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Hepatitis C Virus (HCV) infection is major health problem worldwide, with 150 million infected people according to recent epidemiologic estimations. The introduction of direct-acting antivirals made a revolutionary change in the management of HCV infected patients with surprisingly high rates of antiviral response, improved tolerability and reduced time of treatment. Sofosbuvir, in combination with different partner drugs, has been the molecule that led this incredible change. The last generation of SOF-based regimens, namely Sofosbuvir/Velpatasvir, represents a single tablet, once a day, pangenotypic and pan-fibrotic combination, demonstrated to be safe and effective in almost all type of HCV infected individuals. This review overviews the main clinical data of SOF/VEL registration trials, underlying the key features of this combination in terms of efficacy, safety and Patients Reported Outcomes obtained in more than 1800 HCV chronically infected subjects. (www.actabiomedica.it) more...

Sustainable development goals (SDGs) are the most relevant and recent attempt to integrate sustainable development ambitions and environmental concerns in a policy framework. Recently, few studies have been conducted to investigate the gap between sustainability reporting and the SDGs, initiating a new stream of research (Lozano 2015; Rosati and Faria 2019). However, the role of accounting systems as a support for moving toward goals and targets outlined by the SDGs has been poorly deepened in not-traditional profit-oriented businesses. Among these, there are cooperatives: jointly owned benefit corporations. The peculiarity of cooperatives lays in the collective governance and the fact that profits are re-invested in the cooperative or in local projects and activities rather than being distributed to the shareholders. The present study intends to fill this gap by answering the following research question: can a cooperative, given its peculiar nature, contribute to sustainability? To do so, the annual sustainability reports of the largest Italian cooperative have been analyzed under the lens of SDGs. The results show that cooperatives can actively contribute to sustainability, especially on the local level. In fact, they have proved to be important players in transposing the SDGs from the national level to the local level, constituting an important link between the international community and the local one. more...

Background: Obsessive-Compulsive Disorder is often measured through self-report questionnaires focused on measuring symptomatology (Y-BOCS, OCI-R, and PI). The scientific literature identifies the Pt scale as a distinctive marker, but does not report data related to a specific OCD profile of the MMPI-2 test. Therefore, based on some clinical considerations and preliminary investigations, the following study aims to identify a specific MMPI-OCD configuration marked by the presence of significant indicators able to describe its psychological functioning and its key features in cognitive, emotional and affective terms. Method: In order to explore the expected relationships, 395 participants were involved (average age: 34.20 years) and evaluated through the MMPI-2 test and the Yale-Brown interview. Results: MANOVA, Multiple Linear Regression Analysis and Discriminant Function Analysis confirm that the OCD is marked by the recurrence of three elevated clinical scales (Pt, D, Sc). Hyper-prudential reasoning and some reasoning bias, typically employed by these subjects, could justify such results. Conclusions: This specific configuration could therefore support the clinician during the assessment phases and lead him to identify – as well as differentiate – his characteristics from those of other psychological disorders, thus stimulating him to deepen during the interpretation of the results., Mediterranean Journal of Clinical Psychology, Vol 8, No 3 (2020) more...

O triathlon e uma modalidade esportiva a qual pouco se conhece, tanto em questoes de apenas saber ou ter ouvido falar na modalidade, quanto principalmente na teoria; ou seja, estudos, pesquisas, cientificidade, dentre outras. Resumidamente, por tal motivo de poucas bases teoricas referente ao esporte, fez-se ha aproximadamente 12 anos um grupo de estudos sobre o triathlon, e e desse grupo de estudos, situado no curso de Educacao Fisica da Universidade Estadual de Campinas – UNICAMP que os autores desse livro o assim fizeram. Todos os autores deste livro integram esse grupo de estudos, e nao somente como integrantes de um grupo de estudos, todos colaboradores possuem vivencia na modalidade em questao, sendo essa vivencia como atletas, como treinadores, e/ou observadores; o que nao menos, os faz buscarem e consolidarem espacos na modalidade triathlon e conhecimento cientifico na mesma. more...

Several studies and clinical observations have proven the central role of the fear of guilt in the genesis and maintenance of Obsessive-Compulsive Disorder. To date, questionnaires are available in Italian that measure one’s propensity to experience guilt and sensitivity towards this emotion, understood as a tendency to negatively judge this experience and its effects, but not the fear of guilt and the commitment to prevent or neutralise this experience. The purpose of this study is to validate the Italian version of the Fear of Guilt Scale (FOGS), a tool that would facilitate a more comprehensive understanding of the weight of this specific factor in the obsessive symptomatology. To this end, the FOGS was administered to two non-clinical samples (Study 1) and to a clinical population diagnosed with either Obsessive-Compulsive Disorder, Major Depressive Disorder or Anxiety Disorder (Study2). Study 1 confirmed the original two-factors structure (Punishment and Harm Prevention), and showed adequate internal consistency, convergent and divergent validity of the Italian version of the FOGS. Study 2 revealed that the Italian version of the FOGS was able to discriminate between patients with Obsessive-Compulsive Disorder and the other clinical control groups, and in predicting the severity of obsessive symptoms. Clinical and research implications are also discussed., Rassegna di Psicologia, V. 37, N. 1 (2020) more...

