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Previous studies indicated atypical Theory of Mind (ToM) abilities in individuals with autism spectrum disorder (ASD) at different ages. However, research focused on adolescents with ASD is still rare. This study aims to fill the gaps in the literature, by investigating ToM abilities in adolescents with ASD and in a group of typically developing ones. We applied the Theory of Mind Assessment Scale (Th.o.m.a.s.), a semi-structured interview that allows a multi-dimensional measurement of ToM, including different perspectives (first/s-order, first/third-person, egocentric/allocentric), various mental states (emotions, desires, beliefs) and metacognitive abilities related with mental states (awareness, relation, and strategies). The results indicated that ToM develops atypically in ASD, with strengths and weaknesses. First, participants with ASD were comparable to controls in some specific ToM aspects, i.e., third-person ToM, both from an egocentric and an allocentric perspective. However, they were significantly weaker in attributing an understanding of the mental states of others, both in first- and second-order ToM scenarios. Second, they showed the same level of awareness about mental states as controls, but they were significantly weaker in conceptualizing the relationship between mental states and behavior. Also, they found it very difficult to think about possible strategies that they or others might employ to realize desires and needs. Finally, they performed similarly to controls in understanding emotions, while they poorly understood desires and beliefs. These results point out the distinctive characteristics of ToM development in individuals with ASD, with important implications for individualized interventions.

Taxonomic identification of alien bivalve species in the Mediterranean Sea can be challenging because of high morphological variability and the occurrence of cryptic species complexes, as in the case of pearl oysters. While the presence of the Lessepsian species Pinctada radiata is well-established in the eastern Mediterranean Sea, the presence of P. fucata was recently suggested based on morphological data. In this study we performed an integrative assessment based on morphological and genetic data on pearl oysters collected across the Mediterranean Basin. Molecular species delimitation and phylogenetic analyses allowed a straightforward taxonomic assignment of all collected specimens to P. radiata. These specimens show the entire suite of morphological character states considered diagnostic of either P. fucata or P. radiata by previous studies. This finding clearly demonstrates that these morphological characters have no taxonomic value, and their variability observed in specimens from the Mediterranean Sea represents (part of) the intraspecific variability of P. radiata. While no evidence has been found for the presence of P. fucata, the earlier occurrences of P. radiata from the eastern and southern Mediterranean Sea are complemented with verified occurrence in the western and northern regions, demonstrating a further spreading of this non-native species throughout the Mediterranean Sea. This study clarifies the taxonomic identification and geographical distribution of pearl oysters in the Mediterranean Sea and substantiates the importance of molecular identification of alien bivalves characterized by extensive variation in shell characters.

During underwater monitoring, one specimen of Camachoaglaja africana and one of Biuve fulvipunctata were found at the ‘Tavolara Punta Coda Cavallo’ Marine Protected Area, allowing to expand the known Mediterranean range of distribution of these two species. The finding of both species constitutes the first report for NE Sardinia and the whole Tyrrhenian Sea. By coupling data obtained from the analysis of social media and those present in the bibliography it was also possible to speculate on alternative pattern of distribution of these two species at a global scale. Finally, it is also confirmed the importance of repeated monitoring activities over time on the mooring buoys which act as steppingstone habitats for epifauna or for larval settlement and that are capable to provide important additional information on local biodiversity.

Numerical simulations based on Computational Fluid Dynamics have been performed for the assisted design of the flexible and transportable flow reactor developed within the Turboflux project. The core of the system consists of a tubular pipe, carrying the main fluids, and multiple injection ducts for the additive components. Mixing is ensured by a series of static mixing elements fitted within the main pipe. More specifically, we focus herein on the production of the sanitizing gel, obtained from three main components, i.e., ethanol, water, and glycerol. Hence, the numerical code is customized by implementing the non-ideal behaviour of the mixture. The degree of mixing and pressure drops are estimated in a wide range of scenarios, covering different flow regimes. The analysis allows one to identify the optimal operating conditions and, also, to put the basis for the setup of a digital twin of the system.

