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Assessing students' perceptions of the services provided by school counselors is crucial in promoting these services. However, there is no reliable scale for this assessment in the Persian language to date. Thus, this study aimed to translate and validate the School Counselor Noncognitive Skills Scale (SCNSS) among Iranian high school students. The English version of the SCNSS was translated into Persian, and its content and face validity were confirmed through cognitive interviews and expert evaluations. Using a convenience sampling method, data were collected from 308 high school students across three educational districts in Sanandaj, Iran. Confirmatory factor analysis supported the three-factor structure of the SCNSS, demonstrating good model fit. Measurement invariance analysis indicated consistency across genders. The internal consistency of the scale was high, with Cronbach's alpha coefficients exceeding 0.86 for all subscales. Convergent validity was established through significant correlations with the School Belonging Scale (SBS). Additionally, a positive correlation was found between the number of counseling sessions attended and students' perceptions of their counselors' noncognitive skills. These findings suggest that the Persian version of the SCNSS is a valid and reliable tool for assessing the impact of school counselors on the development of noncognitive skills among Iranian students.

Introduction: Nailfold video-capillaroscopy (NVC) is a non-invasive cost-effective technique involving the microscopic examination of small blood vessels of the distal nailfold with a magnification device. It provides valuable information regarding the microcirculation including anomalies such as tortuous or dilated capillaries, hemorrhages, and avascular areas, which can characterize connective tissue diseases. The utility of NVC in the diagnosis and monitoring of systemic sclerosis (SSc) has been investigated in numerous studies allowing the distinction of the specific microvascular pattern of scleroderma from different conditions other than scleroderma (non-scleroderma pattern). Sarcoidosis (SA) is a systemic inflammatory disease that can affect various organs, including the lungs, skin, and lymph nodes. The purpose of our review was to evaluate the current state of the art in the use of NVC in the diagnosis of SA, to understand the indications for its use and any consequent advantages in the management of the disease in different settings in terms of benefits for patients. Materials and Methods: We searched for the key terms “sarcoidosis” and “video-capillaroscopy” in a computerized search of Pub-Med, extending the search back in time without setting limits. We provided a critical overview of the literature, based on a precise evaluation. After our analysis, we examined the six yielded works looking for answers to our questions. Results: Few studies have evaluated that microcirculation is often compromised in SA, with alterations in blood flow and consequent tissue damage. Discussion: Basing on highlighted findings, NVC appears to be a useful tool in the initial evaluation of sarcoidosis patients. Furthermore, capillaroscopy is useful in the evaluation of the coexistence of sarcoidosis and scleroderma spectrum disorder or overlap syndromes. Conclusions: In conclusions, no specific pattern has been described for sarcoidosis, and further re-search is needed to fully understand the implications of nailfold capillaroscopy find-ings in this disease and to establish standardized guidelines for its use in clinical practice.

Abstract Metabolic plasticity is a hallmark of cancer, and metabolic alterations represent a promising therapeutic target. Since cellular metabolism is controlled by membrane traffic at multiple levels, we investigated the involvement of TBC1 domain-containing proteins (TBC1Ds) in the regulation of cancer metabolism. These proteins are characterized by the presence of a RAB-GAP domain, the TBC1 domain, and typically function as attenuators of RABs, the master switches of membrane traffic. However, a number of TBC1Ds harbor mutations in their catalytic residues, predicting biological functions different from direct regulation of RAB activities. Herein, we report that several genes encoding for TBC1Ds are expressed at higher levels in triple-negative breast cancers (TNBC) vs. other subtypes of breast cancers (BC), and predict prognosis. Orthogonal transcriptomics/metabolomics analysis revealed that the expression of prognostic TBC1Ds correlates with elevated glycolytic metabolism in BC cell lines. In-depth investigations of the three top hits from the previous analyses (TBC1D31, TBC1D22B and TBC1D7) revealed that their elevated expression is causal in determining a glycolytic phenotype in TNBC cell lines. We further showed that the impact of TBC1D7 on glycolytic metabolism of BC cells is independent of its known participation in the TSC1/TSC2 complex and consequent downregulation of mTORC1 activity. Since TBC1D7 behaves as an independent prognostic biomarker in TNBC, it could be used to distinguish good prognosis patients who could be spared aggressive therapy from those with a poor prognosis who might benefit from anti-glycolytic targeted therapies. Together, our results highlight how TBC1Ds connect disease aggressiveness with metabolic alterations in TNBC. Given the high level of heterogeneity among this BC subtype, TBC1Ds could represent important tools in predicting prognosis and guiding therapy decision-making.

