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Introduction Major depressive disorder (MDD), especially in case of suicidal risk, is a psychiatric emergency, associated with high patient burden and healthcare resource utilization. Although active and urgent treatment is crucial, little is known on comprehensive care management of this condition in Italy. Objectives Here we report the ARIANNA study [NCT04463108] interim results to primarily describe the treatment utilization pathways of patients with MDD and active suicidal ideation with intent in the current clinical practice in Italy. Methods This observational prospective cohort study included adult patients with a moderate-to-severe major depressive episode (MDE) and active suicidality from 24 Italian sites. Real-world data on patient characteristics, treatments, clinical outcomes, and healthcare utilization were collected during a 90-day follow-up. Data collection is still ongoing. Results Sixty-four evaluable patients were considered for this interim analysis: 41 (64.1%) females, mean [SD] age 46.0 [15.4] years, a concomitant psychiatric diagnosis in 7 (10.9%), and other comorbidities in 26 (40.6%). The baseline mean [SD] MADRS total score was 37.5 [7.2], with severe MDE and prior suicidal behavior in 30 (46.9%) and 21 (32.8%) patients, respectively. Median [25th;75th percentiles] duration of current MDE was 1.1 [0.3;2.1] months. Acute inpatient hospitalization was provided for 43 (67.2%) patients. Antidepressant augmentation with mood stabilizers and/or antipsychotic drugs and optimization were the most frequent early standard-of-care treatment regimens in 32 (53.3%) and 24 (40.0%) patients with available data (N=60), respectively. Conclusions Our preliminary results suggest that initial treatment approaches in this critical population are mostly polypharmacological and delivered as inpatient care, with consequent intensive resource utilization. Disclosure The ARIANNA study was sponsored by Janssen-Cilag SpA, Italy. DD and MA are employees of Janssen-Cilag SpA. DA and BR are employees of MediNeos S.U.R.L., a company subject to the direction and coordination of IQVIA Solutions HQ Ltd.

The physical and operating principle of a stress sensor, based on two crossing carbon fibers functionalized with ZnO nanorod-shaped nanostructures, was recently demonstrated. The functionalization process has been here extended to tows made of one thousand fibers, like those commonly used in industrial processing, to prove the idea that the same working principle can be exploited in the creation of smart sensing carbon fiber composites. A stress-sensing device made of two functionalized tows, fixed with epoxy resin and crossing like in a typical carbon fiber texture, was successfully tested. Piezoelectric properties of single nanorods, as well as those of the test device, were measured and discussed. [ABSTRACT FROM AUTHOR]

Purpose: Delirium risk assessment in the acute-care setting generally does not account for frailty. The objective of this retrospective study was to identify factors associated with delirium, considering the interdependency of clinical variables with frailty syndrome in complex older patients., Methods: The clinical records of 587 participants (248 M, median age 84) were reviewed, collecting clinical, anamnestic and pharmacological data. Frailty syndrome was assessed with the Clinical Frailty Scale (CFS). Delirium was the main study endpoint. The correlations of the considered anamnestic and clinical variables with delirium and its subtypes were investigated selecting only those variables not showing a high overlap with frailty. Correlations associated with a 25% excess of frequency of delirium in comparison with the average of the population were considered as statistically significant., Results: Delirium was detected in 117 (20%) participants. The presence of one among age > 85 years old, CFS > 4 and invasive devices explained 95% of delirium cases. The main factors maximizing delirium incidence at the individual level were dementia, other psychiatric illness, chronic antipsychotic treatment, and invasive devices. The coexistence of three of these parameters was associated with a peak frequency of delirium, ranging from 57 to 61%, mostly hypoactive forms., Conclusions: In acute-care wards, frailty exhibited a strong association with delirium during hospitalization, while at the individual level, dementia and the use of antipsychotics remained important risk factors. Modern clinical prediction tools for delirium should account for frailty syndrome., (© 2024. The Author(s).)

Background: Treatment-resistant depression (TRD) is defined by the European Medicines Agency as a lack of clinically meaningful improvement after treatment, with at least two different antidepressants. Individual, familiar, and socio-economic burden of TRD is huge. Given the lack of clear guidelines, the large variability of TRD approaches across different countries and the availability of new medications to meet the need of effective and rapid acting therapeutic strategies, it is important to understand the consensus regarding the clinical characteristics and treatment pathways of patients with TRD in Italian routine clinical practice, particularly in view of the recent availability of esketamine nasal spray., Methods: A Delphi questionnaire with 17 statements (with a 7 points Likert scale for agreement) was administered via a customized web-based platform to Italian psychiatrists with at least 5 years of experience and specific expertise in the field of depression. In the second-round physicians were asked to answer the same statements considering the interquartile range of each question as an index of their colleagues' responses. Stata 16.1 software was used for the analyses., Results: Sixty panellists, representative of the Italian territory, answered the questionnaire at the first round. For 8/17 statements more than 75% of panellists reached agreement and a high consensus as they assigned similar scores; for 4 statements the panellists assigned similar scores but in the middle of the Likert scale showing a moderate agreement with the statement, while for 5 statements there was indecision in the agreement and low consensus with the statement., Conclusions: This Delphi Panel showed that there is a wide heterogeneity in Italy in the management of TRD patients, and a compelling need of standardised strategies and treatments specifically approved for TRD. A high level of consensus and agreement was obtained about the importance of adding lithium and/or antipsychotics as augmentation therapies and in the meantime about the need for long-term maintenance therapy. A high level of consensus and agreement was equally reached for the identification of esketamine nasal spray as the best option for TRD patients and for the possibility to administrate without difficulties esketamine in a community outpatient setting, highlighting the benefit of an appropriate educational support for patients., (© 2023. The Author(s).)

