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OBJECTIVE: The COVID-19 pandemic is considered a collective traumatic event. Several studies have highlighted high levels of post-traumatic stress disorder (PTSD) symptoms among the general population during the pandemic. The general aim of this research is to explore the role of adverse childhood experiences (ACEs), alexithymia, and anxiety and avoidance attachment dimensions as risk factors that are making individuals more vulnerable to PTSD-COVID-related symptoms. SUBJECTS AND METHODS: The COVID-19-PTSD Questionnaire, 20-Item Toronto Alexithymia Scale (TAS-20), Adverse Childhood Experiences Questionnaire, and the Experiences in Close Relationships-Revised Form (ECR-R) were administered to 224 participants who were between 18 and 65 years of age, and residents of Italy. Socio-demographic variables were also collected. The data was collected between October 2021 and March 2022. RESULTS: The findings of the Spearman correlation analysis showed several significant associations between alexithymia, attachment dimensions, and PTSD symptoms related to COVID-19 diagnosis and age. A multivariable logistic regression model was performed using the COVID-19-PTSD total scores over/under the clinical cut-off as dependent variables and age, gender, anxiety and avoidance attachment scores, ACEs, and total alexithymia as independent variables, with alexithymia total score (B = .071; p = .001), ECR-R Anxiety (B = .034; p = .001) and ECR-R Avoidance (B = -.033; p = .024) showing to respectively increase and reduce the possibility of reporting clinical symptomatology. CONCLUSIONS: Emotional regulation and attachment have been shown to be risk factors for COVID-19 PTSD symptomatology. Focused intervention programs and emotional education can be useful tools for developing protective factors in the general population. [ABSTRACT FROM AUTHOR]

OBJECTIVE: This study aimed to investigate the presence of psychopathological symptoms and the relations of these dimensions with the quality of life and sexual function in a group of women affected by systemic scleroderma. SUBJECTS AND METHODS: Seventy-one women with systemic scleroderma were invited to participate in the study; 65 agreed to participate, while 6 declined. Four questionnaires were administered to the patients: a specific socio-demographic questionnaire, the Symptom Checklist-90-Revised (SCL-90-R), the Female Sexual Function Index (FSFI), and the Quality-of-Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO-41). RESULTS: Of all the participants in this study, 48% of patients showed a clinical score on SCL-90-R Somatization, 45% on depression, and 37% on obsessive-compulsive. As hypothesized, psychopathological symptoms were related to lower quality of life since somatization and depression predicted the total score of health-related quality of life and lower sexual functions, showing a specific effect of depression on sexuality. CONCLUSIONS: Our findings highlighted the presence of an association between psychopathological symptoms and reduced sexual functioning and the associations between somatization and the health-related quality of life dimensions in scleroderma patients. Furthermore, our results sustain the importance of also considering the mental health of patients with systemic sclerosis, within an integrated biopsychosocial care model. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The aim of the study is to assess alexithymia levels in obese patients using a multimethod measurement (TAS-20 and TSIA) to evaluate both possible differences between the two instruments and their relationship with body weight. PATIENTS AND METHODS: 54 obese patients, seeking surgical treatment, were enrolled. They completed a socio-demographic questionnaire, 20-items Toronto Alexithymia Scale and the Toronto Structured Interview for Alexithymia. RESULTS: Data analysis showed a significant positive association between TAS-20 and TSIA total scores (r=.28, p<.05), but only the TSIA score was positively related to body weight (r=.39; p<.001). Multivariable linear regression models showed the predictive effects of TSIA total score (beta=.41; p<.001) and difficulty in identifying feelings (DIF) (beta=.56; p<.001) respectively on weight. CONCLUSIONS: The findings showed a different association between body weight and alexithymia according to the instrument employed to evaluate alexithymia, supporting the importance of a multimethod assessment in some clinical conditions. [ABSTRACT FROM AUTHOR]