Carbon nanotubes (CNT) are promising electroconductive nano-scale materials for neuroregeneration. Herein, we report on a new electroconductive composite scaffold made of the polymer 1% oxidized polyvinyl alcohol (OxPVA) combined with functionalized water soluble multiwalled CNT (OxPVA + MWCNT-S) (diazotization reaction). Preliminarily, MWCNT-S were characterized to evaluate the reaction outcome, the degree of functionalization and the dispersibility in water. Thereafter, OxPVA + MWCNT-S nanocomposite membranes were fabricated and analyzed for physicochemical properties (Raman spectroscopy, thermal decomposition, calorimetric properties, electroconductivity), macroscopic appearance and ultrastructure, mechanical behavior, in vitro cytotoxicity and in vivo biocompatibility. In parallel, OxPVA + MWCNT-S membranes with a linear pattern were also developed and analyzed for interaction with SH-SY5Y cells. Compared to OxPVA, the presence of MWCNT-S (only 0.016 wt%) significantly increased polymer conductivity and imparted a certain porosity without altering mechanical behaviour, as corroborated by uniaxial tensile tests. Neither cytotoxicity nor local signs of inflammation were detected in vitro and after subcutaneous implantation (14 and 42 days), proving composite material biocompatibility. OxPVA + MWCNT-S nanocomposite revealed as promising for future electroconductive conduits free from toxic effects amenable to CNT agglomeration within the polymer. Ideally, nerve lesions with wide gaps, may be effectively supported by those “active” devices, overcoming limitations of the available ones. Despite preliminary data, the presence of a linear pattern confirmed to have a beneficial effect over the scaffold/cells interaction.

Background: We aim to provide up-to-date real-world evidence on the persistence, adherence, healthcare resource utilization, and costs of multiple sclerosis (MS) by comparing ocrelizumab to other disease-modifying treatments (DMTs) and within different DMT sequences. Methods: We included 3371 people with MS who first received or switched DMT prescriptions from January 2018 to December 2022; they were identified through hospital discharge records, drug prescriptions, and exemption codes from the Campania Region (South Italy). We calculated persistence (time from the first prescription to discontinuation or switching to another DMT), adherence (proportion of days covered (PDC)), DMT costs, and MS hospital admissions and related costs. Results: The most frequently prescribed DMT was dimethyl fumarate (n = 815; age 38.90 ± 11.91 years; 69.5% females), followed by ocrelizumab (n = 682; age 46.46 ± 11.29 years; 56.3%); 28.8% of the patients treated with ocrelizumab were naïve to DMTs. Using ocrelizumab as a statistical reference, the risk of discontinuation was higher for other highly active (HR = 6.32; 95%CI = 3.16, 12.63; p < 0.01) and low-/medium-efficacy DMTs (HR = 10.10; 95%CI = 5.10, 19.77; p < 0.01); adherence was lower for other highly active DMTs (Coeff = −0.07; 95%CI = −0.10, −0.04; p < 0.01) and low-/medium-efficacy DMTs (Coeff = −0.16; 95%CI = −0.19, −0.14; p < 0.01). monthly DMT costs were higher for other highly active DMTs (Coeff = 77.45; 95%CI = 29.36, 125.53; p < 0.01) but lower for low-/medium-efficacy DMTs (Coeff = −772.31; 95%CI = −816.95, −727.66; p < 0.01). The hospital admissions and related costs of MS were similar between ocrelizumab, other highly active DMTs, and other low-/medium-efficacy DMTs, and with ocrelizumab as the first-line DMT after other highly active DMTs and after low-/medium-efficacy DMTs, which was possibly due to the low number of observations. Conclusions: From 2018 to 2022, ocrelizumab was among the most frequently prescribed DMTs, with 28.8% prescriptions to incident MS patients, confirming its relevance in clinical practice. Ocrelizumab was associated with the highest persistence and adherence, pointing towards its favorable benefit–risk profile. The costs of ocrelizumab were lower than those of other highly active DMTs.