Background: Major Depressive Disorder (MDD) with suicidal ideation, intent, or behavior is a psychiatric emergency with controversial care management. Our study describes the comprehensive treatment pathways of this population in Italian routine clinical practice., Methods: ARIANNA [NCT04463108] is an observational prospective and retrospective cohort study involving both primary data collection and secondary data extract. A total of 137 adult MDD patients with suicidality were enrolled from 24 Italian care sites and followed for 90 days. Other than the description of treatment patterns, the impact of treatment on depressive symptoms and suicidality, the burden on the patient's and caregiver's quality of life, healthcare resource utilization and costs were described., Results: Of the 133 eligible patients, 68.4% were female, and the median age was 47. Approximately half of the study population had a current severe major depressive episode. Treatment strategies at the time of active suicidal ideation with intent definition/confirmation (t0) were heterogeneous, increasing in complexity during observation. According to the MADRS, patients with remission at t0+1 day were 2.6%, with the mean total score decreasing from 37.2 at t0 to 32.3., Limitations: The study sites were not randomly selected., Conclusions: To the best of our knowledge, this is the first cohort study that prospectively describes the characteristics of patients with MDD and suicide risk in Italy, and how they are treated in clinical practice. The study confirms this is a difficult-to-treat population. In addition, a lack of rapid, effective treatment for reducing depressive symptoms and suicidality is observed., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: M. Pompili took part in advisory boards and educational activities on intranasal esketamine, receiving occasional fees for consultations or lectures by Janssen, which are unrelated to this article. In the last 2 years, he has received lectures or advisory board honoraria or engaged in clinical trial activities with Angelini, Lundbeck, Janssen, Pfizer, MSD, and Recordati. B.M. Dell'Osso received lecture honoraria from Angelini, Lundbeck, Janssen, Pfizer, Neuraxpharm, Arcapharma, and Livanova. G. Rosso received speaker/consultant fees for Angelini, Innova Pharma, Janssen, Lundbeck and Otsuka. D. Delmonte was employed by Janssen-Cilag SpA. M. Adami was employed by Janssen-Cilag SpA. G. Ascione was employed by Janssen-Cilag SpA. C. Sansone was employed by Janssen-Cilag SpA. L. Simoni was employed by Medineos SURL (IQVIA Ltd.). R. Cipelli was employed by IQVIA solutions SRL. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

We present a new method to synthesize bulk indium nitride by means of a simple solid-state chemical reaction carried out under hydrostatic high-pressure/high-temperature conditions in a multi-anvil apparatus, not involving gases or solvents during the process. The reaction occurs between the binary oxide In 2 O 3 and the highly reactive Li 3 N as the nitrogen source, in the powder form. The formation of the hexagonal phase of InN, occurring at 350 °C and P ≥ 3 GPa, was successfully confirmed by powder X-ray diffraction, with the presence of Li 2 O as a unique byproduct. A simple washing process in weak acidic solution followed by centrifugation allowed us to obtain pure InN polycrystalline powders as a precipitate. With an analogous procedure, it was possible to obtain pure bulk GaN, from Ga 2 O 3 and Li 3 N at T ≥ 600 °C and P ≥ 2.5 GPa. These results point out, particularly for InN, a clean, and innovative way to produce significant quantities of one of the most promising nitrides in the field of electronics and energy technologies.

Multiferroics, showing the coexistence of two or more ferroic orderings at room temperature, could harness a revolution in multifunctional devices. However, most of the multiferroic compounds known to date are not magnetically and electrically ordered at ambient conditions, so the discovery of new materials is pivotal to allow the development of the field. In this work, we show that BaFe 2 O 4 is a previously unrecognized room temperature multiferroic. X-ray and neutron diffraction allowed to reveal the polar crystal structure of the compound as well as its antiferromagnetic behavior, confirmed by bulk magnetometry characterizations. Piezo force microscopy and electrical measurements show the polarization to be switchable by the application of an external field, while symmetry analysis and calculations based on density functional theory reveal the improper nature of the ferroelectric component. Considering the present findings, we propose BaFe 2 O 4 as a Bi- and Pb-free model for the search of new advanced multiferroic materials., (© 2022. The Author(s).)

