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ObjectiveAge is considered a negative prognostic factor for High Grade Gliomas (HGGs) and many neurosurgeons remain skeptical about the benefits of aggressive treatment. New surgical and technological improvements may allow extended safe resection, with lower level of post-operative complications. This opportunity opens the unsolved question about the most appropriate HGG treatment in elderly patients. The aim of this study is to analyze if HGG maximal safe resection guided by an intraoperative multimodal imaging protocol coupled with neuromonitoring is associated with differences in outcome in elderly patients versus younger ones.MethodsWe reviewed 100 patients, 53 (53%) males and 47 (47%) females, with median (IQR) age of 64 (57; 72) years. Eight patients were diagnosed with Anaplastic Astrocytoma (AA), 92 with Glioblastoma (GBM). Surgery was aimed to achieve safe maximal resection. An intraoperative multimodal imaging protocol, including neuronavigation, neurophysiological monitoring, 5-ALA fluorescence, 11C MET-PET, navigated i-US system and i-CT, was used, and its impact on EOTR and clinical outcome in elderly patients was analyzed. We divided patients in two groups according to their age: 65 years, and surgical and clinical results (EOTR, post-operative KPS, OS and PFS) were compared. Yet, to better understand age-related differences, the same patient cohort was also divided into 70 years and all the above data reanalyzed.ResultsIn the first cohort division, we did not found KPS difference over time and survival analysis did not show significant difference between the two groups (p = 0.36 for OS and p = 0.49 for PFS). Same results were obtained increasing the age cut-off for age up to 70 years (p = 0.52 for OS and p = 0.92 for PFS).ConclusionsOur data demonstrate that there is not statistically significant difference in post-operative EOTR, KPS, OS, and PFS between younger and elderly patients treated with extensive tumor resection aided by a intraoperative multimodal protocol.

During the first phase of the COVID-19 outbreak, Italy experienced problems of public order and maladjusted behavior. This study assessed the role of negative affectivity, right-wing authoritarianism, and anxiety of COVID-19 infection in explaining a variety of the maladjusted behaviors (i.e., “China-phobic” discrimination, panic buying) observed with an Italian sample. Specifically, we examined the effect of Negative Affectivity and Right-Wing Authoritarianism on maladjusted behaviors, and the moderating role of anxiety of infection. Seven hundred and fifty-seven Italian participants completed an online survey between March 3rd to the 7th 2020, which was immediately before the lockdown. A moderated-mediation model was tested using a structural equation modeling approach. Results indicated that both Negative Affectivity and Right-Wing Authoritarianism were positively associated with COVID-19-related maladjusted behavior, and that Right-Wing Authoritarianism mediated the relationship between Negative Affectivity and maladjusted behavior. Furthermore, the effect of Right-Wing Authoritarianism on maladjusted behavior was greater for those with high anxiety of infection, and the indirect effect of Negative Affectivity on maladjusted behavior through Right-Wing Authoritarianism was moderated by infection anxiety. Findings highlight potential psychological paths that may inform communication strategies and public health initiatives aimed at promoting healthy behavior during an outbreak.

Background Immune checkpoint inhibition is effective in several cancers. Expression of programmed death-ligand 1 (PD-L1) on circulating tumor or immune effector cells could provide insights into selection of patients for immune checkpoint inhibition. Methods Whole blood was collected at serial timepoints from metastatic breast cancer patients and healthy donors for circulating tumor cell (CTC) and platelet PD-L1 analysis with a phycoerythrin-labeled anti-human PD-L1 monoclonal antibody (Biolegend clone 29E.2A3) using the CellSearch® assay. CTC PD-L1 was considered positive if detected on at least 1% of the cells; platelet PD-L1 was considered positive if ≥100 platelets per CellSearch frame expressed PD-L1. Results A total of 207 specimens from 124 metastatic breast cancer patients were collected. 52/124 (42%) samples at timepoint-1 (at or close to time of progressive disease) had ≥5 CTC/7.5ml whole blood. Of those, 21 (40%) had positive CTC PD-L1. In addition, platelet PD-L1 expression was observed in 35/124 (28%) at timepoint-1. Platelet PD-L1 was not detected in more than 70 specimens from 12 healthy donors. Platelet PD-L1 was associated with ≥5 CTC/7.5ml whole blood (p = 0.0002), less likely in patients with higher red blood cell counts (OR = 0.72, pConclusion PD-L1 expression was found in metastatic breast cancer patients on both CTC and platelets in an independent fashion. Inter-patient platelet PD-L1 expression was highly heterogeneous suggesting that it is a biological event associated with cancer in some but not all patients. Taken together, our data suggest that CTC and platelet PD-L1 expression could play a role in predicting which patients should receive immune checkpoint inhibition and as a pharmacodynamics biomarker during treatment.