Background and purposeClinical outcomes of multiple sclerosis (MS) patients affected by coronavirus disease 2019 (COVID-19) have been thoroughly investigated, but a further analysis on main signs and symptoms and their risk factors still needs attention. The objective of this study was to group together and describe based on similarity the most common signs and symptoms of COVID-19 in MS patients and identify all factors associated with their manifestation.MethodLogistic and linear regression models were run to recognize factors associated with each pooled group of symptoms and their total number.ResultsFrom March 2020 to November 2021, data were collected from 1354 MS patients with confirmed infection of COVID-19. Ageusia and anosmia was less frequent in older people (odds ratio [OR] 0.98; p = 0.005) and more in smoker patients (OR 1.39; p = 0.049). Smoke was also associated with an incremental number of symptoms (OR 1.24; p = 0.031), substance abuse (drugs or alcohol), conjunctivitis and rash (OR 5.20; p = 0.042) and the presence of at least one comorbidity with shortness of breath, tachycardia or chest pain (OR 1.24; p = 0.008). Some disease-modifying therapies were associated with greater frequencies of certain COVID-19 symptoms (association between anti-CD20 therapies and increment in the number of concomitant symptoms: OR 1.29; p = 0.05). Differences in frequencies between the three waves were found for flu-like symptoms (G1, p = 0.024), joint or muscle pain (G2, p = 0.013) and ageusia and anosmia (G5, p

Complete and precise knowledge of the neck anatomy and its eventual anomalies is crucial while performing a safe thyroid and parathyroid surgery. Embryo-genetic malformations of the IV branchial arch can lead to an uncommon anatomical alteration known as non-recurrent inferior laryngeal nerve. Its prevalence varies between 0.7% for the dextral branch and 0.04% for the sinistral. In these cases, the inferior laryngeal nerve branches originate directly from the cervical vagus nerve, entering the larynx without hooking, on the right side around the subclavian artery or on the left around the aortic arch. The presence of a non-recurrent laryngeal nerve is challenging, due to the increased risks of iatrogenic damage to the nerve, which results in hoarseness, dysphagia, glottal obstruction, vocal cords palsy, and serious airway impairment. We present the case of a 58-year-old woman. The patient was admitted to our department for a nodule classified as Bethesda IV in the right thyroid lobe. Through the use of intraoperative neuromonitoring (IONM), surgeons detected intraoperatively a non-recurrent laryngeal nerve. A subsequent computed tomography scan confirmed an anomalous right subclavian artery branching from the left aortic arch, the Lusoria Artery. Anatomical variants represent pitfalls in this case and an accurate knowledge of the neck region is imperative while performing thyroid surgery. Devices such as IONM are useful for detecting abnormalities that may lead to iatrogenic damages.

Objetivo: Sintetizar as principais evidências envolvendo os mecanismos de ligação fisiopatológico e clínico-epidemiológico em mulheres com câncer de mama e a síndrome metabólica. Método: Trata-se de uma revisão de escopo estruturada conforme o Instituto Joanna Briggs, realizado nas bases de dados PubMed, BDENF, LILACS, IBECS, CUMED, WPRIM, BINACIS e Embase. Esta revisão encontra-se protocolada no Open Science Framework. Resultado: Com relação ao nível de evidência dos estudos inclusos, houve predominância para níveis fortes de evidência. Não houve achados de evidência fraca nesta pesquisa. O estado inflamatório crônico do tecido adiposo mamário em casos de obesidade pode agravar o impacto negativo nas células cancerígenas, afetando diretamente a sobrevida e recorrência. Ganho ou perda de peso inexplicável estão associados a uma menor sobrevida em mulheres com câncer de mama, sublinhando a necessidade de orientações específicas durante o tratamento. Conclusão: A síndrome metabólica esta associada ao risco de câncer de mama, entretanto, a perda maciça de peso durante a doença ativa pode ser um fator de pior prognóstico, devendo assim, ser realizada de forma preventiva. Os pacientes devem ser orientados a manter um peso estável durante a quimioterapia e receber orientações sobre alimentação adequada e atividade física em busca de aumento de massa muscular.

Abstract Metabolic alterations in cancers can be exploited for diagnostic, prognostic, and therapeutic purposes. This is exemplified by 18F‐fluorodeoxyglucose (FDG)‐positron emission tomography (FDG‐PET), an imaging tool that relies on enhanced glucose uptake by tumors for diagnosis and staging. By performing transcriptomic analysis of breast cancer (BC) samples from patients stratified by FDG‐PET, a 54‐gene signature (PETsign) is identified that recapitulates FDG uptake. PETsign is independently prognostic of clinical outcome in luminal BCs, the most common and heterogeneous BC molecular subtype, which requires improved stratification criteria to guide therapeutic decision‐making. The prognostic power of PETsign is stable across independent BC cohorts and disease stages including the earliest BC stage, arguing that PETsign is an ab initio metabolic signature. Transcriptomic and metabolomic analysis of BC cells reveals that PETsign predicts enhanced glycolytic dependence and reduced reliance on fatty acid oxidation. Moreover, coamplification of PETsign genes occurs frequently in BC arguing for their causal role in pathogenesis. CXCL8 and EGFR signaling pathways feature strongly in PETsign, and their activation in BC cells causes a shift toward a glycolytic phenotype. Thus, PETsign serves as a molecular surrogate for FDG‐PET that could inform clinical management strategies for BC patients.