Introduction: Treatment-resistant depression (TRD) is a debilitating condition affecting 20-30% of patients with major depressive disorders (MDD). Currently, there is no established standard of care for TRD, and wide variation in the clinical approach for disease management has been documented. Real-world data could help describe TRD clinical features, disease burden, and treatment outcome and identify a potential unmet medical need. Methods: We analyzed the Italian data from a European, prospective, multicentric, observational cohort study of patients fulfilling TRD criteria by the European Medicine Agency, with moderate to severe major depressive episode, and starting a new antidepressant treatment according to routinary clinical practice. They were followed up for minimum 6 months. Treatments received throughout the study period, disease severity, health-related quality of life and functioning were prospectively recorded and analyzed. Results: The Italian subcohort included 124 TRD patients (30.2% of patients of the European cohort; mean age 53.2 [sd = 9.8], women: 82, 66.1%). At enrollement, the mean (SD) duration of MDD was 16 years (sd = 11.1) and the mean duration of the ongoing major depressive episode (MDE) was 97.5 weeks (sd = 143.5); low scores of quality of life and functioning were reported. The most frequently antidepressant classes started at baseline (data available for 98 subjects) were selective serotonin reuptake inhibitors (SSRI, 42 patients [42.9%]) and serotonin-norepinephrine reuptake inhibitors (SNRI, 32 patients [32.7%]). In terms of treatment strategies, 50 patients (51%) started augmentation therapies, 18 (18.4%) combination therapies and 24 (24.5%) monoterapies (6 patients [6%] started a non-antidepressant drug only). Fourteen patients (11.3%) were treated with a psychosocial approach, including psychotherapy. After 6 months of treatment, clinical assessments were collected for 89 patients: 64 (71.9%) showed no response, 9 (10.1%) response without remission and 16 (18.0%) were in remission; non-responder patients showed lower quality of life and higher disability scores than responder patients. Conclusions: In our sample of TRD patients, we documented substantial illness burden, low perceived quality of life and poor outcome, suggesting an unmet treatment need in TRD care in Italy. Registration Number: ClinicalTrials.gov, number: NCT03373253., Competing Interests: GP received grant/research support from Angelini; speaker/consultant for Angelini, Janssen, Lundbeck, Neuraxpharm, Sanofi Aventis. GR received speaker/consultant fees for Angelini, Innova Pharma, Janssen, Lundbeck and Otsuka. AV received grant/research support and speaker/consultant fees for Angelini, Boheringer Ingelheim, Innovapharma, Janssen-Cilag, Lundbeck, Otsuka, Pfizer, Recordati, Roche, Rovi Pharma, Takeda. JM was employed by Janssen EMEA. MA was employed by Janssen-Cilag SpA. GA was employed by Janssen-Cilag SpA. DD was employed by Janssen-Cilag SpA. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. This article was based on the original study 54135419DEP4001 sponsored by Janssen EMEA. The funder had the following involvement with the study: study design, data collection and analysis, decision to publish, and preparation of the manuscript. Support for third-party writing assistance for this article, provided by Carlotta Galeone (Statinfo srl), was funded by Janssen-Cilag SpA in accordance with Good Publication Practice (GPP3) guidelines (http://www.ismpp.org/gpp3)., (Copyright © 2021 Perugi, Calò, De Filippis, Rosso, Vita, Adami, Ascione, Morrens and Delmonte.)

Objectives: It is important to quantify the true burden of coronavirus disease 2019 (COVID-19) in different countries, to enable informed decisions about imposing and relaxing control measures. COVID-19 surveillance data fails in this respect, as it is influenced by different definitions, control policies and capacities. This article aims to quantify excess mortality and estimate the distribution between COVID-19 and non-COVID-19 causes of death., Study Design: Observational study and mathematical modelling., Methods: Publicly available data from multiple institutional sources were used and an in-depth analysis was carried out of deaths from all causes between 2015 and 2020 in Italy at the national, regional and local level. Excess mortality over time and space was first explored, followed by an assessment of how this related to COVID-19 surveillance and, ultimately, assuming a fixed male:female ratio, a model was developed and applied to estimate the proportions of COVID-19 and non-COVID-19 excess mortality in 2020., Results: In Italy, the mortality rate doubled in March and April 2020 compared with data from 2015 to 2019 (+109%, when considering municipalites with >10.000 inhabitants), with excess mortality reaching >600% in large municipalities in northern areas. Notified COVID-19 deaths accounted for only 43.5% (regional range: 43-62%) of excess mortality. It is estimated that more than two-thirds of excess deaths that were not captured by surveillance are non-COVID-19 deaths, which could be a result of the excess burden on the health systems, in addition to reduced demand and supply of other non-COVID healthcare services., Conclusions: The impact of COVID-19 during the early stages of the pandemic is much larger than official figures have reported. Monitoring excess mortality helps to capture the full effect of the COVID-19 pandemic, which differs between regions in Italy and which might have resulted in significant indirect effects on the well-being of the population. In addition, the COVID-19 pandemic has also resulted in significant indirect effects on the well-being of the population., (Copyright © 2020 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.)