Objectives: To develop a deep learning (DL)-model using convolutional neural networks (CNN) to automatically identify the fetal head position at transperineal ultrasound in the second stage of labor., Material and Methods: Prospective, multicenter study including singleton, term, cephalic pregnancies in the second stage of labor. We assessed the fetal head position using transabdominal ultrasound and subsequently, obtained an image of the fetal head on the axial plane using transperineal ultrasound and labeled it according to the transabdominal ultrasound findings. The ultrasound images were randomly allocated into the three datasets containing a similar proportion of images of each subtype of fetal head position (occiput anterior, posterior, right and left transverse): the training dataset included 70 %, the validation dataset 15 %, and the testing dataset 15 % of the acquired images. The pre-trained ResNet18 model was employed as a foundational framework for feature extraction and classification. CNN 1 was trained to differentiate between occiput anterior (OA) and non-OA positions, CNN 2 classified fetal head malpositions into occiput posterior (OP) or occiput transverse (OT) position, and CNN 3 classified the remaining images as right or left OT. The DL-model was constructed using three convolutional neural networks (CNN) working simultaneously for the classification of fetal head positions. The performance of the algorithm was evaluated in terms of accuracy, sensitivity, specificity, F1-score and Cohen's kappa., Results: Between February 2018 and May 2023, 2154 transperineal images were included from eligible participants across 16 collaborating centers. The overall performance of the model for the classification of the fetal head position in the axial plane at transperineal ultrasound was excellent, with an of 94.5 % (95 % CI 92.0--97.0), a sensitivity of 95.6 % (95 % CI 96.8-100.0), a specificity of 91.2 % (95 % CI 87.3-95.1), a F1-score of 0.92 and a Cohen's kappa of 0.90. The best performance was achieved by the CNN 1 - OA position vs fetal head malpositions - with an accuracy of 98.3 % (95 % CI 96.9-99.7), followed by CNN 2 - OP vs OT positions - with an accuracy of 93.9 % (95 % CI 89.6-98.2), and finally, CNN 3 - right vs left OT position - with an accuracy of 91.3 % (95 % CI 83.5-99.1)., Conclusions: We have developed a DL-model capable of assessing fetal head position using transperineal ultrasound during the second stage of labor with an excellent overall accuracy. Future studies should validate our DL model using larger datasets and real-time patients before introducing it into routine clinical practice., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

Background: B-lineage acute lymphoblastic leukemias (B-ALL) harboring the t(9;22)(q34;q11)/BCR::ABL1 rearrangement represent a category with previously dismal prognosis whose management and outcome dramatically changed thanks to the use of tyrosine kinase inhibitors (TKIs) usage and more recently full chemo-free approaches. The prompt identification of these cases represents an important clinical need., Objectives: We sought to identify an optimized cytofluorimetric diagnostic panel to predict the presence of Philadelphia chromosome (Ph) in B-ALL cases by the introduction of CD146 in our multiparametric flow cytometry (MFC) panels., Methods: We prospectively evaluated a total of 245 cases of newly diagnosed B-ALLs with a CD146 positivity threshold >10% referred to the Division of Hematology of 'Sapienza' University of Rome. We compared the results of CD146 expression percentage and its mean fluorescence intensity (MFI) between Ph+ ALLs, Ph-like ALLs, and molecularly negative ALLs., Results: Seventy-nine of the 245 B-ALL cases (32%) did not present mutations at molecular testing, with 144/245 (59%) resulting in Ph+ ALL and 19/245 (8%) Ph-like ALLs. Comparing the 3 groups, we found that Ph+ B-ALLs were characterized by higher expression percentage of myeloid markers such as CD13, CD33, and CD66c and low expression of CD38; Ph+ B-ALL showed a higher CD146 expression percentage and MFI when compared with both molecular negative B-ALL and Ph-like ALLs; neither the mean percentage of CD146 expression neither CD146 MFI were statically different between molecular negative B-ALL and Ph-like ALLs., Conclusions: Our data demonstrate the association between CD146 expression and Ph+ ALLs. CD146, along with myeloid markers, may help to identify a distinctive immunophenotypic pattern, useful for rapid identification in the diagnostic routine of this subtype of B-ALLs that benefits from a specific therapeutic approach., Competing Interests: Competing interests: The authors declare no conflict of Interest.