We report the discovery of the Indo-Pacific sacoglossan Elysia nealae Ostergaard, 1955 from northeastern Sardinia (Central Tyrrhenian Sea). This is the first record of this species in the western Mediterranean Sea and only the second for the whole of the Mediterranean Sea following a report from Cape Epanomi, Greece. We discuss the identification of this species as well as the expansion of its geographical range. Data on the ecology and behavior of E. nealae leads us to hypothesize that the increase in the Mediterranean’s water temperature due to climate change has favored this non-native species and contributed to its expanded distribution.

Abstract Background Advanced lung adenocarcinoma (LAC) is one of the most lethal malignancies worldwide. The aim of this study was to evaluate the global survival in a real-life cohort of patients with LAC harboring driver genetic alterations. Methods A series of 1282 consecutive Sardinian LAC patients who underwent genetic testing from January 2011 through July 2016 was collected. Molecular tests were based on the clinical needs of each single case (EGFR-exon18/19/21, ALK, and, more recently, BRAF-exon15), and the availability of tissue (KRAS, MET, and presence of low-frequency EGFR-T790M mutated alleles at baseline). Results The mean follow-up time of the patients was 46 months. EGFR, KRAS, and BRAF mutations were detected in 13.7%, 21.3%, and 3% of tested cases, respectively; ALK rearrangements and MET amplifications were found respectively in 4.7% and 2% of tested cases. As expected, cases with mutations in exons 18–21 of EGFR, sensitizing to anti-EGFR tyrosine kinase inhibitors (TKIs) agents, had a significantly longer survival in comparison to those without (p

Kettlebell sport (KBs) is increasingly popular, but very few studies have been focused on this discipline. This research aims to investigate the effects of KBs on body composition, strength symmetry, and segmental body composition symmetry in a sample of Italian elite athletes. Data were collected from a sample of 16 athletes of both sexes (11 men and 5 women; 34.5 ± 9.0 years of age). Anthropometric (height, weight, arm, thigh, calf, and waist circumferences), hand grip strength, and total and segmental bioelectrical variables were taken. Body composition was analysed by using specific bioelectrical impedance vector analysis (BIVA). Paired t-tests and confidence ellipses were applied to analyse bilateral differences. Elite athletes of both sexes showed high values of phase angle, indicative of high body cell mass and quality and proxy of muscle mass. Hand grip strength and body composition were symmetrical, with the only exception of a higher %FM in the right leg (Zsp: t = 3.556; p = 0.003). In conclusion, this study suggests that KBs contributes to muscle mass improvement, body composition, and strength symmetry, especially in the upper body.

Hypoxia can impair cognitive performance, whereas exercise can enhance it. The effects of hypoxia on cognitive performance during exercise appear to be moderated by exercise duration and intensity and by severity and duration of hypoxia and cognitive task. In normal individuals, exercise under hypoxia can evoke adverse post-exercise mood states, such as tension and fatigue. However, little is known about the effects of hypoxia during exercise in trained athletes. The purpose of this study was to investigate how hypoxia affected executive functions and mood states, assessed, respectively, during and post-exercise and to explore the role of motivation moderators, such as inhibition and activation systems (BIS-BAS). Two different sessions of exercise in normoxia and hypoxia (FiO2 13%), each lasting 18 min, were randomly assigned in a counterbalanced order and administered to seventeen male athletes. During exercise bouts, participants performed a mental task (BST) aimed to produce cognitive interference and suppression. Reaction times and accuracy of responses were recorded. After 5 min, all participants completed two questionnaires assessing mood states (ITAMS) and incidence of symptoms potentially related to hypoxia (AMS-C). The results show that hypoxia impairs cognitive performance in terms of slower reaction times, but a high BAS attenuates this effect. Participants with high BAS show an equivalent cognitive performance under hypoxia and normoxia conditions. No effects were found on mood states. Further research is required to investigate the role of BAS, cognitive abilities, and mood states in prolonged hypoxic conditions.