Aim: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus-specific reverse transcriptase-polymerase chain reaction (RT-PCR) represents the diagnostic gold standard. We explored the value of chest ultrasonography to predict positivity to SARS-CoV-2 on RT-PCR in suspected COVID-19 cases. Patients & methods: Consecutive patients with suspect COVID-19 were included if they had fever and/or history of cough and/or dyspnea. Lung ultrasound score (LUSS) was computed according to published methods. Results: A total of 76 patients were included. A 3-variable model based on aspartate transaminase (AST) > upper limit of normal, LUSS >12 and body temperature >37.5°C yielded an overall accuracy of 91%. Conclusion: A simple LUSS-based model may represent a powerful tool for initial assessment in suspected cases of COVID-19.

Stage III laryngeal collapse is defined as the collapse of the corniculate processes of the arytenoid cartilages and the destructuration of the dorsal portion of the rima glottidis. The primary cause is chronic upper airway obstruction, and the condition is often present in brachycephalic dogs. The treatment is still controversial; the patients are generally treated with a permanent tracheostomy. This article reports the authors’ experience with 16 dogs affected by stage III laryngeal collapse treated with subtotal epiglottectomy and the ablation of unilateral arytenoid cartilage. Before the surgery, all of the dogs underwent an effort test to classify the clinical severity of the disease and an endoscopic examination of the airways to determine the stage of severity of the laryngeal collapse. One month after surgery, the effort test was repeated in order to evaluate the clinical outcome. One year after surgery, the owners of 12 patients rated their dogs as follows: excellent in five cases, good in five cases, and fair in two cases. According to this pilot study, epiglottectomy associated with the photoablation of unilateral arytenoid cartilage increases airway flow, and thus may be considered a valid surgical procedure to treat dogs affected by grade III laryngeal collapse.

We present 4 years of continuous seafloor deformation measurements carried out in the Campi Flegrei caldera (Southern Italy), one of the most hazardous and populated volcanic areas in the world. The seafloor sector of the caldera has been monitored since early 2016 by the MEDUSA marine research infrastructure, consisting of four instrumented buoys installed where sea depth is less than 100 m. Each MEDUSA buoy is equipped with a cabled, seafloor module with geophysical and oceanographic sensors and a subaerial GPS station providing seafloor deformation and other environmental measures. Since April 2016, the GPS vertical displacements at the four buoys show a continuous uplift of the seafloor with cumulative measured uplift ranging between 8 and 20 cm. Despite the data being affected by environmental noise associated with sea and meteorological conditions, the horizontal GPS displacements on the buoys show a trend coherent with a radial deformation pattern. We use jointly the GPS horizontal and vertical velocities of seafloor and on-land deformations for modeling the volcanic source, finding that a spherical source fits best the GPS data. The geodetic data produced by MEDUSA has now been integrated with the data flow of other monitoring networks deployed on land at Campi Flegrei.

The Clinical Interview on the Sense of Grip on Chronic Disease has been administered to 68 mothers of children affected by Hereditary Angioedema (C1-Inh HAE), Type 1 Diabetes (T1D), Juvenile Rheumatoid Arthritis (JRA). The objectives are to detect general features of the experience of parenting children with chronic illness as well as the specificities of this experience related to the different conditions. Four Profiles of Sense of Grip were identified: Adempitive, Controlling, Reactive, Dynamic. The Sense of Grip Interview is an effective clinical tool for understanding the characteristics of the disease in daily life, which can help clinicians to encourage family adjustment to disease.

DOI: https://doi.org/10.26694/reufpi.v5i3.5441 Objetivo: caracterizar o perfil socioeconômico das gestantes de alto risco atendidas em serviço pré-natal na cidade de Aracaju, Sergipe, e compará-lo com grupo de gestantes de baixo risco. Metodologia: estudo observacional, prospectivo e controlado, realizado no período de janeiro a março de 2014. As pacientes de alto risco foram oriundas do Centro de Atenção Integrada à Saúde da Mulher e as do grupo de baixo risco foram oriundas de Unidades de Saúde da Família. A pesquisa obteve um N de 200 pacientes que responderam a um questionário estruturado. Esta pesquisa atendeu às normas éticas da Resolução 466/2012 do Conselho Nacional de Saúde, sendo o projeto de pesquisa submetido e aprovado pelo Comitê de Ética da Universidade Federal de Sergipe, sob o número do Certificado de Apresentação para Apreciação Ética 26764814.6.0000.5546. Resultados: a análise estatística mostrou associação significativa entre risco gestacional e doença crônica anterior à gestação (74%), pré-natalista não tirou dúvidas sobre o risco gravídico (57,44%) e condições de moradia ruim (81%). Conclusão: risco gravídico ocorreu com maior frequência em gestantes com história de doença crônica prévia, que não foram esclarecidas sobre seus riscos gravídicos e que possuíam condições de moradia ruins.

