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International Guidelines as well as Cancer Associations recommend a multidisciplinary approach to lung cancer care. A multidisciplinary team (MDT) can significantly improve treatment decision-making and patient coordination by putting different physicians and other health professionals “in the same room”, who collectively decide upon the best possible treatment. However, this is not a panacea for cancer treatment. The impact of multidisciplinary care (MDC) on patient outcomes is not univocal, while the effective functioning of the MDT depends on many factors. This review presents the available MDT literature with an emphasis on the key factors that characterize high-quality patient care in lung cancer. The study was conducted with a bibliographic search using different electronic databases (PubMed Central, Scopus, Google Scholar, and Google) referring to multidisciplinary cancer care settings. Many key elements appear consolidated, while others emerge as prevalent and actual, especially those related to visible barriers which work across geographic, organizational, and disciplinary boundaries. MDTs must be sustained by strategic management, structured within the entity, and cannot be managed as a separate care process. Furthermore, they need to coordinate with other teams (within and outside the organization) and join with the broad range of services delivered by multiple providers at various points of the cancer journey or within the system, with the vision of integrated care.

Therapist responsiveness is an emerging construct in psychotherapy research that still lacks a clear definition and, consequently, a unique operationalization. Indeed, there is a great overlap between therapist responsiveness and other variables, such as attunement, flexibility, and empathy. This overlap inevitably hinders the assessment of the therapist’s responsiveness, although it is crucial for the effectiveness of the treatments. Therefore, the current systematic review aims at exploring the different methodologies of measurement and analysis of therapist responsiveness, including both direct and indirect instruments. The results confirmed difficulties and divergences in the operationalization of the construct, as shown by the great heterogeneity found in the choice and use of the tools. Furthermore, this review provides guidance for future research, clinical practice, and training of therapists.

Global fish and seafood consumption is increasing annually, frequently leading to the emergence of food fraud, mainly related to mislabeling and adulteration like, for example, the use of illicit/unauthorized food additives to mask or delay fish spoilage. Among the available diagnostic tools for control purposes, spectroscopic techniques have often been proposed to identify these kinds of illicit practices in fish and seafood products. The presented study aims to test two cheap and portable near infrared (NIR) spectrometers, a handheld MicroNIR and a pocket-sized SCiO, to uncover use of the illicit food additive Cafodos, a mixture of sodium citrate and hydrogen peroxide used to preserve some fish characteristics (like smell, color, na dtexture). The NIR spectroscopy in combination with chemometric approaches, allowed the successfully classification of (81–100%) samples of sea bass (Dicentrarchus labrax) treated with Cafodos. The study highlights the potential of this technique that, by not requiring pre-treatment of samples with further reagents, is cheaper and safer for the environment. In conclusion, the study confirmed the potential of portable devices for rapid NIR spectroscopy analysis to identify food fraud and ensure consumer safety.

Epistemic trust can be defined as the ability to rely on social and cultural information from others. It allows to integrate the new knowledge in the vision of self and world, promoting the learning from experience. Recently, the issue of epistemic trust is gaining growing interest in literature thanks to the recognition of the significant implications that it may have for treatment effectiveness but not only, as evidenced by the extension of it field of research and application to different contexts and psychopathological conditions. However, this makes it increasingly difficult to identify a unique relational dynamic between epistemic trust, attachment and mentalization. In addition, this issue is still predominantly addressed on the theoretical level, while empirical studies are still scarce, and this allows each researcher to make a different hypothesis. Therefore, this systematic review aims at exploring the role of epistemic trust in the relationship between attachment and mentalization, looking also at factors able to affect this bond. The keywords were the following: “mentalization”, “attachment” and “epistemic trust” and its dimensions and dysfunction. Articles were included if they explicitly focused on the relationship between attachment, mentalization and epistemic trust, and if they were research articles. Studies were excluded if they addressed only one or two of the three constructs, and if they were theoretical articles, opinion articles, commentary, book chapters and interviews. Results predominantly showed a relation of interdependence between these variables, although from studies that empirically investigated this topic an interesting, contrasting datum emerges: there seems to be a relationship of interdependence only between mentalization and epistemic mistrust or credulity, but not between mentalization and epistemic trust. These findings highlight the need to empirically deepen the link between these three variables and suggest therapists to pay attention not only to the creation of a secure therapeutic relationship and the improvement of mentalizing abilities, but also to clients’ epistemic trust, especially to its disrupted forms.

Background:Preterm birth may affect maternal mental health. We explored the relationship between preterm birth and the risk of initiating antidepressant use during the year after birth.Methods:We conducted a population-based investigation using regional healthcare utilization databases. The exposure considered was preterm birth. The outcome was having at least one prescription for antidepressant medications during the year after birth. We used a log-binomial regression model including terms for maternal age at birth, nationality, educational level, parity, modality of conception, modality of delivery, use of other psychotropic drugs, and diabetes to estimate relative risk (RR) and 95% confidence intervals (CI) for the association between preterm birth and the initiation of antidepressant use. In addition, the absolute risk differences (ARD) were also computed according to the timing of birth.Results:The cohort included 727,701 deliveries between 2010 and 2020 in Lombardy, Northern Italy. Out of these, 6,522 (0.9%) women had at least one prescription for antidepressant drugs during the year after birth. Preterm births were related to a 38% increased risk of initiation of antidepressant use during the year after birth (adjusted RR = 1.38; 95% CI: 1.25–1.52) for moderate to late preterm and to 83% (adjusted RR = 1.83; 95% CI: 1.46–2.28) for extremely and very preterm. Excluding women with only one antidepressant prescription, the association was consistent (adjusted RR = 1.41, 95%CI: 1.23–1.61 for moderate to late preterm and adjusted RR = 1.81, 95% CI: 1.31–2.49 for extremely and very preterm). Also, excluding women who used other psychotropics, the association remained consistent (adjusted RR = 1.39, 95%CI: 1.26–1.54 and adjusted RR = 1.91, 95% CI: 1.53–2.38, respectively for moderate to late and extremely and very preterm).Conclusion:Women who delivered preterm may have an excess risk of initiation of antidepressant consumption during the first year after birth.