The ability to respond to gaze cueing is essential for successful social interactions and social learning. An active area of research in human robot interactions (HRI) focuses on the computational encoding of biologically realistic gaze cueing responses in robots. Studies of human development are a primary source of guidance for this field of research. The investigation of how perceived gazes constrain the developmental trajectories of visual attention in humans from childhood to adulthood might reveal important factors to implement realistic gaze following in social robots. This study investigated spontaneous gaze following in 2 and 4-year-old children and adults. Participants saw faces of an adult gazing toward an object. We found that accuracy of gaze following improved significantly with age. The results are discussed considering the development of the executive control of visual attention in humans and its possible implication in implementing gaze following in social robotics.

Clear cell odontogenic carcinoma (CCOC) is a rare odontogenic tumor of the jaw with a particular histology and a deceptive behavior. The clinical presentation may be misleading, that is why the contribution of incisional biopsy, molecular biology, immunohistochemistry and cytogenetics is essential in the diagnostic process.This review article aims to discuss its various aspects, summarizing the currently published studies of CCOC to enhance the diagnosis and to present a case report of a 41-year-old man that presented to the Department of Maxillofacial Surgery at Gemelli University Hospital in Rome, Italy.

The notion that engagement with social media platform reduces adolescents’ and young adults’ well-being has become a recurring feature in public and scientific discourses. The actual level of psychological and behavioural evidence, however, is in stark contrast with the certainty voiced by many commentators. There is little clear-cut evidence that social media engagement reduces adolescents’ and young adults’ wellbeing, and most conclusions are drawn from exploratory studies mainly focusing on the Facebook microblogging usage, a 15 years’ old functionality that British adolescents and young adults (18-25 years’ old) have, to date, abandoned en masse. The present research independently collected two nationally large-scale data sets from the British Isles (total N = 600 after data exclusions) and included detailed self-reports of social media use on numerous platforms. We used measures of subjective wellbeing and life satisfaction drawn from OECD surveys and assessed social cognitive dimensions (e.g., social comparison). The research makes use of both data mining tools and confirmatory designs to bring analytical improvements to a growing research area. We found robust evidence for several negative associations between social media engagement and adolescents’ and young adults’ well-being. Those findings on the behavioural consequences of social media usage raise further issues relevant to many actors in the community: for the academic researchers, for the technology industry, and also for the community organizers as any society has to understand how it is shaped by technological change. The present results are particularly relevant for making the most effective use of citizens’ engagement in future e-government systems.

Eye‐tracking is a valuable tool in cognitive science for measuring how attention is directed during visual scene exploration. Here, the authors introduce a new, touchscreen-based method that accomplishes the same goal via tracking finger movements.

Abstract Background Lung cancer is one of the most incident neoplastic diseases, and a leading cause of death for cancer worldwide. Knowledge of the incidence of druggable genetic alterations, their correlation with clinical and pathological features of the disease, and their interplay in cases of co-occurrence is crucial for selecting the best therapeutic strategies of patients with non-small cell lung cancer. In this real-life study, we describe the molecular epidemiology of genetic alterations in five driver genes and their correlations with the demographic and clinical characteristics of Sardinian patients with lung adenocarcinoma. Methods Data from 1440 consecutive Sardinian patients with a histologically proven diagnosis of lung adenocarcinoma from January 2011 through July 2016 were prospectively investigated. EGFR mutation analysis was performed for all of them, while KRAS and BRAF mutations were searched in 1047 cases; ALK alterations were determined with fluorescence in situ hybridization in 899 cases, and cMET amplifications in 788 cases. Results KRAS mutations were the most common genetic alterations involving 22.1% of the cases and being mutually exclusive with the EGFR mutations, which were found in 12.6% of them. BRAF mutations, ALK rearrangements, and cMET amplifications were detected in 3.2, 5.3, and 2.1% of the cases, respectively. Concomitant mutations were detected only in a few cases. Conclusions Almost all the genetic alterations studied showed a similar incidence in comparison with other Caucasian populations. Concomitant mutations were rare, and they probably have a scarce impact on the clinical management of Sardinians with lung adenocarcinoma. The low incidence of concomitant cMET amplifications at diagnosis suggests that these alterations are acquired in subsequent phases of the disease, often during treatment with TKIs.