Objetivo: Describir la evolución de la fuerza muscular, las habilidades motoras, y la función respiratoria de 4 pacientes pediátricos con Distrofia Muscular de Duchenne (DMD). Materiales y método: Cuatro niños con diagnóstico de DMD ingresados a control y/o tratamiento en la Unidad de Kinesiología del Hospital Ludovica de La Plata. Se evaluó la fuerza muscular, el test de marcha de 10 metros (TM10m), el tiempo de supino a parado y las pruebas respiratorias de pico flujo tosido y espirometría. Resultados: Los parámetros de media global de fuerza muscular (MGFM), velocidad de marcha y tiempo de supino a parado evidenciaron un menor rendimiento, excepto en un solo paciente, que aumentaron. Los parámetros respiratorios de capacidad vital forzada (CVF) y pico flujo tosido (PFT), en valores absolutos y teóricos, aumentaron en dos pacientes; en otro caso hubo un descenso prematuro de todas las variables, y en el sujeto de mayor edad la CVF absoluta aumentó y la teórica descendió. Conclusión: Se describió la evolución clínica de cuatro niños con DMD. Se observó que la fuerza muscular y las habilidades motoras disminuyeron. Los valores de las pruebas de función respiratoria variaron de acuerdo a lo esperado según la edad de los pacientes.

Background and Aim: Cytomegalovirus (CMV) is the main cause of congenital infection in developed countries leading to deafness but the burden of sensorineural hearing loss (SNHL) in asymptomatic children remains incompletely characterized. Aim of this study was to evaluate the long-term audiological outcome in this group of patients.Methods: Consecutive neonates with congenital CMV infection were followed from 2002 to 2018. Patients were considered asymptomatic if free from any clinical and instrumental impairment at referral and underwent serial clinical exams, audiological evaluations and CMV-PCR determinations.Results: A cohort of 258 children was analyzed and the disease onset was asymptomatic in 125 (48%) infants. Among these, we studied 102 patients with a follow-up longer than 1 year and a median observation period of 2.8 years (range: 1–10.3 years). No patient developed a stable delayed SNHL but only 14 (14%) presented a variable hearing impairment, seven of which bilateral. The unstable SNHL was mild in 12 infants and moderate in two. Patients with fluctuating SNHL had significantly higher urine viral load (p 0.002) and more often positive viremia (p 0.015) than babies with stable normal hearing.Conclusions: CMV infected, asymptomatic neonates have a low risk of transient SNHL later in infancy. Positive viremia and high urine viral load at onset are significant risk factors for delayed fluctuating SNHL. These data are relevant for an appropriate follow up plan of these patients.

This paper presents a procedure that aims to combine explanatory and predictive modeling for the construction of new psychometric questionnaires based on psychological and neuroscientific theoretical grounding. It presents the methodology and the results of a procedure for items selection that considers both the explanatory power of the theory and the predictive power of modern computational techniques, namely exploratory data analysis for investigating the dimensional structure and artificial neural networks (ANNs) for predicting the psychopathological diagnosis of clinical subjects. Such blending allows deriving theoretical insights on the characteristics of the items selected and their conformity with the theoretical framework of reference. At the same time, it permits the selection of those items that have the most relevance in terms of prediction by therefore considering the relationship of the items with the actual psychopathological diagnosis. Such approach helps to construct a diagnostic tool that both conforms with the theory and with the individual characteristics of the population at hand, by providing insights on the power of the scale in precisely identifying out-of-sample pathological subjects. The proposed procedure is based on a sequence of steps that allows the construction of an ANN capable of predicting the diagnosis of a group of subjects based on their item responses to a questionnaire and subsequently automatically selects the most predictive items by preserving the factorial structure of the scale. Results show that the machine learning procedure selected a set of items that drastically improved the prediction accuracy of the model (167 items reached a prediction accuracy of 88.5%, that is 25.6% of incorrectly classified), compared to the predictions obtained using all the original items (260 items with a prediction accuracy of 74.4%). At the same time, it reduced the redundancy of the items and eliminated those with less consistency.