Abstract Background A diagnosis of cancer during pregnancy or within one year after the end of pregnancy is a major clinical and public health issue. The current study aimed at estimating the incidence of pregnancy-associated cancer (PAC) and assessing whether the risk of abortion is increased in women diagnosed with cancer. Methods This population-based cohort study used the regional healthcare utilization (HCU) databases of Lombardy, the largest region in Italy, to identify the women who delivered between 2010 and 2020. PAC were identified by oncological ICD-9-CM codes reported in the hospital discharge forms. We computed the ratio of PAC cases to the total number of pregnancies. Following a diagnosis of PAC, the prevalence ratio (PR) of abortion and the corresponding 95% confidence interval (CI), was estimated using a log-binomial model adjusted for maternal age. Results During the study period, 926 women who gave birth (1.29 cases per 1000 births) and 341 women who had an abortion (1.52 cases per 1000 abortions) were diagnosed with PAC. Regardless of the outcome of pregnancy, the risk of PAC increased with increasing age. The rate of PAC was initially lower among births, but it came very close to the rate of PAC among abortions in the last two calendar years. The proportion of abortions among women with PAC gradually decreased from 27.7% in 2010–2012 to 18.5% in 2019–2020 (p-value

This population-based study aimed at providing an overview of drug prescription patterns during pregnancy in the Italian region of Lombardy from 2010 to 2020. The cohort consisted of 780,075 deliveries identified from the regional healthcare utilization databases. The prevalence of drugs’ dispensed prescriptions was estimated as the proportion of pregnant women with at least one prescription out of the total deliveries over the entire pregnancy and by trimester. Drugs were classified according to the Anatomical Therapeutic Chemical code. In addition, interrupted time series analysis was conducted to investigate temporal trends of antibiotics’ use during the onset of the COVID-19 pandemic. A total of 497,515 women (63.8%) used at least a drug, including vitamins and minerals, at some point during pregnancy. Vitamins, minerals, and anti-anaemic preparations were prescribed in 20.8%, 13.3%, and 18.3% of deliveries over the trimesters of pregnancy. Folic acid was the most prescribed drug, with about one woman out of four, followed by iron preparations, progestogen, and antibiotics (prescription rate, respectively: 15.9%, 10.2%, and 9.8%). A decreasing trend in the dispensing of antibiotics emerged during the entire study period; however, a significant further decrease following the spread of the pandemic was observed. Further evidence is needed to monitor the use of drugs during pregnancy, determinants, and implications.

A case report of a premenarcheal patient with ovarian torsion and mullerian agenesis is presented. A 12-year-old prepubertal girl is presented with severe right lower quadrant abdominal pain and mild rebound. Laparoscopy showed mullerian agenesis and twisted right adnexa. Detorsion and cystectomy of the right ovary were done, and the ovary was fixed to the pelvic sidewall. The postoperative course was uneventful. An association between the lax attachment of the adnexa and torsion may be a contributing factor in this condition.

Lactococcosis, mainly sustained by the warm-water bacterium Lactococcus garvieae, is a disease associated with evident mortalities and economic lossed. Main disease signs are commonly bilateral exophthalmia, hyperpigmentation in the body, haemorrhages around the eye area, opercula, and mouth region, swollen abdomen, and anal prolapse. An effective monitoring system of fish diseases relies on rapid techniques for the timely management of infection outbreaks. We evaluated the potential of the SCiO sensor, a portable near infrared spectroscope, to assess in field the health status of rainbow trout. The study sample was composed of 20 symptomatic and 20 asymptomatic rainbow trout obtained from an aquaculture farm and submitted to molecular detection of L. garvieae and SCiO examination. In order to detect presence or absence of septicaemia condition, blood smears were prepared from peripheral blood. Part of the symptomatic individuals (9/20) showed septicaemia, whereas no bacteria were found in the asymptomatic individuals. PCR assay of bacterial DNA was positive in spleen and kidney of 19/20 symptomatic and in 1/20 asymptomatic individuals. Bacteriological analysis revealed L. garvieae in 18/20 symptomatic samples and in 2/20 asymptomatic samples. The SCiO sensor was found to be able to discriminate between healthy and sick fish [sensibility 0.95 (0.75–1.00 I.C. 95%), specificity 0.80 (0.56–0.94 I.C. 95%)]. By virtue of rapid acquisition, low cost and use on site, the SCiO was considered as a useful diagnostic tool for monitoring L. garvieae infection in rainbow trout.

Food supplements are a category of products perceived safe and therefore commonly used by different categories of consumers without any particular attention or precaution. However, health risks associated with the consumption of supplements containing undeclared substances cannot be excluded. A variety of analytical methods are used to control supplement quality composition, but usually, these procedures are complex and time-consuming. Here, we report the results of a simple and fast liquid chromatography-tandem mass spectrometry (LC–MS/MS) method, to detect and quantify simultaneously different categories of active molecules, such as biogenic ammines and natural alkaloids that at high doses can produce negative health effect in consumers. Three categories of products intended for body weight loss, energy boosting, and erectile dysfunction treatment, purchased through e-commerce sites and from local supermarkets, were analyzed (n = 91). The caffeine, synephrine, agmatine sulfate, yohimbine, phenethylamine, and icariin were correctly separated and identified with good precision (RSD