Abstract Background Cutaneous malignant melanoma (CMM) is one of the most common skin cancers worldwide. Limited information is available in the current scientific literature on the concordance of genetic alterations between primary and metastatic CMM. In the present study, we performed next-generation sequencing (NGS) analysis of the main genes participating in melanoma pathogenesis and progression, among paired primary and metastatic lesions of CMM patients, with the aim to evaluate levels of discrepancies in mutational patterns. Methods Paraffin-embedded tumor tissues of the paired lesions were retrieved from the archives of the institutions participating in the study. NGS was performed using a specific multiple-gene panel constructed by the Italian Melanoma Intergroup (IMI) to explore the mutational status of selected regions (343 amplicons; amplicon range: 125–175 bp; coverage 100%) within the main 25 genes involved in CMM pathogenesis; sequencing was performed with the Ion Torrent PGM System. Results A discovery cohort encompassing 30 cases, and a validation cohort including eleven Sardinian patients with tissue availability from both the primary and metachronous metastatic lesions were identified; the global number of analyzed tissue specimens was 90. A total of 829 genetic non-synonymous variants were detected: 101 (12.2%) were pathogenic/likely pathogenic, 131 (15.8%) were benign/likely benign, and the remaining 597 (72%) were uncertain/unknown significance variants. Considering the global cohort, the consistency in pathogenic/pathogenic like mutations was 76%. Consistency for BRAF and NRAS mutations was 95.2% and 85.7% respectively, without statistically significant differences between the discovery and validation cohort. Conclusions Our study showed a high level of concordance in mutational patterns between primary and metastatic CMM, especially when pathogenic mutations in driver genes were considered.

Abstract Cutaneous malignant melanoma is a heterogeneous disease, being the consequence of specific genetic alterations along several molecular pathways. Despite the increased knowledge about the biology and pathogenesis of melanoma, the incidence has grown markedly worldwide, making it extremely important to develop preventive measures. The beneficial role of correct nutrition and of some natural dietary compounds in preventing malignant melanoma has been widely demonstrated. This led to numerous studies investigating the role of several dietary attitudes, patterns, and supplements in the prevention of melanoma, and ongoing research investigates their impact in the clinical management and outcomes of patients diagnosed with the disease. This article is an overview of recent scientific advances regarding specific dietary compounds and their impact on melanoma development and treatment.

The improvement of the immunotherapeutic potential in most human cancers, including melanoma, requires the identification of increasingly detailed molecular features underlying the tumor immune responsiveness and acting as disease-associated biomarkers. In recent past years, the complexity of the immune landscape in cancer tissues is being steadily unveiled with a progressive better understanding of the plethora of actors playing in such a scenario, resulting in histopathology diversification, distinct molecular subtypes, and biological heterogeneity. Actually, it is widely recognized that the intracellular patterns of alterations in driver genes and loci may also concur to interfere with the homeostasis of the tumor microenvironment components, deeply affecting the immune response against the tumor. Among others, the different events linked to genetic instability—aneuploidy/somatic copy number alteration (SCNA) or microsatellite instability (MSI)—may exhibit opposite behaviors in terms of immune exclusion or responsiveness. In this review, we focused on both prevalence and impact of such different types of genetic instability in melanoma in order to evaluate whether their use as biomarkers in an integrated analysis of the molecular profile of such a malignancy may allow defining any potential predictive value for response/resistance to immunotherapy.