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease (COVID-19) is characterized by severe pneumonia and/or acute respiratory distress syndrome in about 20% of infected patients. Computed tomography (CT) is the routine imaging technique for diagnosis and monitoring of COVID-19 pneumonia. Chest CT has high sensitivity for diagnosis of COVID-19, but is not universally available, requires an infected or unstable patient to be moved to the radiology unit with potential exposure of several people, necessitates proper sanification of the CT room after use and is underutilized in children and pregnant women because of concerns over radiation exposure. The increasing frequency of confirmed COVID-19 cases is striking, and new sensitive diagnostic tools are needed to guide clinical practice. Lung ultrasound (LUS) is an emerging non-invasive bedside technique that is used to diagnose interstitial lung syndrome through evaluation and quantitation of the number of B-lines, pleural irregularities and nodules or consolidations. In patients with COVID-19 pneumonia, LUS reveals a typical pattern of diffuse interstitial lung syndrome, characterized by multiple or confluent bilateral B-lines with spared areas, thickening of the pleural line with pleural line irregularity and peripheral consolidations. LUS has been found to be a promising tool for the diagnosis of COVID-19 pneumonia, and LUS findings correlate fairly with those of chest CT scan. Compared with CT, LUS has several other advantages, such as lack of exposure to radiation, bedside repeatability during follow-up, low cost and easier application in low-resource settings. Consequently, LUS may decrease utilization of conventional diagnostic imaging resources (CT scan and chest X-ray). LUS may help in early diagnosis, therapeutic decisions and follow-up monitoring of COVID-19 pneumonia, particularly in the critical care setting and in pregnant women, children and patients in areas with high rates of community transmission., Competing Interests: Conflict of interest disclosure Dr. Allinovi, Dr. Parise, Dr. Giacalone, Prof. Amerio, Dr. Delsante, Prof. Odone, Dr. Gigliotti, Dr. Franci, Dr. Amadasi, Prof. Delmonte, Dr. Parri, and Dr. Mangia report no conflicts of interest., (Copyright © 2020 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.)

We report on the high-pressure solid-state synthesis and the detailed structural characterization of the metastable, CuAu-type CuInS 2 (CA-CIS) phase. Although often present in CIS thin films as unwanted phase, it has been never synthesized in pure form, and its effect on the performance of CIS-based solar cells has been long debated. In this work, pure CA-CIS phase is synthesized in bulk polycrystalline form through a high-pressure-high-temperature solid-state reaction. Single-crystal X-rays diffraction reveals the formation of tetragonal CA-CIS ( a = 3.9324(5), c = 5.4980(7) Å) either in cation-ordered and disordered phase, pointing out the role of the pressure/temperature increase on the Cu/In ordering. The resistivity measurements performed on CA-CIS show low resistivity and a flat trend vs temperature and, in the case of the ordered phase, highlight a bad-metallic behavior, probably due to a high level of doping. These findings clearly rule out the possibility of a beneficial effect of this phase on the CIS-based thin film solar cells.

The temperature behavior of the crystal structure as well as dielectric and magnetic properties of the perovskite bismuth chromate ceramics with the 10 mol % Cr 3+ -to-Sc 3+ substitution were studied and compared with those of the unmodified compound. Using a high-pressure synthesis, BiCrO 3 and BiCr 0.9 Sc 0.1 O 3 were obtained as metastable perovskite phases which are monoclinic C 2/ c with the √6 a p × √2 a p × √6 a p superstructure (where a p is the primitive perovskite unit-cell parameter) under ambient conditions. At room temperature, the unit cell volume of BiCr 0.9 Sc 0.1 O 3 is ∼1.3% larger than that of BiCrO 3 . Both perovskites undergo a reversible structural transition into a nonpolar GdFeO 3 -type phase (orthorhombic Pnma , √2 a p × 2 a p × √2 a p ) in the temperature ranges of 410-420 K (BiCrO 3 ) and 470-520 K (BiCr 0.9 Sc 0.1 O 3 ) with a relative jump of the primitive perovskite unit cell volume of about -1.6 and -2.0%, respectively. Temperature dependences of the complex dielectric permittivity demonstrate anomalies in the phase transition ranges. The Pnma -to- C 2/ c crossover in BiCrO 3 is accompanied by a decrease in the direct current (dc) conductivity, while in BiCr 0.9 Sc 0.1 O 3 the conductivity increases. The onset of an antiferromagnetic order in BiCr 0.9 Sc 0.1 O 3 is observed at the Néel temperature ( T N ) of about 85 K as compared with T N = 110 K in BiCrO 3 . In contrast to BiCrO 3 , which exhibits a spin reorientation at T sr ∼ 72 K, no such a transition occurs in BiCr 0.9 Sc 0.1 O 3 .