Background: A cholesterol-lowering diet score was previously developed for epidemiological studies; its association with serum lipid profile was not confirmed yet. Methods: The score was developed as an adaptation of the dietary portfolio for cholesterol reduction, assigning one point for adherence to seven dietary indicators and ranging from 0 (null adherence) to 7 (highest adherence). The score was calculated for breast cancer patients enrolled in the DEDiCa study using a 7-day food record; serum lipid profile, including total and low-density lipoprotein cholesterol (LDL-C), was evaluated in serum at baseline. Results: Patients with the highest adherence to the cholesterol-lowering diet (i.e., score ≥ 4) reported lower LDL-C level than women with score 0–1 (median: 107 mg/dL and 122 mg/dL, respectively; p < 0.01). The proportion of women with LDL-C above the recommended limit of 116 mg/dL was 60.0% with score 0–1 and 42.6% with score ≥4. Although the score directly correlates with consumption of foods from vegetal sources, it was mildly associated with the healthful plant-based diet index (r-Spearman = 0.51) and the Mediterranean Diet Adherence Screener (r-Spearman = 0.30) Conclusions: These results provide experimental evidence that the cholesterol-lowering diet score is capable of detecting a specific plant-based dietary pattern that affects circulating cholesterol levels.

Food products are heterogeneous and complex matrices characterized by various compounds and in variable proportions [...]

Background: University counselling services assume a fundamental support function for students who are facing moments of crisis during their academic career. Such services often aim to reduce drop-out rates and achieve improvement in terms of psychological well-being. COVID-19 contagion containment measures have also had an impact on the psychological health of university students and their ability to cope with important developmental tasks. It has become necessary, therefore, to offer online counselling services which has become, however, the means of choice to support students during the university course in the pandemic era, as a complementary intervention to the traditional face-to-face approach. Methods: In a clinical and health psychology perspective, this study aims to analyze the efficacy of 13 online counselling groups involving 66 underachieving students, lagging with their studies. The intervention has adopted the methodology of the Narrative Mediation Path, which aims at promoting mentalization, academic engagement and psychological well-being in order to have an impact on students’ academic performance and prevent university dropouts. At the beginning and end of counselling the following measures were administered: a) Reflective Functioning Questionnaire, b) Psychological General Well-Being Index Short Form, c) Academic Performance Inventory, d) University Student Engagement Inventory, e) Group Climate Questionnaire. Results: The results showed that online counselling groups enabled an overall improvement in all the variables considered. Conclusion: Overall, the present study showed the efficacy of the online group counselling service in supporting students during the pandemic period and in coping with the difficulties encountered during the academic career.

Abstract Background All over the world, especially in the developed countries, maternal age at birth is rising. This study aimed to assess the role of maternal age on the occurrence of preterm birth (PTB) in a large birth cohort of Lombardy Region, Northern Italy. Methods This population-based study used data from regional healthcare utilization databases of Lombardy to identify women who delivered between 2007 and 2017. PTBs were defined as births before 37 completed weeks of gestation and considered according to the gestational age (two categories: 40 age categories). PTB before 32 completed weeks occurred more frequently in the same age categories, except that among multiples no association with advanced maternal age emerged. Conclusion Our study suggested that, after adjustment for potential confounders, both advance and young maternal age were associated with an increased risk of PTB.

The COVID-19 pandemic caused unprecedented changes to educational institutions, forcing their closure and a subsequent shift to online education to cater to student learning requirements. However, successful online learning depends on several factors and may also vary between countries. As such, this cross-sectional study sought to investigate how engagement of university students, a major driver of online learning, was influenced by course content, online interaction, student acceptance, and satisfaction with online learning, as well as self-efficacy across nine countries (China, India, Iran, Italy, Malaysia, Portugal, Serbia, Turkey, and the United Arab Emirates) during the COVID-19 pandemic. Using a questionnaire-based approach, data collected from 6,489 university students showed that student engagement was strongly linked to perception of the quality of the course content and online interactions (p < .001). The current study also indicated that online interactions are a major determinant of academic efficacy but only if mediated by engagement within the online learning context. A negative correlation between student engagement and satisfaction with online learning was found, demonstrating the importance of students being engaged behaviorally, emotionally, and cognitively to feel satisfied with learning. Academic efficacy and student satisfaction were explained by course content, online interaction, and online learning acceptance, being mediated by student engagement. Student satisfaction and, to a lesser degree academic efficacy, were also associated with online learning acceptance. Overall, the structural equation model was a good fit for the data collected from all nine countries (CFI = .947, TLI = .943; RMSEA = .068; SRMR = .048), despite differences in the percentage variations explained by each factor (no invariance), likely due to differences in levels of technology use, learning management systems, and the preparedness of teachers to migrate to full online instruction. Despite limitations, the results of this study highlight the most important factors affecting online learning, providing insight into potential approaches for improving student experiences in online learning environments.

Introduction. In group psychotherapy research, there are few reliable measures for tracking members’ change. This study proposes a further adaptation of the Innovative Moment Coding System for Groups (IMCS-G), a reliable method previously developed in one format of group intervention for detecting innovative moments (IMs). IMs are exceptions to the clients’ problematic narratives, organized in different levels of complexity in terms of meaning elaboration (Level 1, 2, and 3). IMCS-G consists of 7 categories (Self-Directed, Other-Directed, Explicit Mirroring, Interaction 1, Interaction 2, Collective, Voice of Group) organized in two macro-categories: Individual (e.g., change was narrated by a single participant) and Group IMs (e.g., change was co-constructed by more than one participant). Methods. Two reliable coders applied the IMCS-G to analyze the transcripts of nine sessions of a counseling group addressed to underachieving university students (N=10) and eight sessions of a brief group psychotherapy targeted to substance abusers (N=8). Agreement and reliability for IMCS-G categories and their Levels were calculated. Results. Consistently with previous studies, a strong agreement and reliability for IMCS-G categories and Levels were found in both group interventions. Furthermore, despite some differences in the frequency of IMCS-G categories and Levels, in both interventions, there was a higher frequency of Self-Directed IMs, a lower frequency of the Explicit Mirroring IMs, and a higher frequency of Level 3 Group IMs. Discussion. This study confirmed the reliability of IMCS-G in different group formats, but it also suggested rooms of improvement for some IMCS-G categories.