We present a model for the process of redesigning the laboratory curriculum in Introductory Organismal Biology to increase opportunities for meaningful inquiry and increase student recognition of their scientific skill development. We created scaffolded modules and assignments to allow students to build and practice key skills in experimental design, data analysis, and scientific writing. Using the Tool for Interrelated Experimental Design, we showed significantly higher gains in experimental design scores in the redesigned course and a more consistent pattern of gains across a range of initial student scores compared with the original format. Students who completed the redesigned course rated themselves significantly higher in experimental design, data collection, and data analysis skills compared with students in the original format. Scores on the Laboratory Course Activity Survey were high for both formats and did not significantly differ. However, on written course evaluations, students in the redesigned course were more likely to report that they engaged in “real science” and their “own experiments.” They also had increased recognition of their specific analytical and writing skill development. Our results demonstrate that intentional, scaffolded instruction using inquiry modules can increase experimental design skills and sense of scientific ability in an introductory biology course.

Abstract Background Staphylococcus aureus is an opportunistic pathogen and a leading cause of nosocomial infections. It can acquire resistance to all the antibiotics that entered the clinics to date, and the World Health Organization defined it as a high-priority pathogen for research and development of new antibiotics. A deeper understanding of the genetic variability of S. aureus in clinical settings would lead to a better comprehension of its pathogenic potential and improved strategies to contrast its virulence and resistance. However, the number of comprehensive studies addressing clinical cohorts of S. aureus infections by simultaneously looking at the epidemiology, phylogenetic reconstruction, genomic characterisation, and transmission pathways of infective clones is currently low, thus limiting global surveillance and epidemiological monitoring. Methods We applied whole-genome shotgun sequencing (WGS) to 184 S. aureus isolates from 135 patients treated in different operative units of an Italian paediatric hospital over a timespan of 3 years, including both methicillin-resistant S. aureus (MRSA) and methicillin-sensitive S. aureus (MSSA) from different infection types. We typed known and unknown clones from their genomes by multilocus sequence typing (MLST), Staphylococcal Cassette Chromosome mec (SCCmec), Staphylococcal protein A gene (spa), and Panton-Valentine Leukocidin (PVL), and we inferred their whole-genome phylogeny. We explored the prevalence of virulence and antibiotic resistance genes in our cohort, and the conservation of genes encoding vaccine candidates. We also performed a timed phylogenetic investigation for a potential outbreak of a newly emerging nosocomial clone. Results The phylogeny of the 135 single-patient S. aureus isolates showed a high level of diversity, including 80 different lineages, and co-presence of local, global, livestock-associated, and hypervirulent clones. Five of these clones do not have representative genomes in public databases. Variability in the epidemiology is mirrored by variability in the SCCmec cassettes, with some novel variants of the type IV cassette carrying extra antibiotic resistances. Virulence and resistance genes were unevenly distributed across different clones and infection types, with highly resistant and lowly virulent clones showing strong association with chronic diseases, and highly virulent strains only reported in acute infections. Antigens included in vaccine formulations undergoing clinical trials were conserved at different levels in our cohort, with only a few highly prevalent genes fully conserved, potentially explaining the difficulty of developing a vaccine against S. aureus. We also found a recently diverged ST1-SCCmecIV-t127 PVL− clone suspected to be hospital-specific, but time-resolved integrative phylogenetic analysis refuted this hypothesis and suggested that this quickly emerging lineage was acquired independently by patients. Conclusions Whole genome sequencing allowed us to study the epidemiology and genomic repertoire of S. aureus in a clinical setting and provided evidence of its often underestimated complexity. Some virulence factors and clones are specific of disease types, but the variability and dispensability of many antigens considered for vaccine development together with the quickly changing epidemiology of S. aureus makes it very challenging to develop full-coverage therapies and vaccines. Expanding WGS-based surveillance of S. aureus to many more hospitals would allow the identification of specific strains representing the main burden of infection and therefore reassessing the efforts for the discovery of new treatments and clinical practices.