By means of single-crystal X-ray diffraction, we give direct crystallographic evidence of a centrosymmetry breaking below T S = 200 K, concomitant with the onset of a commensurate structural modulation in the quadruple perovskite YMn 3 Mn 4 O 12 . This result, which explains the anomalously large thermal coefficient of the Y 3+ ion in previously reported structural models, is attributed to the small size of the Y 3+ ion, which causes its underbonding within the dodecahedral coordination polyhedron. The present data are consistent with a commensurate superstructure described by an I-centered pseudo-orthorhombic cell with polar Ia symmetry and a ≈ a F √2 = 10.4352(7) Å, b ≈ 2 b F = 14.6049(9) Å, c ≈ c F √2 = 10.6961(7) Å, and β = 90.110(3)°, where a F ≈ c F ≈ 7.45 Å, b F ≈ 7.34 Å, and β ≈ 91° are the unit cell parameters of the I 2/ m structure observed at room temperature. Consistent with the above polar structure, at lower temperature, T * = 70 K, we observe in polycrystalline samples an anomaly of the direct current (DC) and alternating current (AC) magnetization, concomitant with the appearance of a net electric polarization, as indicated by pyrocurrent and dielectric constant measurements. These results, complemented by electrical transport measurements, suggest a magnetic ferroelectricity driven by short-range magnetic order in YMn 3 Mn 4 O 12 .

The physical and operating principle of a stress sensor, based on two crossing carbon fibers functionalized with ZnO nanorod-shaped nanostructures, was recently demonstrated. The functionalization process has been here extended to tows made of one thousand fibers, like those commonly used in industrial processing, to prove the idea that the same working principle can be exploited in the creation of smart sensing carbon fiber composites. A stress-sensing device made of two functionalized tows, fixed with epoxy resin and crossing like in a typical carbon fiber texture, was successfully tested. Piezoelectric properties of single nanorods, as well as those of the test device, were measured and discussed.

We report a detailed study on the magnetic properties of the pyroxene series M2M1Si 2 O 6 , with M2  =  Ca and M1  =  Mg, where magnesium and then calcium are progressively substituted by cobalt. For cobalt site occupancy larger than 0.7 at the M1 site, a collinear antiferromagnetic phase is detected for T  <  T N1   =  12 K with a monodimensional character (i.e. M1 site intra-chain order parallel to c axis). Moreover the magnetization easy axis has been estimated to lie roughly along the [1 0 1] direction. Cobalt content  ⩾0.5 at the M2 site (overall content 1.5) determines the formation of a new independent antiferromagnetic order with higher Néel temperature, involving only the M2 site intra-chain interactions. The incoming M2 site order is accompanied by a lowering of the space symmetry which yields to a weakly ferromagnetic resultant due to spin canted distribution of the magnetic moments either along the M1 or M2 chains. Furthermore, metamagnetic transitions are observed for both M1 and M2 site intra-chain orders at relatively low critical magnetic fields, around 2 T, suggesting that this series of pyroxenes can be used as a model system for investigating the fundamental aspects of magnetism in the matter.

Background and Aim of the Work: electroconvulsive therapy is a psychiatric procedure requiring general anesthesia. The choice of the hypnotic agent is important because the success of the intervention is associated to the occurrence and duration of motor convulsion. However, all available anesthetic agents have anti-convulsant activity. We compared the effect of thiopental and propofol on seizures., Methods: We designed a retrospective study at Mood Disorders Unit of a teaching Hospital. Fifty-six consecutive patients undergoing electroconvulsive therapy were enrolled. Patients received fentanyl followed by either thiopental or propofol. We evaluated the incidence and the duration of seizure after electric stimulus at the first session of electroconvulsive therapy for each patient. Adverse perioperative effects were recorded., Results: Patients were 60±12.1 years old and 64% was female. There was a statistically significant higher number of patients who had motor convulsion activity in the thiopental group when compared to the propofol group (25 vs 13, p=0.023). Seizure duration was statistically significant longer in the thiopental group than in the propofol group (35 sec vs 11 sec, p=0.046). No hemodynamic instability, oxygen desaturation episodes, prolonged recovery time from anesthesia and adverse effects related to anesthesia were recorded., Conclusions: Thiopental induction has a favourable effect on seizure when compared to propofol in patients undergoing electroconvulsive therapy.