It is well known that in past decades group psychotherapies encountered many difficulties of application and demonstration of its effectiveness and efficacy. This was mainly due to the complexity of the group therapies and the problems in measuring outcome and process of change (Kivlinghan, 2021). Despite the many obstacles and problems that group psychotherapies face conceptually and scientifically, ....

Few treatment options are available for patients with small cell lung cancer (SCLC) in progression after a first-line therapy. A novel therapeutic approach is represented by lurbinectedin, a synthetic derivative of trabectedin that works by inhibiting oncogenic transcription and promoting apoptosis in tumor cells. A phase II basket trial demonstrated the activity of lurbinectedin at the dose of 3.2 mg/m2 in patients with SCLC who had failed a previous chemotherapy, with a response rate of 35.2%, a median progression-free survival (mPFS) of 3.5 months, and a median overall survival (mOS) of 9.3 months. Common severe adverse events (grades 3–4) were hematological disorders, including anemia (9%), leukopenia (29%), neutropenia (46%), and thrombocytopenia (7%). On the basis of the positive results of this phase II study, on June 2020, lurbinectedin was approved by the Food and Drug Administration as second line for SCLC patients in progression on or after platinum-based therapy. The subsequent phase III trial comparing the combination of lurbinectedin plus doxorubicin vs. CAV (cyclophosphamide, Adriamycin, and vincristine) or topotecan did not demonstrate an improvement in overall survival, although the experimental arm showed a superior safety profile. Combinations of lurbinectedin with other drugs, cytotoxic agents and immune checkpoint inhibitors, are currently under investigation. The results of these studies should better define the optimal clinical application of lurbinectedin.

Abstract Background Chemotherapy-induced neutropenia (CIN) has been demonstrated to be a prognostic factor in several cancer conditions. We previously found a significant prognostic value of CIN on overall survival (OS), in a pooled dataset of patients with advanced non-small-cell lung cancer (NSCLC) receiving first line chemotherapy from 1996 to 2001. However, the prognostic role of CIN in NSCLC is still debated. Methods We performed a post hoc analysis pooling data prospectively collected in six randomized phase 3 trials in NSCLC conducted from 2002 to 2016. Patients who never started chemotherapy and those for whom toxicity data were missing were excluded. Neutropenia was categorized on the basis of worst grade during chemotherapy: absent (grade 0), mild (grade 1–2), or severe (grade 3–4). The primary endpoint was OS. Multivariable Cox model was applied for statistical analyses. In the primary analysis, a minimum time (landmark) at 180 days from randomization was applied in order to minimize the time-dependent bias. Results Overall, 1529 patients, who received chemotherapy, were eligible; 572 of them (who received 6 cycles of treatment) represented the landmark population. Severe CIN was reported in 143 (25.0%) patients and mild CIN in 135 (23.6%). At multivariable OS analysis, CIN was significantly predictive of prognosis although its prognostic value was entirely driven by severe CIN (hazard ratio [HR] of death 0.71; 95%CI: 0.53–0.95) while it was not evident with mild CIN (HR 1.21; 95%CI: 0.92–1.58). Consistent results were observed in the out-of-landmark group (including 957 patients), where both severe and mild CIN were significantly associated with a reduced risk of death. Conclusion The pooled analysis of six large trials of NSCLC treatment shows that CIN occurrence is significantly associated with a longer overall survival, particularly in patients developing severe CIN, confirming our previous findings.

Abstract Background Pregnancy associated cancer (PAC) may lead to adverse obstetric and neonatal outcomes. This study aims to assess the association between PACs and adverse perinatal outcomes [i.e. labor induction, iatrogenic delivery, preterm birth, small for gestational age (SGA) newborn, low Apgar score, major malformations, perinatal mortality] in Lombardy, Northern Italy. Methods This population-based historic cohort study used the certificate of delivery assistance and the regional healthcare utilization databases of Lombardy Region to identify beneficiaries of National Health Service who delivered between 2008 and 2017. PACs were defined through oncological ICD-9-CM codes reported in the hospital discharge forms. Each woman with PAC was matched to four women randomly selected from those cancer-free (1:4). Log-binomial regression models were fitted to estimate crude and adjusted prevalence ratio (aPR) and the corresponding 95% confidence interval (CI) of each perinatal outcome among PAC and cancer-free women. Results Out of the 657,968 deliveries, 831 PACs were identified (1.26 per 1000). PAC diagnosed during pregnancy was positively associated with labor induction or planned delivery (aPR=1.80, 95% CI: 1.57–2.07), cesarean section (aPR=1.78, 95% CI: 1.49–2.11) and premature birth (aPR=6.34, 95% CI: 4.59–8.75). No association with obstetric outcomes was found among PAC diagnosed in the post-pregnancy. No association of PAC, neither during pregnancy nor in post-pregnancy was found for SGA (aPR=0.71, 95% CI: 0.36–1.35 and aPR=1.04, 95% CI: 0.78–1.39, respectively), but newborn among PAC women had a lower birth weight (p-value

Several preclinical studies suggested a potential benefit from combined treatment with inhibitors of epidermal growth factor receptor (EGFR) and angiogenesis, both effective in patients with advanced non-small-cell lung cancer (NSCLC). In pretreated patients with advanced EGFR wild type NSCLC, bevacizumab plus erlotinib improved progression-free survival as second-line therapy in the BeTa study and as maintenance therapy in the ATLAS trial, although the benefit was modest and did not translate into an advantage in overall survival. Disappointing results were reported with oral VEGF inhibitors plus erlotinib in pretreated patients with EGFR wild type NSCLC. On the contrary, erlotinib plus bevacizumab or ramucirumab showed a clinically relevant improvement of progression-free survival in naïve patients with EGFR mutations, leading to the approval of these two regimens as first-line treatment of NSCLC patients with EGFR mutant tumors. Several clinical studies are evaluating the feasibility and activity of osimertinib plus bevacizumab or ramucirumab. However, limits that could affect its use in clinical practice are the need of an intravenous infusion for angiogenesis inhibitors, the increased incidence of treatment associated adverse events, the exclusion of patients with tumors located in central position or at risk of hemorrhage. The identification of predictive biomarkers is an important goal of research to optimize the combined use of these agents.