Previous research has documented that type 2 diabetes mellitus (T2DM) is associated with cognitive impairment. Psychological variables were repeatedly investigated to understand why T2DM patients are poorly active, despite standards of medical care recommends performing aerobic and resistance exercise regularly and reducing the amount of time spent sitting. This exploratory study aims to investigate how affective variables as thoughts, feelings, and individuals’ stage of exercise adoption can modulate low cognitive performances during an experimental procedure based on exercise. The Exercise Thoughts Questionnaire (ETQ), Exercise-Induced Feeling Scale (EFI), and Physical Activity Stage of Change were administered to a sample of 12 T2DM patients. The Bivalent Shape Task (BST) alone (BST), BST with exercise [control exercise recovery (CER) + BST], and BST with metaboreflex [post-exercise muscle ischemia (PEMI) + BST] were used as mental task, and response time to congruent, incongruent, and neutral stimuli was recorded. Concomitant cerebral oxygenation (COX) was evaluated by near-infrared spectroscopy (NIRS). As expected, T2DM patients performed significantly better when the stimulus was presented in congruent trials (followed by neutral and incongruent). In the CER + BST session, T2DM patients showed longer reaction time to incongruent trials than in the PEMI + BST and BST alone sessions. Positive feelings toward exercise seem to modulate cognitive performances in high challenging task only if T2DM patients were conscious to play exercise. These results could provide some insights for health intervention targeting exercise for patients with T2DM in order to enhance cognitive performances.

Objective: The hemodynamic response to muscle metaboreflex has been reported to be significantly altered by metabolic syndrome (MS), with exaggerated systemic vascular resistance (SVR) increments and reduced cardiac output (CO) in comparison to healthy controls (CTLs). Moreover, patients with metabolic disorders, such as type 2 diabetes, have proven to have impaired cerebral blood flow in response to exercise. Thus, we hypothesized that contemporary mental task (MT) and metaboreflex would result in reduced cerebral oxygenation (COX) in these patients.Methods: Thirteen MS patients (five women) and 14 normal age-matched CTLs (six women) were enrolled in this study. All the participants underwent five different tests, each lasting 12 min: post-exercise muscle ischemia (PEMI) to activate the metaboreflex, control exercise recovery (CER), PEMI + MT, CER + MT, and MT alone. Cerebral oxygenation was evaluated using near-infrared spectroscopy with sensors applied to the forehead. Hemodynamics were measured using impedance cardiography.Results: The main results show that MS patients had higher SVR and lower CO levels compared to the CTL group during metaboreflex activation. Stroke volume and ventricular filling and emptying rates were also significantly reduced. Moreover, when MT was added to PEMI, COX was significantly increased in the CTL group with respect to the baseline (103.46 ± 3.14%), whereas this capacity was reduced in MS patients (102.37 ± 2.46%).Conclusion: It was concluded that (1) patients with MS showed hemodynamic dysregulation during the metaboreflex, with exaggerated vasoconstriction and that (2) as compared to CTL, MS patients had reduced capacity to enhance COX when an MT superimposed the metaboreflex.

The aeolid nudibranch Caloria elegans (Facelinidae) is quite common in the Mediterranean Sea and eastern Atlantic Ocean and is easily recognized by the presence of a typical black spot at the apical portion of its cerata. Facelina quatrefagesi (Facelinidae) was long considered as a synonym of C. elegans until recently, when it was re-evaluated as a valid species based mainly on rhinophore morphology. In order to definitively assess the status of these aeolid taxa, we employed an integrative taxonomy approach using the nuclear H3 and the two mitochondrial cytochrome oxidase subunit I and 16S markers. The molecular analyses clearly showed that, although morphologically closely related to C. elegans, F. quatrefagesi is a valid species.

The metabolic syndrome (MS) has been associated with poor performances in multiple cognitive domains, as processing speed, visuo-spatial abilities, and executive functioning. Exercise is a critical factor for MS people’s vulnerability to cognitive dysfunction, because this may be beneficial to reduce cognitive impairment, but limited physical activity and impaired cerebral blood flow in response to exercise have been reported by individuals suffering from MS. Using an attentional interference test, the Bivalent Shape Task (BST), and metaboreflex, we analyzed cognitive performance and cerebral oxygenation (COX) in 13 MS people (five women), and 14 normal age-matched control (CTL, six women). Five different sessions were administered to all participants, each lasting 12 min: control exercise recovery (CER), post-exercise muscle ischemia (PEMI) to activate the metaboreflex, CER + BST, PEMI + BST, and BST alone. During each session, cognitive performance was assessed by means of response times and response accuracy with which participants make the decision and COX was evaluated by near infrared spectroscopy with sensors applied in the forehead. Compared to CTL, MS group performed significantly worse in all sessions (F = 4.18; p = 0.05; ES = 0.13): their poorest performance was observed in the BST alone session. Moreover, when BST was added to PEMI, individuals of the CTL group significantly increased their COX compared to baseline (103.46 ± 3.14%), whereas this capacity was impaired in MS people (102.37 ± 2.46%). It was concluded that: (1) MS affects cognitive performance; (2) people with MS were able to enhance COX during exercise, but they impair their COX when an attentional interference task was added.