This article deals with the role of the Italian Mafia Organizations in illicit firearms trafficking. The author offers an overview of several criminal investigations, especially involving ’ndrangheta and camorra affiliates, in illicit firearms trafficking. This study contends that there is no a hegemonic Italian Mafia Group governing illicit firearms trafficking, and that this criminal activity (which in most cases does not represent, per se, the main goal of the Organization) constitutes a very powerful instrument to strengthen operational capacities of Mafia Organizations to commit other crimes, such as illicit drugs trafficking. Keywords: Illicit firearms trafficking, criminal investigations, mafia-type organizations, illegal routes, Balkans Questo articolo esamina il ruolo delle organizzazioni criminali mafiose italiane nel traffico di armi da fuoco. L’autore presenta numerosi casi di indagini penali relative, in particolare, ad affiliati della ’ndrangheta e della camorra coinvolti nel traffico di armi da fuoco. La tesi qui sostenuta è che nessuno dei gruppi criminali mafiosi italiani esercita un ruolo egemonico sul traffico illecito di armi da fuoco; e che questa attività criminale generalmente non costituisce un reato-scopo delle organizzazioni mafiose, ma piuttosto un potente strumento a loro disposizione per rafforzare le capacità operative necessarie per commettere altri reati quali il traffico illecito di stupefacenti. Parole chiave: traffico illecito di armi, indagini penali, mafia, ’ndrangheta, camorra, rotte illegali, Balcani

Neuromuscular diseases (NMDs) are dysfunctions that involve skeletal muscle and cause incorrect communication between the nerves and muscles. The specific causes of NMDs are not well known, but most of them are caused by genetic mutations. NMDs are generally progressive and entail muscle weakness and fatigue. Muscular impairments can differ in onset, severity, prognosis, and phenotype. A multitude of possible injury sites can make diagnosis of NMDs difficult. Mitochondria are crucial for cellular homeostasis and are involved in various metabolic pathways; for this reason, their dysfunction can lead to the development of different pathologies, including NMDs. Most NMDs due to mitochondrial dysfunction have been associated with mutations of genes involved in mitochondrial biogenesis and metabolism. This review is focused on some mitochondrial routes such as the TCA cycle, OXPHOS, and β-oxidation, recently found to be altered in NMDs. Particular attention is given to the alterations found in some genes encoding mitochondrial carriers, proteins of the inner mitochondrial membrane able to exchange metabolites between mitochondria and the cytosol. Briefly, we discuss possible strategies used to diagnose NMDs and therapies able to promote patient outcome.

Offering counselling to students is increasingly considered as a key academic service. However, the reduction of resources allocated to Italian universities emphasises the need to assess the quality of interventions. This paper presents data reporting the effectiveness of a university counselling service. A sample of 45 undergraduate students completed a cognitive-relational intervention at a counselling service in a University in the North of Italy. The project focused on the development of reappraisal skills and problem-solving strategies to manage difficult situations. The results showed a significant pre and post-intervention reduction in self-reported psychopathological symptoms (measured with Symptoms Check List 90-Revised) as well as in general levels of distress (measured with Clinical Outcome in Routine Evaluation-Outcome Measure). A significant increase in reappraisal levels, measured with the Emotion Regulation Questionnaire, was observed, which is a focal element of the counselling intervention. There were no detectable changes in the level of suppression.

Resistant starch (RS) is the starch fraction that eludes digestion in the small intestine. RS is classified into five subtypes (RS1–RS5), some of which occur naturally in plant-derived foods, whereas the others may be produced by several processing conditions. The different RS subtypes are widely found in processed foods, but their physiological effects depend on their structural characteristics. In the present study, foods, nutrition and biochemistry are summarized in order to assess the type and content of RS in foods belonging to the Mediterranean Diet (MeD). Then, the benefits of RS consumption on health are discussed, focusing on their capability to enhance glycemic control. RS enters the large bowel intestine, where it is fermented by the microbiome leading to the synthesis of short-chain fatty acids as major end products, which in turn have systemic health effects besides the in situ one. It is hoped that this review will help to understand the pros of RS consumption as an ingredient of MeD food. Consequently, new future research directions could be explored for developing advanced dietary strategies to prevent non-communicable diseases, including colon cancer.

The Neapolitan volcanic area includes three active and high-risk volcanoes: Campi Flegrei caldera, Somma–Vesuvius, and Ischia island. The Campi Flegrei volcanic area is a typical example of a resurgent caldera, characterized by intense uplift periods followed by subsidence phases (bradyseism). After about 21 years of subsidence following the 1982–1984 unrest, a new inflation period started in 2005 and, with increasing rates over time, is ongoing. The overall uplift from 2005 to December 2019 is about 65 cm. This paper provides the history of the recent Campi Flegrei caldera unrest and an overview of the ground deformation patterns of the Somma–Vesuvius and Ischia volcanoes from continuous GPS observations. In the 2000–2019 time span, the GPS time series allowed the continuous and accurate tracking of ground and seafloor deformation of the whole volcanic area. With the aim of improving the research on volcano dynamics and hazard assessment, the full dataset of the GPS time series from the Neapolitan volcanic area from January 2000 to December 2019 is presented and made available to the scientific community.