One of the main challenges in group therapy with drug-addicted patients is collective pseudomentalization, i.e., a group discourse consisting of words and clichés that are decoupled from any inner emotional life and are poorly related to external reality. In this study, we aimed to explore the phenomenology of pseudomentalization and how it was addressed by the therapist in an outpatient group for drug-addicted patients. The group was composed of seven members, and the transcripts of eight audio-recorded sessions (one per month) were rated and studied. The interventions of the therapist were measured with the mentalization-based group therapy (MBT-G) adherence and quality scale by independent raters. Two sessions, one with the highest and one with the lowest adherence, were selected, and the clinical sequences of pseudomentalization were analyzed in a comparative way. The findings revealed that pseudomentalization does occur as a collective phenomenon, akin to “basic assumptions” of Wilfred Bion, which we reconceptualized in this study. Any pseudomentalization seemed to be reinforced by the therapist when she was presenting frequent and long interventions, when abstaining from the management of group boundaries, when providing questions focused more on content than on the mental states of the group members, and when not focusing on emotions. However, the ultimate source of collective pseudomentalization seemed to be the fear of the group members of being overwhelmed by painful emotions, mental confusion, and a loss of identity. The findings also indicated that the principles of MBT-G may be a good antidote to pseudomentalization.

Background: Nutrition may impact reproductive health and fertility potential. The role of dietary antioxidants in affecting conception and birth outcomes is a topic of emerging interest. Methods: This cross-sectional analysis from a prospective cohort study aims to explore the relationship between the intake of antioxidants, vitamins, and carotenoids and the outcomes of assisted reproduction techniques. Information on the socio-demographic characteristics, health histories, lifestyle habits, and diet information of subfertile couples referred to a fertility center was obtained. Results: A total of 494 women were enrolled. According to the four IVF outcomes considered, 95% of women achieved good quality oocytes, 87% achieved embryo transfer, 32.0% achieved clinical pregnancies, and 24.5% achieved pregnancy at term. Associations were found between age and the number of good quality oocytes (p = 0.02). A moderate level of physical activity in the prior 5 years was associated with a better rate of achieving clinical pregnancy (p = 0.03). Smoking habits, alcohol intake, and caffeine consumption did not show associations with any outcome. No associations were found, even after accounting for potential confounders, with the intake of vitamins C, D, E, and α-carotene, β-carotene, beta-cryptoxanthin, lutein, and folate. Conclusion: Further research is needed to understand how antioxidant intake may have a role in modulating fertility.

Several studies suggested that male's diet affects fertility. This cross-sectional analysis from a prospective cohort study aims to explore the relation between antioxidants intake and sperm parameters in sub-fertile couples referring to a Fertility center. Socio-demographic characteristics, health history, lifestyle habits, and diet information were obtained. A semen sample was analyzed to proceed with assisted reproduction. Three hundred and twenty-three men were enrolled: 19.1% had semen volume (SV) < 1.5 mL, 31.4% sperm concentration (SC) < 15.0 mil/mL, 26.8% sperm motility < 32%, and 33.0% had total sperm count (TSC) < 39.0 mil. Higher levels of α-carotene were associated to lower risk of low SC [4th vs. 1st quartile, adjusted OR (aOR) 0.43, 95% CI 0.20–0.91) and low TSC (aOR 0.46, 95% CI 0.22–0.95). Higher intake of β-carotene was inversely associated with risk of low TSC. Lycopene intake was associated with higher risk for these conditions (aOR 2.46, 95%CI 1.01–5.98, SC), and (aOR 3.11, 95%CI 1.29–7.50, TSC). Risk of low semen volume was lower in men with higher level of vitamin D intake (aOR 0.25, 95%CI 0.09–0.66)]. Further research, especially, well-designed randomized clinical trials (RCT), is needed to understand how diet modifications may have a role in modulating male fertility and fecundability.

Abstract Background Pioglitazone, a synthetic peroxisome proliferator activated receptor (PPAR-γ) ligand, is known as an antidiabetic drug included in the thiazolidinediones (TZDs) class. It regulates the lipid and glucose cell metabolism and recently a role in the inhibition of numerous cancer cell processes has been described. Methods In our work we investigate the anti-tumor effects of pioglitazone in in vitro models of non small cell lung cancer (NSCLC) and also, we generated ex-vivo three-dimensional (3D) cultures from human lung adenocarcinoma (ADK) as a model to test drug efficacy observed in vitro. The inhibitory effect of pioglitazone on cell proliferation, apoptosis and cell invasion in a panel of human NSCLC cell lines was evaluated by multiple assays. Results Pioglitazone reduced proliferative and invasive abilities with an IC50 ranging between 5 and 10 μM and induced apoptosis of NSCLC cells. mRNA microarray expression profiling showed a down regulation of MAPK, Myc and Ras genes after treatment with pioglitazone; altered gene expression was confirmed by protein analysis in a dose-related reduction of survivin and phosphorylated proteins levels of MAPK pathway. Interestingly mRNA microarray analysis showed also that pioglitazone affects TGFβ pathway, which is important in the epithelial-to-mesenchimal transition (EMT) process, by down-regulating TGFβR1 and SMAD3 mRNA expression. In addition, extracellular acidification rate (ECAR) and a proportional reduction of markers of altered glucose metabolism in treated cells demonstrated also cell bioenergetics modulation by pioglitazone. Conclusions Data indicate that PPAR-γ agonists represent an attractive treatment tool and by suppression of cell growth (in vitro and ex vivo models) and of invasion via blockade of MAPK cascade and TGFβ/SMADs signaling, respectively, and its role in cancer bioenergetics and metabolism indicate that PPAR-γ agonists represent an attractive treatment tool for NSCLC.