The crystal structure and ferroelectric properties of ε-Ga 2 O 3 deposited by low-temperature MOCVD on (0001)-sapphire were investigated by single-crystal X-ray diffraction and the dynamic hysteresis measurement technique. A thorough investigation of this relatively unknown polymorph of Ga 2 O 3 showed that it is composed of layers of both octahedrally and tetrahedrally coordinated Ga 3+ sites, which appear to be occupied with a 66% probability. The refinement of the crystal structure in the noncentrosymmetric space group P6 3 mc pointed out the presence of uncompensated electrical dipoles suggesting ferroelectric properties, which were finally demonstrated by independent measurements of the ferroelectric hysteresis. A clear epitaxial relation is observed with respect to the c-oriented sapphire substrate, with the Ga 2 O 3 [10-10] direction being parallel to the Al 2 O 3 direction [11-20], yielding a lattice mismatch of about 4.1%.

We present a comprehensive study of the electrical properties of bulk polycrystalline BiFe0.5Mn0.5O3, a double perovskite synthesized in high-pressure and high-temperature conditions. BiFe0.5Mn0.5O3 shows an antiferromagnetic character with TN = 288 K overlapped with an intrinsic antiferroelectricity due to the Bi(3+) stereochemical effect. Beyond this, the observation of a semiconductor-insulator transition at TP ≈ 140 K allows one to define three distinct temperature ranges with completely different electrical properties. For T > TN, electric transport follows an ordinary thermally activated Arrhenius behavior; the system behaves as a paramagnetic semiconductor. At intermediate temperatures (TP < T < TN), electric transport is best described by Mott's variable range hopping model with lowered dimensionality D = 1, stabilized by the magnetic ordering process and driven by the inhomogeneity of the sample on the B site of the perovskite. Finally, for T < TP, the material becomes a dielectric insulator, showing very unusual poling-induced soft ferroelectricity with high saturation polarization, similar to the parent compound BiFeO3. Under external electric poling, the system irreversibly evolves from antiferroelectric to polar arrangement.

The physical characterization and the extended crystallographic study of the double perovskite system Pb2Mn0.6Co0.4WO6 indicate an improper ferroelectric contribution to the polarization induced by the magnetic ordering. In the paramagnetic phase, the compound displays a centrosymmetric orthorhombic double perovskite structure with the Pmcn1' symmetry. The structure is strongly distorted by the lead stereoactivity. Magnetization measurements show two magnetic transitions at 188 and 9 K, but the time-of-flight neutron diffraction data provide evidence for a long-range magnetic ordering only below the second transition. Quantitative structure refinements combined with a comprehensive symmetry analysis indicate the Pm'c21' magnetic space group to be the adequate symmetry to describe the structural distortions and spin ordering in the ground state of the system. The symmetry implies a coexistence of a spontaneous ferromagnetic moment and a ferroelectric polarization along the orthogonal b- and c-axes, respectively, in the long-range ordered structure. Macroscopic measurements confirm the presence of the spontaneous polarization also below the first transition at 188 K, where only short-range magnetic correlations are evidenced by diffuse scattering in neutron diffraction.

Background and Aim: Early diagnosis of congenital deafness is fundamental to minimize the negative consequences on a child's educational and psychosocial development. To lower the age of hearing-impaired children at the time of diagnosis, universal neonatal hearing screening (UNHS) is considered essential. The aim of this study was to review tha data of the first 4 years of implementation of UNHS in the University Hospital of Parma., Methods: 11624 infants born between February 2010 and December 2013 were included into the study. Transient evoked otoacoustic emissions were used as screening test. When the newborn had failed at the initial test, he was re-tested within 3 weeks from birth. If the same result was obtained at the second step, the newborns were referred for clinical auditory brainstem response. We calculated quality indicators and compared them with international guidelines., Results: 11592 infants (99.7%) were screened during the birth admission. 10359 (88.5%) were well-babies, while 1233 (11.5%) had audiological risk factors. Among 11592 newborns screened, 42 (3.59‰) had a final diagnosis of sensorineural hearing loss. The incidence of deafness was 1.64‰ in well-babies, and 2.02% in neonates with audiological risk factors. Only 71 infants (0.6%) did not complete the screening program. False-positive rate was 1.7%., Conclusions: The analysis of benchmarks and outcomes of UNHS demonstrated the good quality of our hearing screening program. Introduction of automated auditory brainstem response as well as enhanced enrollment of patients who do not complete the screening could further improve the quality program.