Anthropology is overall a scientific and unethical system. However its scientific nature can not ignore the ethical tension proper to man, in whose nature is already inscribed the judgment on himself and on the world, where every judgment, as the etymology suggests, is "pronunciation of judgment" towards what is judged, therefore implying an act of responsibility. Just with this assumption of responsibility I had to deal in the summer 2013, when I observed some patients at the psychiatric ward of the Civil Hospital of Sassari, determined to grasp concretely the nature of the human person from the theory of Ernesto de Martino. The clash between theory and practice that has occurred as a result of this observation, generated from my dissent to recognize the mental patient as a non-person and at the same time, paradoxically, from my full recognition of madness as non-value, after some time has become an opportunity for a critical rethinking of anthropological science and its methods, in order to prevent any damage against the subject of research and to stimulate a more responsible participation in the integral knowledge of the human being.

Abstract INTRODUCTION: Despite the success of antiretrovirals, human immunodeficiency virus (HIV) coinfections continue to cause mortality. We investigated the prevalence of coinfections in women with HIV/acquired immunodeficiency syndrome in Sergipe, Brazil. METHODS: We conducted a cross-sectional study. The coinfections investigated were syphilis, hepatitis B and C, toxoplasmosis, rubella, tuberculosis, and cytomegalovirus. RESULTS: Among the 435 women, 85 (19.5%) had coinfections. The most prevalent was HIV/syphilis, followed by tuberculosis, toxoplasmosis, hepatitis C, hepatitis B, and rubella. Additionally, 300 (96.2%) were seropositive for cytomegalovirus immunoglobulin G. CONCLUSIONS: Despite significant progress in the treatment for people with HIV, coinfections continued to affect this population.

Background and aims: In pediatrics receiving a diagnosis of a chronic condition is a matter that involves caregivers at first. Beyond the basic issues of caring for the physical condition of the ill child, how caregivers face and make sense of the disease orients and co-constructs their children’s sensemaking processes of the disease itself. The aim of this article is to explore the experience of a rare chronic illness, a pediatric case of Hereditary Angioedema (HAE) from the caregivers’ perspective. Hereditary angioedema is characterized by subcutaneous swellings that can involve internal as well as external mucosal tissues and is highly variable and unpredictable in terms of severity, frequency, and where it occurs.A qualitative narrative semiotic analysis of n. 28 maternal narratives on their children’s disease experience. Narratives were collected by an ad hoc interview on three domains of the disease experience: (A) interpretation of disease variability, (B) dialogical processes, and (C) management of the disease. Subsequently, we executed a TwoStep cluster analysis for categorical data to detect cross-sectional profiles of the maternal sensemaking processes of the disease.Results: The coding grid was built analyzing the characteristics of the narrative links that orient the connection between the elements of the experience within each domain: (A) the connection among events, for the domain of disease variability interpretation, (B) the connection between self and other, for the dialogue domain, and (C) the connection among sensemaking and actions, for the disease management domain. Results from the cluster analysis show three narrative profiles: (1) adempitive; (2) reactive; (3) dynamic.Discussion: Profiles will be discussed in light of the general conceptual framework of the Sense of Grip on the Disease (SoGoD) highlighting the importance of those sensemaking processes which, instead of relying on a coherent and closed interpretation of the disease, are characterized by a degree of tolerance for uncertainty and the unknown.

In the last few years, two technological events emerged. First, the rising of Industry 4.0 concepts and technologies such as IoT allowed the direct link between machines on the shop floor, establishing a machine-to-machine communication (M2M). Second, blockchain enables transactions such payments and contracts without a formal reliable or accreditation institutions, such as banks or government. Goal: The goal of this paper is to explore the state-of-art of the blockchain technology applied to the manufacture sector. In this sense, the option of the M2M transaction being intermediated by blockchain on the shop floor is a hypothesis to be tested. Moreover, it could be questioned if these subjects are being appreciated by the academia. Design / Methodology / Approach: a systematic review of the literature was conducted, considering blockchain, the industrial context, and the Industry 4.0 related technologies. Results: As a result, only 12 papers that were classified according to their application fields and practice stages were obtained. Limitations of the investigation: this field of application is brand new; thus, the available literature is scarce; only 12 papers were obtained. Practical implications: As the main result, it was identified that the possibilities of blockchain applications to Industry have been poorly explored by literature. Originality / Value: The paper addresses the possibility of application of blockchain in M2M-based manufacture, and detaches the research gap in the academic literature related to it.

