestingly, yeast and bacteria isolates presented a high resistance to bile acid, and about 65% of the yeast were able to resist at pH 2.5 for 2 h. Finally, bacteria showed no biofilm activity compared to yeast.

This work describes the construction of family-couple-parenting (FCP) questionnaire, a new measure of three aspects related to the developmental path toward parenting choices, within the perspective of the family life cycle and attachment theory. Two studies are reported. Study 1 reports the development of the FCP questionnaire and its psychometric properties. Study 2 assesses the FCP’s nomological validity by investigating group differences on FCP factors and links between FCP factors and romantic attachment (experience in close relationships–revised) and recalled parental bonding (parental bonding instrument). Participants were 791 Italian participants: 405 young adults (203 students, 202 workers) and 193 couples (91 childless-by-choice, 102 parents-to-be). The results suggest that the FCP’s stable psychometric structure and strong theoretical basis make FCP a useful instrument for research related to the path to parenthood.

Background: Today carbapenem-resistant A. baumannii isolates are rising in several parts of the world including Vietnam, they are recognized to be among the most difficult resistant bacteria to treat and control. Carbapenem resistance is most commonly caused by the production of OXA-type carbapenemases and metallo-β-lactamases (MBLs). Objectives: Determine the rate and detect the genes encoding acquired carbapenemase of carbapenem-resistant A. baumannii isolates. Materials and methods: Study design is cross-sectional descriptive study. Carbapenem-resistant A. baumannii isolates in 90 A. baumannii (ACB) complex isolates were collected from Hue Central Hospital (HCH) and Hue University Hospital (HUP). Susceptibility to carbapenem of A. baumannii strains were performed by MicroScan method. Multiplex PCRs were performed to detect the genes encoding acquired carbapenemase. Results: Carbapenem resistance rates in A. baumannii were 88.5% and 87.5% in HCH and HHUMP, respectively. All of genes blaOXA-51, blaOXA-23, blaOXA-58, blaIMP, blaNDM as well as coexistence of two genes (blaIMP, blaNDM) or three genes ((blaOXA-51, blaOXA-23, blaOXA-58) or (blaIMP, blaNDM, blaOXA-58)) were detected in carbapenem resistant A. baumannii isolates. Conclusions: Carbapenem resistance rate in A. baumannii was relatively high. The emergence of carbapenem resistance in A. baumannii is associated with the production of OXA-type carbapenemases and metallo-β-lactamases (MBLs). Key words: Acinetobacter baumannii; carbapenem resistance; carbapenemase

Background and aims: The median nerve is formed by the union of the medial and lateral roots from the medial [C8, Tl] and lateral cords [C5, 6, 7] of brachial plexus respectively. The nerve is formed in the axilla embracing the axillary artery. Lateral root of median nerve is a terminal branch of lateral cord and medial root of median is a terminal branch of medial cord. Variations in the formation of the median nerve are common and have been reported by various authors. The aim of this study is to observe the variations in the formation of median nerve that would help in clinical evaluation. Materials & Methods: The present study was conducted in the Department of Anatomy, Jorhat Medical College, Jorhat. Fifteen embalmed and formalin fixed cadavers were studied for variation of the median nerve. The dissections were carried out according to the Cunningham’s Manual of practical Anatomy. In total 30 upper limb specimens were used for the study. Results: Out of 30 upper limbs, in three limbs [10%] there was duplication in the formation ofthe median nerve. Among the three, two specimens were of right side and one from the left side. Conclusion: We know that brachial plexus is located in axilla and axillary region is important not only from anatomical point of view but also from various clinical aspects as well. Awareness about the many variations of brachial plexus is important in understanding nerve blocks, diagnostic imaging, trauma and surgery.

Bacterial diversity of 15 extra virgin olive oils, obtained from different Italian varieties, including Frantoio, Coratina, Bosana, and Semidana, was analyzed in this study. All bacterial isolates were genotyped using RAPD and REP-PCR method and grouped by means of cluster analyses. Sequencing of 16S rDNA of 51 isolates, representative of 36 clusters, led to the identification of Bacillus spp., Brevibacillus spp., Micrococcus spp., Staphylococcus spp., Pantoea spp., Kocuria spp., Lysinbacillus spp., and Lactobacillus spp., most of which reported for first time in olive oils. Phenotypic characterization of the 51 isolates, some of which ascribed to potentially probiotic species, indicate that two of them have beta-glucosidase activity while 37% present lipolytic activity. Preliminary evaluation of probiotic potential indicates that 31% of the isolates show biofilm formation ability, 29% acidic pH resistance, and 25% bile salt resistance. Finally, 29% of the isolates were sensitive to antibiotics while the remaining 71%, that include bacterial species well-recognized for their ability to disseminate resistance genes in the environment, showed a variable pattern of antibiotic resistance. The results obtained underline that microbial diversity of extra virgin olive oils represents an unexpected sink of microbial diversity and poses safety issues on the possible biotechnological exploitation of this microbial biodiversity.