Meanwhile, measurement of liver stiffness (LS) is the standard for fibrosis screening in patients with chronic hepatitis C virus (HCV) and chronic hepatitis B virus (HBV), namely for the diagnosis of severe fibrosis and cirrhosis (F3 or F4 according to the METAVIR scoring system, respectively) and for the exclusion of significant fibrosis. LS values can be influenced by the degree of necroinflammation in both HBV and HCV infection. In particular, the international guidelines suggest considering normal ALT versus elevated ALT (5 × ULN) in the measurement of LS in HBV-infected patients. Several studies were performed using transient elastography to evaluate its reliability in defining the presence of portal hypertension and esophageal varices. A wide range of cut-off levels have been reported to date. LS is also a strong pre-treatment predictor with regard to the response to antiviral treatment. The precise distinction between advanced fibrosis and cirrhosis is of fundamental importance in terms of both diagnostic and therapeutic approaches. Regression of fibrosis has been demonstrated in patients with HCV after virus elimination and in patients with HBV during antiviral treatment. In HCV patients, a sustained virological response was accompanied by a significant improvement in hepatic function and a decrease of LS. In HBV patients, pre-treatment and LS changes during nucleoside/nucleotide analogues can predict liver-related events. In conclusion, LS measurement has become essential for the clinical management of patients with HCV and HBV chronic infection. more...

Rituximab (RTX) represents a milestone in the treatment of mixed cryoglobulinemic vasculitis (MCV). Despite usually well-tolerated, RTX may induce different types of adverse drug reactions, including exacerbation of vasculitis. Recently, RTX biosimilar CT-P10 has been approved in Europe for the treatment of rheumatoid arthritis, but no data are available about effectiveness and safety of CT-P10 in the treatment of MCV. In this multicenter open-label study, we analyzed the safety of CT-P10 in patients with MCV treated in first-line or after a shift by RTX originator. Fifty-one consecutive MCV patients (females/males 35/16, median age 68 years, median disease duration 42 months, 51% HCV positive) were included in the study between July and December 2018 and were treated with CT-P10 (group 1). Safety and effectiveness of CT-P10 were compared with a retrospective group (group 2) including 75 consecutive patients treated with RTX originator between July 2017 and July 2018. Thirty-six patients were treated with CT-P10 for the first time, while the other 15 switched from RTX originator. RTX was administrated with high or dosage schemes (375 mg/m2 four times a week apart/1000 mg twice one week apart or 250 mg/m2 twice one week apart). During a month period after the last infusion, 13/51 adverse events (AE) were observed in group 1 and 17/75 in group 2 (p not significant). Among them, 7/13 and 6/17 (in group 1 and 2, respectively) could be considered immune-mediated AE (p not significant). At univariate analysis patients with IM-AE were more frequently males (p = 0.04) and with a lower disease duration (p = 0.03), but both the parameters were not significant at logistic regression. About clinical response after 6 months by the end of the treatment, no differences were observed between patients treated with originator and CT-P10 regarding the response to the therapy. No differences were observed in safety and effectiveness between patients naive at RTX or switching from originator. Despite the higher prevalence of immune-mediated AE among patients treated with CT-P10 than originator, we have observed no significant differences between the 2 groups. The use of a low-dosage regimen is more common in group 1 than in group 2, representing a possible bias of the study, possibly influencing the appearance of AE. Considering the cost/efficacy ratio of biosimilars, their use could be helpful to treat a large number of MCV patients with an effectiveness and safety comparable to originator. Multicenter studies including a large number of patients and the new RTX biosimilars could be useful to fully elucidate the possible risk of immune-mediated adverse events with biosimilar drugs. Considering the cost/efficacy ratio of CT-P10, its use could help to treat a large number of MCV patients with an effectiveness and safety comparable to originator. more...

Zwitterionic polysaccharides (ZPs) have been shown in recent years to display peculiar immunological properties, thus attracting the interest of the carbohydrate research community. To fully elucidate the mechanisms underlying these properties and exploit the potential of this kind of structures, in depth studies are still required. In this context, the preparation of two cationic, an anionic, as well as two zwitterionic tetrasaccharide analogues of the smallest immunogenic structure of Streptococcus pneumoniae type 14 (SP14) capsular polysaccharide are presented. By exploiting a block strategy, the negative charge has been installed on the non-reducing end of the lactose unit of the tetrasaccharide and the positive charge either on the non-reducing end of the lactosamine moiety or on an external linker. These structures have then been tested by competitive ELISA, showing that the structural variations we made do not modify the affinity of the neutral compound to binding to a specific antibody. However, lower efficacies than the natural SP14 compound were observed. The results obtained, although promising, point to the need to further elongate the polysaccharide structure, which is likely too short to cover the entire epitopes. more...