In recent years, aging has become a focal point of scientific research and health policies due to the growing demographic trend of an aging worldwide population. Understanding the protective and risk factors that influence aging trajectories is crucial for designing targeted interventions that support healthy aging and improve people's quality of life. The aim of this study was to explore the relationships between variables of aging. A total of 103 Italian participants (55-75 years old) underwent multidimensional assessments that covered cognitive, functional, emotional, and quality of life dimensions. Structural equation modeling was used to analyze the data and elucidate the relationships between depression, quality of life, cognitive reserve, executive functions, and daily autonomy. The findings revealed that a higher quality of life was associated with reduced depressive symptoms. In addition, cognitive reserve emerged as a protective factor positively correlated with both quality of life and daily autonomy. In this study, quality of life was determined using physical health, psychological, social relationships, and environmental domains. Identifying the significant relationships between these variables in a sample of late adults and young-aged people has given us useful elements for designing psycho-educational interventions that can be aimed at preventing frailty in later old age or supporting healthy longevity.

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This study aims to explore the perspectives of Italian psychologists who work in assisted reproductive treatment (ART) centres regarding their roles within multidisciplinary teams. Twenty-eight psychologists were interviewed, recorded and their transcribed text was analysed using emotional text mining. The analysis revealed four clusters representing the psychologists' cultural symbolizations of their works: 'Clinical Practice with the patient', 'Placing Psychology within the Treatment', 'Psychologist's Loneliness' and; 'Collusion with Medicine'. The symbolic representations emerging clearly highlighted a lack of integration of psychology within the medical field. Psychologists expressed emotional and practical difficulties in trying to integrate their role, including a desire to provide psychological assistance, feelings of loneliness and concerns about jeopardizing their professional opportunities, which are intertwined with the medical field. Present findings underscore the importance of integrating psychology within ART centres and multidisciplinary teams and of establishing operational guidelines for psychologists. These steps are crucial for reaching integration of psychologists within the medical setting., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: B-lineage acute lymphoblastic leukemias (B-ALL) harboring rearrangements of the histone lysine [K]-Methyltransferase 2A ( KMT2A ) gene on chromosome 11q23 ( KMT2A-r ) represent a category with dismal prognosis. The prompt identification of these cases represents an urgent clinical need. Considering the correlation between rat neuron glial-antigen 2 (NG2) chondroitin-sulfate-proteoglycan molecule expression and KMT2A-r , we aimed to identify an optimized cytofluorimetric diagnostic panel to predict the presence of KMT2A-r ., Materials and Methods: We evaluated 88 NG2+ B-ALL cases identified with an NG2 positivity threshold >10% from a cohort of 1382 newly diagnosed B-ALLs referred to the Division of Hematology of 'Sapienza' University of Rome., Results: Eighty-five of 88 (96.6%) NG2+ B-ALLs harbored KMT2A-r and were mainly pro-B ALL (77/85; 91%). Only 2 B-ALLs with KMT2A-r showed NG2 expression below 10%, probably due to the steroid therapy administered prior to cytofluorimetric analysis.Compared to KMT2A-r- cases, KMT2A r+ B-ALLs showed a higher blast percentage, significantly higher mean fluorescence intensity (MFI) of CD45, CD38, and CD58, and significantly lower MFI of CD34, CD22, TdT, and CD123.The study confirmed differences in CD45, CD34, CD22, and TdT MFI within the same immunologic EGIL group (European Group for the immunological classification of leukemias), indicating no influence of the B-ALLs EGIL subtype on the KMT2A-r+ B-ALLs immunophenotype., Conclusions: Our data demonstrate the association between NG2 and KMT2A-r in B-ALLs identify a distinctive immunophenotypic pattern, useful for rapid identification in diagnostic routines of these subtypes of B-ALLs with a poor prognosis that benefits from a specific therapeutic approach., Competing Interests: Competing interests: The authors declare no conflict of Interest.