Objective: Blood flow restriction training (BFRT) has been proposed to induce muscle hypertrophy, but its safety remains controversial as it may increase mean arterial pressure (MAP) due to muscle metaboreflex activation. However, BFR training also causes metabolite accumulation that may desensitize type III and IV nerve endings, which trigger muscle metaboreflex. Then, we hypothesized that a period of BFR training would result in blunted hemodynamic activation during muscle metaboreflex.Methods: 17 young healthy males aged 18–25 yrs enrolled in this study. Hemodynamic responses during muscle metaboreflex were assessed by means of postexercise muscle ischemia (PEMI) at baseline (T0) and after 1 month (T1) of dynamic BFRT. BFRT consisted of 3-min rhythmic handgrip exercise applied 3 days/week (30 contractions per minute at 30% of maximum voluntary contraction) in the dominant arm. On the first week, the occlusion was set at 75% of resting systolic blood pressure (always obtained after 3 min of resting) and increased 25% every week, until reaching 150% of resting systolic pressure at week four. Hemodynamic measurements were assessed by means of impedance cardiography.Results: BFRT reduced MAP during handgrip exercise (T1: 96.3 ± 8.3 mmHg vs. T0: 102.0 ± 9.53 mmHg, p = 0.012). However, no significant time effect was detected for MAP during the metaboreflex activation (P > 0.05). Additionally, none of the observed hemodynamic outcomes, including systemic vascular resistance (SVR), showed significant difference between T0 and T1 during the metaboreflex activation (P > 0.05).Conclusion: BFRT reduced blood pressure during handgrip exercise, thereby suggesting a potential hypotensive effect of this modality of training. However, MAP reduction during handgrip seemed not to be provoked by lowered metaboreflex activity.

Background: The objective evaluation of the olfactory function of coronavirus disease 2019 patients is difficult because of logistical and operator-safety problems. For this reason, in the literature, the data obtained from psychophysical tests are few and based on small case series. Methods: A multicenter, cohort study conducted in seven European hospitals between March 22 and August 20, 2020. The Sniffin-Sticks test and the Connecticut Chemosensory Clinical Research Center orthonasal olfaction test were used to objectively evaluate the olfactory function. Results: This study included 774 patients, of these 481 (62.1%) presented olfactory dysfunction (OD): 280 were hyposmic and 201 were anosmic. There was a significant difference between self-reported anosmia/hyposmia and psychophysical test results (p = 0.006). Patients with gastroesophageal disorders reported a significantly higher probability of presenting hyposmia (OR 1.86; p = 0.015) and anosmia (OR 2.425; p < 0.001). Fever, chest pain, and phlegm significantly increased the likelihood of having hyposmia but not anosmia or an olfactory disturbance. In contrast, patients with dyspnea, dysphonia, and severe-to-critical COVID-19 were significantly more likely to have no anosmia, while these symptoms had no effect on the risk of developing hyposmia or an OD. Conclusions: Psychophysical assessment represents a significantly more accurate assessment tool for olfactory function than patient self-reported clinical outcomes. Olfactory disturbances appear to be largely independent from the epidemiological and clinical characteristics of the patients. The non-association with rhinitis symptoms and the high prevalence as a presenting symptom make olfactory disturbances an important symptom in the differential diagnosis between COVID-19 and common flu.