Infectious diseases place an economic burden on aquaculture and a limitation to its growth. An innovative approach to mitigate their impact on production is breeding for disease resistance: selection for domestication, family-based selection, marker-assisted selection, and more recently, genomic selection. Advances in genetics and genomics approaches to the control of infectious diseases are key to increasing aquaculture efficiency, profitability, and sustainability and to reducing its environmental footprint. Interaction and co-evolution between a host and pathogen can, however, turn breeding to boost infectious disease resistance into a potential driver of pathogenic change. Parallel molecular characterization of the pathogen and its virulence and antimicrobial resistance genes is therefore essential to understand pathogen evolution over time in response to host immunity, and to apply appropriate mitigation strategies.

European sea bass (Dicentrarchus labrax L.) is one of the most economically important fish species in the Mediterranean Sea area. Despite strict requirements regarding indications of production method (wild/farmed), incorrect labelling of sea bass is a practice still frequently detected. The aim of this study was to evaluate the capabilities of two techniques, Near-InfraRed (NIR) spectroscopy and mass spectrometry, to discriminate sea bass according to the production method. Two categories were discriminated based on the docosahexaenoic and arachidonic fatty acid ratio by using a Direct Sample Analysis (DSA) system integrated with a time-of-flight (TOF) mass spectrometer. The cut-off value of 3.42, of fatty acid ratio, was able to discriminate between the two types of fish with sensitivity and specificity of 100%. It was possible to classify fish production by using multivariate analysis with portable NIR. The results achieved by the developed validation models suggest that this approach is able to distinguish the two product categories with high sensitivity (100%) and specificity (90%). The results obtained from this study highlight the potential application of two easy, fast, and accurate screening methods to detect fraud in commercial sea bass production.

Fish species substitution is one of the most common forms of fraud all over the world, as fish identification can be very challenging for both consumers and experienced inspectors in the case of fish sold as fillets. The difficulties in distinguishing among different species may generate a “grey area” in which mislabelling can occur. Thus, the development of fast and reliable tools able to detect such frauds in the field is of crucial importance. In this study, we focused on the distinction between two flatfish species largely available on the market, namely the Guinean sole (Synaptura cadenati) and European plaice (Pleuronectes platessa), which are very similar looking. Fifty fillets of each species were analysed using three near-infrared (NIR) instruments: the handheld SCiO (Consumer Physics), the portable MicroNIR (VIAVI), and the benchtop MPA (Bruker). PLS-DA classification models were built using the spectral datasets, and all three instruments provided very good results, showing high accuracy: 94.1% for the SCiO and MicroNIR portable instruments, and 90.1% for the MPA benchtop spectrometer. The good classification results of the approach combining NIR spectroscopy, and simple chemometric classification methods suggest great applicability directly in the context of real-world marketplaces, as well as in official control plans.

Inhibition of angiogenesis has been demonstrated to be an efficacious strategy in treating several tumors. Vascular endothelial growth factor (VEGF) is the most important protein with proangiogenic functions and it is overexpressed in small cell lung cancer (SCLC). Bevacizumab, a monoclonal antibody directed against VEGF, showed a promising activity in combination with etoposide and cisplatin as first-line treatment of patients with extended stage (ES)-SCLC and two randomized studies confirmed that bevacizumab improved PFS, but failed to prolong OS. Instead, disappointing results have been observed with endostar, sunitinib, sorafenib, vandetanib, and thalidomide in combination with chemotherapy in the first-line setting, with sunitinib in the maintenance setting, with sunitinib, cediranib and nintedanib as single agents or ziv-aflibercept in combination with topotecan in second-line setting. Only anlotinib improved OS and PFS as third-line therapy in Chinese patients with SCLC, and it was approved with this indication in China. Future challenges are the evaluation of the role of angiogenesis inhibitors in combination with immune- checkpoint inhibitors and chemotherapy in SCLC patients and the identification of predictive biomarkers of response to both agents.

Although recent literature has stated that mentalizing (or reflective functioning; RF) promoted the clinical recovery (symptomatic remission; CR) of individuals with borderline personality disorder (BPD), to our knowledge, there have been no studies that analyzed the relationship between RF and a process more complex than CR, namely personal recovery (PR) - a deep and unique process of change in one’s attitudes, values, feelings, goals and/or roles. Furthermore, while there have been a few studies concerning PR of BPD individuals, but to date none analyzed PR of BPD individuals through online narratives shared on social media platforms. This study investigates the relationship between RF and PR of 14 Instagram users with a selfreported diagnosis of BPD. Two groups of users were distinguished on the basis of hashtags, #bpd and #bpdrecovery. Seventy randomized text posts (5 from each user) were extracted from users’ profiles: 35 from the #bpd group and 35 from #bpdrecovery. Two methods of analysis were applied: i) a thematic analysis, by using the theoretical framework CHIME, which identifies five dimensions of PR; and ii) a stylistic analysis of RF utilizing computerized reflective functioning (CRF), which identifies RF lexical markers. Results indicate that the #bpdrecovery group presented more dimensions of PR, and that its posts showed a significantly higher RF than the #bpd group. These findings suggest that RF could be involved in the PR of BPD individuals, thus mentalization-based treatment could be effective in supporting PR processes and enhancing the impaired RF in BPD users even in the online context.