Breast cancer is a potential traumatic event associated with psychological symptoms, but few studies have analysed its impact in under-50 women. Emotional processing is a successful function in integrating traumatic experiences. This work analysed the relationship between emotional processing and psychological symptoms during three phases of treatment (before hospitalization, counselling after surgery and adjuvant therapy) in 50 women under the age of 50 with breast cancer. Mixed-effects models tested statistical differences among phases. There were significant differences in symptoms during the treatments: the levels of anxiety decrease from T1 to T3 (0.046), while those of hostility increase (

Abstract INTRODUCTION Cases of visceral leishmaniasis (VL) and HIV co-infection have increased worldwide. We investigated the prevalence of HIV and associated factors among VL patients in Sergipe state, Brazil. METHODS We conducted a population-based study of all cases of VL and HIV reported in Sergipe from 1999 to 2015. RESULTS We studied a total of 917 patients; 41 (4.5%) co-infection cases were detected. VL-HIV co-infected patients were more likely to have weight loss, cough, treatment failure or loss to follow-up and death. CONCLUSIONS The prevalence of VL-HIV co-infection was high and co-infected patients were more likely to have adverse outcomes.

BackgroundFew studies, based on a limited number of patients using non-uniform therapeutic protocols, have analyzed Methicillin-resistant Staphylococcus aureus (MRSA) eradication.MethodsIn a randomized multicenter trial conducted on patients with new-onset MRSA infection we evaluated the efficacy of an early eradication treatment (arm A) compared with an observational group (B). Arm A received oral rifampicin and trimethoprim/sulfamethoxazole (21 days). Patients' microbiological status, FEV1, BMI, pulmonary exacerbations and use of antibiotics were assessed.ResultsSixty-one patients were randomized. Twenty-nine (47.5%) patients were assigned to active arm A and 32 (52.5%) patients to observational arm B. Twenty-nine (47.5%) patients, 10 patients in arm A and 19 in arm B, dropped out of the study. At 6 months MRSA was eradicated in 12 (63.2%) out of 19 patients in arm A while spontaneous clearance was observed in 5 (38.5%) out of 13 patients in arm B. A per-protocol analysis showed a 24.7% difference in the proportion of MRSA clearance between the two groups (z = 1.37, P(Z>z) = 0.08). Twenty-seven patients, 15 (78.9%) out of 19 in arm A and 12 (92.3%) out of 13 in arm B, were able to perform spirometry. The mean (±SD) FEV1 change from baseline was 7.13% (±14.92) in arm A and -1.16% (±5.25) in arm B (p = 0.08). In the same period the BMI change (mean ±SD) from baseline was 0.54 (±1.33) kg/m2 in arm A and -0.38 (±1.56) kg/m2 in arm B (p = 0.08). At 6 months no statistically significant differences regarding the number of pulmonary exacerbations, days spent in hospital and use of antibiotics were observed between the two arms.ConclusionsAlthough the statistical power of the study is limited, we found a 24.7% higher clearance of MRSA in the active arm than in the observational arm at 6 months. Patients in the active arm A also had favorable FEV1 and BMI tendencies.

(1) Background: Congenital factor (F) VII deficiency is caused by mutations in the F7 gene. Patients with modest differences in FVII levels may display large differences in clinical severity. The variant p.A354V-p.P464Hfs is associated with reduced FVII antigen and activity. The aim of the study was to investigate the clinical manifestation of this variant and the underlying molecular mechanisms. (2) Methods: Analyses were conducted in 37 homozygous patients. The recombinant variant was produced in mammalian cells. (3) Results: We report a large variation in clinical phenotypes, which points out genetic and acquired components beyond F7 mutations as a source of variability. In contrast, patients displayed similarly reduced FVII plasma levels with antigen higher than its activity. Comparative analysis of the recombinant variant and of plasma samples from a subset of patients indicated the presence of an elongated variant with indistinguishable migration. Treatment of cells with the chemical chaperone 4-phenylbutyrate (4-PBA) improved the intracellular trafficking of the variant and increased its secretion to the conditioned medium up to 2-fold. However, the effect of 4-PBA on biological activity was marginal. (4) Conclusions: Chemical chaperones can be used as biochemical tools to study the intracellular fate of a trafficking-defective FVII variant.