Systemic sclerosis (SSc) is a complex autoimmune disease characterized by significant fibrosis of the skin and internal organs, with the main involvement of the lungs, kidneys, heart, esophagus, and intestines. SSc is also characterized by macro- and microvascular damage with reduced peripheral blood perfusion. Several studies have reported more than 240 pathways and numerous dysregulation proteins, giving insight into how the field of biomarkers in SSc is still extremely complex and evolving. Antinuclear antibodies (ANA) are present in more than 90% of SSc patients, and anti-centromere and anti-topoisomerase I antibodies are considered classic biomarkers with precise clinical features. Recent studies have reported that trans-forming growth factor β (TGF-β) plays a central role in the fibrotic process. In addition, interferon regulatory factor 5 (IRF5), interleukin receptor-associated kinase-1 (IRAK-1), connective tissue growth factor (CTGF), transducer and activator of transcription signal 4 (STAT4), pyrin-containing domain 1 (NLRP1), as well as genetic factors, including DRB1 alleles, are implicated in SSc damage. Several interleukins (e.g., IL-1, IL-6, IL-10, IL-17, IL-22, and IL-35) and chemokines (e.g., CCL 2, 5, 23, and CXC 9, 10, 16) are elevated in SSc. While adiponectin and maresin 1 are reduced in patients with SSc, biomarkers are important in research but will be increasingly so in the diagnosis and therapeutic approach to SSc. This review aims to present and highlight the various biomarker molecules, pathways, and receptors involved in the pathology of SSc.

Hyperspectral images consist of a multitude of spectral bands for each pixel. Spectral bands provide information about wavelengths that may cover a larger spectrum of what the human eye may see. In the hyperspectral domain, the classification of hyperspectral images is usually addressed by taking into account only the spectral information. However, in the wood domain, spatial information is also relevant. To bridge this gap, this paper proposes a CNN-based end-to-end framework for the classification of hyperspectral images in the wood domain. The proposed framework consists of a spatial and spectral classifier that are integrated to make the final prediction. Each classifier is built by adapting a general image classifier, which is suitable for the classification of three-band images, to handle hyperspectral images. The framework is trained and validated on a real dataset, provided by a company working in the wood domain to detect wood fungi. The results obtained have shown that the proposed framework is a lightweight and effective approach for the recognition of wood fungi categories. The framework outperforms a benchmark classifier by 17% and can generate a classification map of hyperspectral images of wood boards of any size with an accuracy of 96%.

Starting from the discussion between Gabriele Pedullà and Carlo Ginzburg that followed the publication of Ginzburg’s Nevertheless: Machiavelli, Pascal (2018), the article proposes a re-reading of Machiavelli, the rule and the exception (2003), the essay that sparked the research later merged into the volume and now constituting its first chapter. The analysis brings out a contradiction between, on the one hand, the theoretical-methodological underpinnings that Ginzburg has always defended against the so-called postmodern skepticism and, on the other hand, a way of proceeding that on the contrary takes implicitly advantage of principles one finds in texts by authors whose work Ginzburg has often criticized, such as, for instance, Jacques Derrida. The article focuses especially on the notions of ‘context’ and ‘specific context’, notions which Ginzburg used to reply to Pedullà’s objections, but that are both deconstructed – with procedures that are surprisingly similar to those indicated by Derrida himself in Signature Event Context (1972) – precisely in his own essay.

Dating violence (DV) is a form of intentional abuse carried out in young couples, which over the years has increasingly gained attention for its pervasiveness and high frequency. The present study represents an effort to expand and deepen the literature on factors associated with DV perpetration. The sample consisted of 225 Italian young people who completed an online survey. A model was tested, in which DV perpetration is affected by the presence of gender stereotypes and personal values oriented to power and dominance (i.e., self-enhancement) and to universalism and interest in others (i.e., self-transcendence) through the mediation of the perception of the romantic relationship quality, controlling for age. Sex was also considered in the model. The findings showed that self-enhancement and self-transcendence were, respectively, linked positively and negatively to a negative perception of the relationship quality, which in turn explained DV perpetration. The results also suggested that hostile sexism, self-enhancement and being male were directly linked to DV perpetration, thus representing potential risk factors for it. The study suggests the importance of working on gender role beliefs and personal orientation to power, which guide the way people perceive their romantic relationships and behave toward their partners, providing interesting insights for the implementation of DV prevention programs. Moreover, the findings highlight the importance of working with families and other educational agencies to foster a change in cultural terms.