We report a comprehensive study of the spontaneous magnetization reversal (MRV) performed on the disordered polycrystalline perovskite BiFe(0.5)Mn(0.5)O(3), an intriguing compound synthesized in high pressure-high temperature conditions. In disordered systems, the origin of MRV is not completely clarified, yet. In BiFe(0.5)Mn(0.5)O(3), compositional disorder involves the ions on the B-site of the perovskite determining the presence of mesoscopic clusters, characterized by high concentrations of iron or manganese and thus by different resultant magnetization. This leads to the observation of two singular fields H(1) and H(2) dependent on the degree of inhomogeneity, unpredictably changing from sample to sample due to synthesis effects. These fields separate different magnetic responses of the system; for applied fields H < H(1), the Fe and Mn clusters weakly interact in a competitive way, giving rise to MRV, while for an intermediate field regime the energy of this weak interaction becomes comparable to the energy of the system under field application. As a consequence, the zero field cooled magnetization thermal evolution depends on the sample degree of inhomogeneity. In this field regime, applied field Mössbauer spectroscopy indicates that the iron rich clusters are highly polarized by the field, while the largest part of the material, consisting of AFM clusters characterized by axial anisotropy and uncompensated moments, shows soft or hard magnetism depending on T. Above the higher singular field, the M(T) curves show the trend expected for a classical antiferromagnetic material and the competitive character is suppressed. The MRV phenomenon results to be highly sensitive on both the thermal and magnetic measurement conditions; for this reason the present work proposes a characterization strategy that in principle has a large applicability in the study of disordered perovskites showing similar phenomenology.

In this paper we describe the new ferri-electric compound Pb2MnWO6 (PMW), a double perovskite that can be considered as a novel structural prototype showing complex nuclear structure and interesting electric properties. According to single-crystal synchrotron data, PMW crystallizes in the noncentrosymmetric polar group Pmc21, in which the two symmetry-independent lead atoms give rise to a ferrielectric arrangement. The accurate crystallographic characterization indicates the presence of a complex distortion of the perovskite lattice driven by the local instability induced by the 6s(2) lone pair of the lead atoms. These peculiar structural features are confirmed by the complete electrical characterization of the system. Dielectric and transport measurements indicate an insulating character of the sample, while pyroelectric measurements point out a ferrielectric state characterized by different contributions. The magnetic transition at 45 K is accompanied by a magnetostrictive effect indicating a probable spin-lattice coupling. The characterizations carried out on PMW, showing the evidence of a coexistence of antiferromagnetism and ferrielectricity at low temperature, could lead to the definition of a new class of multiferroic materials.

Introduction: Agomelatine is a relatively new antidepressant with a mechanism of action that is different from other antidepressants: it is a melatonergic agonist and a 5-HT2C antagonist. It is an effective treatment for depression, with relatively mild side effects. It may be a valuable pharmacological alternative in the clinical approach on depression., Areas Covered: The literature about agomelatine has been comprehensively reviewed. Agomelatine's efficacy, safety and tolerability are reviewed based on the studies undertaken in patients with major depressive disorder (MDD) and bipolar disorder (BPD)., Expert Opinion: Agomelatine has shown an antidepressant effect in preclinical models, and the results of a large-scale clinical trial program, conducted in MDD, indicate both an antidepressant activity and a favorable tolerability profile. Agomelatine has no discontinuation syndrome, sexual discomfort is rare, and it is generally weigh neutral. The drug appears to be relatively safe in case of overdose. However, some cases of elevated hepatic transaminases are reported during treatment. As agomelatine has a mechanism of action that differs from other agents, it may represent a valuable additional treatment option in those patients who do not respond fully or who do not tolerate the side effects of other antidepressants.

Aims: Literature data show that one third of patients discontinue antidepressant therapy within the first month of treatment. The aim of this study was to evaluate whether paroxetine liquid solution 10 mg/ml may influence adherence inpatients receiving long-term treatment., Methods: 71 subjects affected by mood disorders or panic disorder were monitored for six months. The study sample was divided into two groups: controls (n=33) maintained their own therapy with paroxetine tablets; 38 patients maintained the same dosage of paroxetine, but shifted to liquid formulation 10 mg/ml. Compliance and general wellness were evaluated with the Medication Adherence Rating Scale (MARS) and the World Health Organization Quality of Life questionnaire (WhoQol). Data were analyzed using analysis of variance (ANOVA) and multivariate analysis of covariance (MANCOVA)., Results: Significant differences were found in MARS scores: patients on oral solution 10 mg/ml showed an improvement of compliance month by month. In addition, age, formulation and quality of life had a significant impacton patient compliance. Significant correlations were found between MARS and quality of life. A specific paroxetine formulation could be a variable able to influence adherence to psychopharmacological treatment. The same consideration can be made for quality of life, sex and age that showed a trend towards improved adherence when compared with controls. Inparticular, the WhoQol subscale analysis of delta scores showed a significant difference in self-perception of quality of life inpatients treated with paroxetine either in tablet or drop formulation., Discussion: Formulation in drops 10 mg/ml is equally effective to tablets, but it may allow patients having a higher cognition and control on drug assumption.