Real-world evidence regarding the effectiveness of prulifloxacin in the treatment of acute exacerbations of chronic bronchitis (AECB) is limited. Therefore, this study aimed to assess the rates and time to symptom improvement and resolution in patients with moderate-to-severe AECB who were given prulifloxacin in the routine care in Greece. This observational, prospective study, conducted in 15 hospital-based clinics across Greece, enrolled outpatients >40 years old, with moderate-to-severe AECB, for whom the physician had decided to initiate treatment with prulifloxacin. Data were collected at prulifloxacin onset (baseline), 7–10 days after baseline, and at least 28 days after therapy completion. Between 23 November 2015 and 27 January 2018, 305 patients (males: 76.4%; mean (standard deviation) (SD) age: 69.7 (9.8) years; Anthonisen type I/II: 94.8%; chronic bronchitis duration >10 years: 24.9%) were consecutively enrolled. At baseline, >80% had increased sputum volume, cough, dyspnoea, and sputum purulence. Prulifloxacin improved symptoms in 99.7% of the patients after a mean (SD) of 5.47 (3.57) days, while symptoms fully recovered after a mean (SD) of 10.22 (5.00) days in 95.4%. The rate of adverse events related to prulifloxacin was 1.3% (serious: 0.7%). In the routine care in Greece, prulifloxacin was highly effective in moderate-to-severe AECB, while displaying a predictable safety profile.

In a Clinical Health Psychology perspective, which focuses on the promotion and maintenance of mental and physical health of the individuals, mentalization (operationalized as reflective functioning; RF) may be conceived as a psycho-social competence associated with psychological well-being and good outcome treatment. In the university contexts, some studies demonstrated that the students' academic achievements may be related, on one hand, to RF improvements, on the other, to psychological well-being. Nevertheless, there is a lack of studies exploring RF in relationship with both academic achievement and psychological well-being regarding university students. This study aims at assessing the effectiveness, in terms of RF, psychological well-being and academic performance, of ten counselling groups addressed to 63 underachieving university students lagging behind in their studies. The counselling adopted an innovative narrative methodology, the Narrative Mediation Path (NMP), which aims to improve mentalization and psychological well-being in order to produce an impact on the students' academic performance. The Reflective Functioning Questionnaire (RFQ), the Psychological General Well-Being Index (PGWBI), and the Academic Performance Inventory (API) were administered at the beginning and at the end of the counselling. Results showed an overall improvement of students in genuine mentalization, especially of the hypomentalizing dimension of RF, an increase of the psychological well-being index and its sub-dimensions (except for the General Health dimension) and an improvement of the academic performance. This study highlighted the effectiveness of the NMP methodology for students' success and suggests the utility of planning clinical psychology interventions aimed at enhancing mentalization in the university contexts.

Academic engagement describes students’ involvement in academic learning and achievement. This paper reports the psychometric properties of the University Student Engagement Inventory (USEI) with a sample of 3992 university students from nine different countries and regions from Europe, North and South America, Africa, and Asia. The USEI operationalizes a trifactorial conceptualization of academic engagement (behavioral, emotional, and cognitive). Construct validity was assessed by means of confirmatory factor analysis and reliability was assessed using Cronbach’s alpha and McDonald’s omega coefficients. Weak measurement invariance was observed for country/region, while strong measurement invariance was observed for gender and area of graduation. The USEI scores showed predictive validity for dropout intention, self-rated academic performance, and course approval rate while divergent validity with student burnout scores was also evident. Overall, the results indicate that the USEI can produce reliable and valid data on academic engagement of university students across the world.

Hydrogen sulfide (H2S) is a ubiquitous gaseous signaling molecule that has an important role in many physiological and pathological processes in mammalian tissues, with the same importance as two others endogenous gasotransmitters such as NO (nitric oxide) and CO (carbon monoxide). Endogenous H2S is involved in a broad gamut of processes in mammalian tissues including inflammation, vascular tone, hypertension, gastric mucosal integrity, neuromodulation, and defense mechanisms against viral infections as well as SARS-CoV-2 infection. These results suggest that the modulation of H2S levels has a potential therapeutic value. Consequently, synthetic H2S-releasing agents represent not only important research tools, but also potent therapeutic agents. This review has been designed in order to summarize the currently available H2S donors; furthermore, herein we discuss their preparation, the H2S-releasing mechanisms, and their -biological applications.

Diabetes increases endometrial cancer risk. We investigated the role of a diabetes risk reduction diet (DRRD) on the risk of endometrial cancer using data from a multicentric, Italian hospital-based case–control study (1992–2006) enrolling 454 histologically confirmed cases of endometrial cancer and 908 controls matched by age and center. We derived a DRRD score assigning higher scores for higher intakes of cereal fiber, fruit, coffee, polyunsaturated:saturated fatty acid ratio, and nuts and for lower glycemic load and lower intakes of red/processed meat and sugar-sweetened beverages/fruit juices. The odds ratios (OR) of endometrial cancer according to the DRRD score were derived by multiple conditional logistic regression models. The OR for high (DRRD score >24, i.e., third tertile) versus medium–low adherence to the DRRD was 0.73 (95% confidence interval, CI, 0.55–0.97). Similar results were observed after the exclusion of diabetic women (OR 0.75; 95% CI, 0.56–1.00) and allowance for total vegetable consumption (OR 0.80; 95% CI, 0.60–1.07). Inverse associations were observed in most of the analyzed subgroups. The OR for high DRRD combined with high vegetable consumption was 0.45 (95% CI, 0.28–0.73). Our results suggest that diets able to reduce diabetes risk may also reduce endometrial cancer risk. High vegetable consumption combined with high adherence to the DRRD may provide additional benefit in endometrial cancer prevention.