Plant bioactives, such as polyphenols, can differentially affect (positively or negatively) sperm quality, depending on their concentration. These molecules have been proposed as natural scavengers of reactive oxygen species (ROS) for male infertility treatment. However, few data are available about their effects on the molecular mechanisms related to sperm quality and, in particular, to sperm mitochondrial function. We investigated the effects of quercetin, naringenin, genistein, apigenin, luteolin, and resveratrol at the concentration of 0.1–1000 nM on mitochondrial respiration efficiency. Upon chemical exposure, spermatozoa were swollen in a hypotonic solution and used for polarographic assays of mitochondrial respiration. All tested compounds, except for apigenin, caused a significant increase in the mitochondrial respiration efficiency at the concentration of 0.1 nM, and a significant decrease starting from concentrations of 10 nM. The analysis of oxygen consumption rate in the active and in the resting state of mitochondrial respiration suggested different mechanisms by which the tested compounds modulate mitochondrial function. Therefore, by virtue of their ability to stimulate the respiration active state, quercetin, genistein, and luteolin were found to improve mitochondrial function in asthenozoospermic samples. Our results are relevant to the debate on the promises and perils of natural antioxidants in nutraceutical supplementation.

Functional Gastrointestinal Disorders (FGIDs) are common in pediatric age. To estimate the prevalence of FGIDs in Italian children and evaluate the impact of diet. Healthy children aged 4–18 years were recruited in a multicenter cross-sectional study. We evaluated their eating habits and the presence of FGIDs, using Rome IV criteria, 3-day food diaries and Mediterranean Diet Quality Index (KIDMED) questionnaires. Seven hundred forty subjects were enrolled:369 children aged 4–9 years (Group A), and 371 adolescents 10–18 years old (Group B). The overall prevalence of FGIDs was 26.4% in Group A and 26.2% in Group B, with a significant higher prevalence in females in both groups. The most frequent disorders were functional constipation, functional dyspepsia, and abdominal migraine. No significant difference in FGIDs prevalence was found between Northern and Southern Italy, despite significant variation in diet. In Group A there was a significant difference in KIDMED between North and South (5.3 ± 1 vs 6 ± 1.2, respectively; p = 0.001). A significant association between FGIDs and KIDMED was found in Group A (OR=0.83, p = 0.034), but not in Group B (OR=0.89, p = 0.166). FGIDs are common in Italian children, with a higher prevalence in females. Despite significant differences in dietary habits between North and South, FGIDs prevalence does not vary significantly. [ABSTRACT FROM AUTHOR]

Zakes Mda’s The Heart of Redness (2000) is investigated by adopting Riane Eisler’s ‘Cultural TransformationTheory’ in order to highlight the culture-nature dialectic at the core of a novel that explores the long-lasting conflict between tradition and modernity through a distinctive South African perspective. The article shows how in Mda’s novel the notions of ‘progress’ and ‘civilization’ are called into question by denouncing the catastrophic consequences that ensue when they are blindly pursued at the expense of a respectful and harmonious cohabitation on Earth. Particular attention is given to the forms and ways in which the borders between nature and culture, tradition and progress, past and present are deconstructed and traversed within the complex narrative framework of the novel which testifies to the central and permanent concern of the writer for ethical, social and environmental issues. Mda, as I intend to demonstrate, encourages a critical re-thinking and reorientation of ossified dichotomical oppositions and prejudiced assumptions as a necessary first step in fostering a more equitable and sustainable world so that a future of equal opportunities available to all can be reimaged. From this perspective, fundamental is the role played by literature, language and education (Eisler 2013), a responsibility the writer fully endorses through his committed and challenging fiction.

Abstract – This chapter focuses on relevant novels by contemporary black British writers, novels which represent the condition of exile, uprootedness and ‘in-betweenness’ experienced by the first and the second generation of migrants who arrived in Great Britain from colonized or once colonized-countries in the second half of the 20th century. Creative writing presents itself as a privileged area of investigation of the problematic question of belonging and of identity negotiations. The new fluid and hybrid identities which emerge out of the inevitable processes of contamination between different worlds and cultures – identities ‘positioned’ by the interaction of different historical, political and cultural factors – challenge the binary dichotomies at the very roots of Western civilization dismantling the myth of a homogeneous and static Englishness based on the traditional opposition between Self and Other. Through the novels taken into examination mostly by writers born and/or bred in England whose identities are enriched by different ethnic roots, the chapter will reflect upon the concept of cultural diversity and on the problematic issue of multiculturalism: a model which has undoubtedly revealed its flaws. The question of cultural identity stands out as a relevant common thread and is explored in its most different declinations, from the suffered sense of uprootedness and alienation to the celebration of hybridism, from generational conflicts to adherence to forms of fundamentalism, from the attempt to assimilate to the enthusiastic celebration of diversity. All the novels selected for analysis reveal both in narrative form and content a diasporic connotation and a dialogic afflatus which is aimed at prefiguring a ‘new world order’ whose objective is a more equitable and caring society ready not simply to accept and tolerate but to appreciate and cultivate its fruitful, precious diversity.