Background. Research on mood disorders has progressively focused on the study of seasons and on the mood in association with them during depressive or manic episodes yet few studies have focused on the seasonal fluctuation that characterizes the patient's clinical course both during an illness episode and during euthymic periods. Methods. 113 euthymic outpatients 46 affected by major recurrent depression and 67 affected by bipolar disorder were recruited. We evaluated the impact of clinical "rhythmical" factors: seasonality, sleep disturbance, and chronotype. Patients completed the SPAQ+ questionnaire, the MEQ questionnaire, and the medical outcomes study (MOS) sleep scale. We used t-test analyses to compare differences of clinical "rhythmical" and sociodemographic variables and of differences in the assessment scales among the diagnostic groups. Results. Patients reporting a family history for mood disorders have higher fluctuations throughout seasons. Sleep disturbance is more problematic in unipolars when compared to bipolars. Conclusions. Sleep, light, and seasonality seem to be three interconnected features that lie at the basis of chronobiology that, when altered, have an important effect both on the psychopathology and on the treatment of mood disorders.

Serotonergic transmission impairment and abnormal phosphorylation of tau protein have been implicated in the physiopathology of Alzheimer's disease (AD) and frontotemporal lobar dementia (FTLD). Associations between a functional polymorphism (5-HTTLPR), in the promoter region of the serotonin transporter gene, and susceptibility to sporadic AD and FTLD have been reported. A polymorphism (Q7R) in saitohin gene inside the microtubule-associated protein tau gene has also been related to dementia. To determine the possible role of the two polymorphisms in susceptibility to AD and FTLD, we performed a case-control study collecting 218 Italian sporadic dementia patients and 54 controls. We found a significant excess of 5-HTTLPR short alleles and an interaction between 5-HTTLPR and Q7R polymorphisms in demented subjects. Our study confirms the role of 5-HTTLPR as a potential susceptibility factor for sporadic dementia in the Italian population, and suggests a possible interaction between 5-HTTLPR and Q7R polymorphisms in neurodegenerative diseases.

Background/aims: Several linkage studies demonstrated that different chromosomal regions are involved in the susceptibility to bipolar disorder. In particular, some genome scans evidenced the role of chromosome 12. For this reason, our group chose this chromosome for a preliminary genome scan on a sample of 137 Italian sib pairs, including at least 1 bipolar subject., Methods: The analyses were carried out by means of DNA extracted from whole blood. DNA samples were genotyped by 19 simple tandem repeat markers (microsatellites). Starting from the genetic data, we performed two- and multipoint linkage analyses (both parametric and nonparametric) by means of Easy Linkage plus package (version 5.05)., Results: The multipoint linkage analyses pointed out a region suggestive of linkage between the markers D12S310 and D12S364, at locus 12p12. In particular, we reached the best evidence of linkage performing multipoint analyses and assuming a recessive model, under the hypothesis of genetic heterogeneity (heterogeneity LOD score = 2.01 and alpha = 0.77)., Conclusion: It is interesting to notice that the region at the marker D12S364 is located inside the gene coding for the glutamatergic receptor GRIN2B. Therefore, our finding not only confirmed the role of genetics in determining liability to bipolar disorder, but suggested glutamatergic transmission impairment as a possible cause. Nevertheless, we acknowledge that our study is heavily underpowered. Therefore, independent replication is needed., ((c) 2009 S. Karger AG, Basel.)

Interferon-gamma induced protein of 10 kDa (IP-10) is a C-X-C chemokine that attracts T lymphocytes and inhibits angiogenesis. In this study, we investigated the expression of IP-10 by human retinal pigment epithelial cells (HRPE) and compared IP-10 expression to that of interleukin-8 (IL-8), which is a leukocytic chemoattractant and pro-angiogenic factor. Cultured HRPE cells were incubated with either IL-1 beta (0.2-20 ng/ml) or tumor necrosis factor (TNF)-alpha (0.2-20 ng/ml) alone or in combination with interferon-gamma (IFN-gamma) (1000 U/ml). HRPE cells were also incubated with: (1) media conditioned by activated human T lymphocytes (CM), or (2) the same CM treated with neutralizing antibodies to IL-1, TNF, and/or IFN-gamma. IL-8 and IP-10 protein levels were measured by ELISA and mRNA levels by Northern blot analysis of HRPE cells. HRPE cells produced very high levels of IP-10 in response to either IL-1 beta/IFN-gamma, TNF-alpha/IFN-gamma or CD3-activated T-lymphocyte CM. The levels of IP-10 were at least tenfold higher (p<.001) than IL-8 measured in the same samples. Neutralizing antibodies to TNF and IFN-gamma, but not to IL-1, abrogated the ability of the CD3-activated T lymphocytes CM to induce HRPE IP-10 (p<.001). HRPE cells produce differential levels of IP-10 and IL-8 in response to various combinations of recombinant and T-lymphocyte-secreted pro-inflammatory cytokines. This may be important in evolving inflammatory and angiogenic ocular responses.