This comprehensive literature review explores the involvement of the gastrointestinal (GI) tract in sarcoidosis, a multisystem granulomatous disorder of unknown etiology. GI sarcoidosis presents a diagnostic and therapeutic challenge due to its rarity and nonspecific clinical manifestations, including overlap with other gastrointestinal diseases. We conducted a comprehensive screening of articles addressing the clinical features, diagnostic approaches, and treatment strategies for GI sarcoidosis. Our findings reveal that GI sarcoidosis can affect any part of the gastrointestinal tract, with the stomach and small intestine being the most involved. Clinical presentations range from asymptomatic cases to severe complications such as obstruction and perforation, with reflux being a common symptom. Diagnosis is often delayed due to the nonspecific nature of symptoms and the need for histopathological confirmation. Therapeutic approaches are poorly defined, typically involving corticosteroids as the mainstay of treatment. However, the long-term efficacy and safety of these treatments remain uncertain in this patient group, given the significant risks and complications associated with prolonged glucocorticoid therapy. There is a clear need to develop accurate diagnostic protocols to distinguish GI sarcoidosis from other conditions and to establish standardized therapeutic guidelines to optimize patient outcomes. Further research is essential to enhance our understanding and management of this complex condition.

Nintedanib, an intracellular inhibitor that targets multiple tyrosine kinase, is an important drug for the treatment of pulmonary fibrosis. Until now, no studies have been published reporting the nintedanib tolerability or its efficacy in patients with chronic pulmonary lung disease and chronic kidney disease comorbidity. The safety, efficacy and pharmacokinetics of nintedanib have not been studied in patients with severe renal impairment (creatinine clearance < 30 mL/min) and for this reason it is contraindicated in these patients. We describe a case of use of nintedanib in a patient affected by idiopathic pulmonary fibrosis (IPF) who started, from 2022, nintedanib 150 mg twice a day with careful monitoring of liver and kidney function. Due to the onset of stage 3/4 chronic kidney disease associated with proteinuria, nintedanib was suspended for two months, and the patient received Prednisone at a dose of 12.5 mg/day. During the two months of suspension, the renal function did not improve, unlike the respiratory status worsened. In the past a renal biopsy was performed which showed no correlation with nintedanib use. Nintedanib therapy started again following the decline in lung function and desaturation below 90% in the 6-min walking test (6MWT). Patient showed a good tolerability of nintedanib with sporadic episode of diarrhea and an improvement of pulmonary function leading to a stable state of chronic pulmonary fibrosis disease. For this reason, in mutual agreement with the patient, we decided to maintain nintedanib therapy even when the patient required hemodialysis. No toxic effects appeared. This case report revealed the safety of nintedinab in patient with concomitant kidney failure, but more studies are necessary.

Idiopathic pulmonary fibrosis (IPF) is a rare and progressive interstitial lung disease characterized by irreversible distortion of lung architecture and subsequent loss of pulmonary function. Pirfenidone is an antifibrotic agent associated with increased progression-free survival and overall survival rates, but it carries multiple side effects. The aim of the study was to examine the efficacy and safety profile of pirfenidone in a real-life context, with a focus on the concomitant use of antithrombotic and/or anticoagulant treatments. The clinical and functional data (forced vital capacity [FVC], forced expiratory volume in 1 s [FEV1], diffusing lung capacity for carbon monoxide [DLCO], and 6 min walking test distance [6MWD]) of all IPF patients treated with pirfenidone and referred to our two centers between 2019 and 2022 were retrospectively analyzed at baseline, 6 and 12 months after the start of treatment. A total of 55 IPF subjects undergoing pirfenidone treatment were included in the analysis (45.5% females, median [IQR] age at disease onset 68.0 [10.0] years, median [IQR] age at baseline 69.0 [10.8] years). Compared to baseline, at 12 months, FVC (86.0% vs. 80.0%; p = 0.023) and DLCO (44.0% vs. 40.0%; p = 0.002) were significantly reduced, while FEV1 (p = 0.304) and 6MWD (p = 0.276) remained stable; no significant change was recorded at 6 months. Most of the reported adverse events were mild or moderate. Gastrointestinal intolerance (9.1%) was the main cause of treatment discontinuation. A total of 5% of patients reported at least one minor bleeding event, although all episodes occurred in those receiving concomitant antithrombotic or anticoagulant. Overall, this real-life experience confirms the efficacy and safety profile of pirfenidone in the case of the concomitant use of antithrombotic and/or anticoagulant drugs.