Introduction: Benzodiazepines, including temazepam are described as TSPO antagonists. In fact, TSPO was initially described as a peripheral benzodiazepine receptor (PBR) with a secondary binding site for diazepam. TSPO is a potential imaging target of neuroinflammation because there is an amplification of the expression of this receptor. Objectives: Herein, we developed a novel fluorinated benzodiazepine ligand, [18F]Fluoroethyltemazepam ([18F]F-FETEM), for positron emission tomography (PET) imaging of translocator protein (18 kDa). Methods: [18F]F-FETEM was radiolabelled with an automated synthesizer via a one-pot procedure. We conducted a [18F]F-aliphatic nucleophilic substitution of a tosylated precursor followed by purification on C18 and Alumina N SPE cartridges. Quality control tests was also carried out. Results: We obtained 2.0–3.0% decay-uncorrected radiochemical activity yield (3.7% decay-corrected) within the whole synthesis time about 33 min. The radiochemical purity of [18F]F-FETEM was over 90% by TLC analysis. Conclusions: This automated procedure may be used as basis for future production of [18F]F-FETEM for preclinical PET imaging studies.

The sale of frozen–thawed fish and fish products, labeled as fresh, is currently one of the most common and insidious commercial food frauds. For this reason, the demand of reliable tools to identify the storage conditions is increasing. The present study was performed on two species, commonly sold in large-scale distribution: Cuttlefish (Sepia officinalis) and musky octopus (Eledone spp.). Fifty fresh cephalopod specimens were analyzed at refrigeration temperature (2 ± 2 °C), then frozen at −20 °C for 10 days and finally thawed and analyzed again. The performance of three near-infrared (NIR) instruments in identifying storage conditions were compared: The benchtop NIR Multi Purpose Analyzer (MPA) by Bruker, the portable MicroNIR by VIAVI and the handheld NIR SCiO by Consumer Physics. All collected spectra were processed and analyzed with chemometric methods. The SCiO data were also analyzed using the analytical tools available in the online application provided by the manufacturer to evaluate its performance. NIR spectroscopy, coupled with chemometrics, allowed discriminating between fresh and thawed samples with high accuracy: Cuttlefish between 82.3–94.1%, musky octopus between 91.2–97.1%, global model between 86.8–95.6%. Results show how food frauds could be detected directly in the marketplace, through small, ultra-fast and simplified handheld devices, whereas official control laboratories could use benchtop analytical instruments, coupled with chemometric approaches, to develop accurate and validated methods, suitable for regulatory purposes.

This study investigated the structure of mentalization (Bateman & Fonagy, 2012) in a training context. The dual purpose was to evaluate the effectiveness of practicum student training and whether the Linguistic Inquiry method (Pennebaker, 2000) could be used to evaluate the three dimensions of mentalization — relational, cognitive, and emotional. The training utilized the groups and their accounts as devices and mediators to conceptualize the relationship between self-mentalizing training, the academic context and the practicum experience. Accounts from 38 Italian students pursuing master degree in Clinical, Dynamic, and Community Psychology were analyzed by LIWC software. The Wilcoxon test showed a significant increase in mentalizing words during the middle and end of the term, as compared with the beginning. The results displayed a need to promote mentalization within academic settings and indicated the value of this competence for clinical psychology.

Construction and Validation of the ISCOS Questionnaire: A study on School Counselling Development Indicators. The aim of the study is to construct and validate a new questionnaire called ISCOS (Development Indicators of School COunselling) designed to measure specific usage profiles of counselling at school. These profiles related to couselling service are called Provoke Profile, Distrust Profile, Fear Profile and Trust Profile, as identified in previous exploratory researches (Freda et al., 2009; Esposito et al., 2010). These profiles have been conceptualized as symbolic and cultural models (Carli & Paniccia, 2003 and 2011) of the service representation. Another aim of the study is to investigate possible associations among these usage models and the influences of variables such as age and gender of the students. ISCOS was submitted to a number of 241 students (Female = 115; Male = 126) aged among 13 and 20 years (M = 16.23; ds = 1.81), attending a high school in Naples where a counselling service was already activated. The exploratory factor analysis showed the stability of two factors (Types of Investment and Retreat) that explain 37% of the total variance. Finally, for both factors was found a significant difference concerning only the gender variable. The questionnaire showed good psychometric qualities. It presents itself as an innovative tool designed to analyze specific emotional dimensions underlying the usage models identified. However, further investigations are deemed necessary to further diversifying and expanding the sample with regard to the origin and the field of studies.

An overactivation of hepatocyte growth factor (HGF)/mesenchymal-epithelial transition factor (MET) axis promotes tumorigenesis and tumor progression in various cancer types. Research data recently evidenced that HGF/MET signaling is also involved also in the immune response, mainly modulating dendritic cells functions. In general, the pathway seems to play an immunosuppressive role, thus hypothesizing that it could constitute a mechanism of primary and acquired resistance to cancer immunotherapy. Recently, some approaches are being developed, including drug design and cell therapy to combine MET and programmed cell death receptor-1 (PD-1)/programmed cell death receptor-ligand 1 (PD-L1) inhibition. This approach could represent a new weapon in cancer therapy in the future.

The ability to visualize plasmid DNA entrapment in muscle cells undergoing an “in vivo” electroporation treatment was investigated on BALB/c mice using a 7-T magnetic resonance imaging (MRI) scanner using the paramagnetic Gd–DOTA–spd complex as imaging reporter. Gd–DOTA–spd bears a tripositively charged spermidine residue that yields a strong binding affinity toward the negatively charged DNA chain (6.4 kb, K a = 2.2 × 10 3 M −1 for approximately 2500 ± 500 binding sites). Cellular colocalization of Gd-DOTA-spd and plasmid DNA has been validated by histological analysis of excised treated muscle. In vivo MRI visualization of Gd-DOTA-spd distribution provides an excellent route to access the cellular entrapment of plasmid DNA upon applying an electroporation pulse.