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Abstract Background We set out to assess the appropriateness of current placement of mentally disordered offenders allocated by the courts in Italy to REMS or to forensic community residences. We hypothesised that as in other countries, the match between a standardised assessment and the decision of the court would be imperfect. Methods The DUNDRUM Toolkit was translated into Italian. The translation had good psychometric properties. In order to compare the current level of therapeutic security with a calculated safest current placement, we compared the DUNDRUM-1 triage security assessment of need for therapeutic security prior to treatment, with evidence for progress made in treatment (DUNDRUM-3) and forensic recovery (DUNDRUM-4). The more conservative of these two would be taken as the safe current level of need for therapeutic security. Results The Italian translation of the DUNDRUM Toolkit had good internal consistency and mean scores had a Reliable Change Index less than one unit. 3.7% of those in REMS (medium security) were assessed as needing high security and 38% were ready to move to a less secure place. In low secure places, 56% were assessed as needing a higher level of therapeutic security and 6% could have moved to open non-secure places. Conclusions The Italian translation of the DUNDRUM Toolkit allows an assessment of the current working of the model of care for forensic psychiatry following the reforms of 2015. Most patients are safely placed. A small but important proportion needed high secure places that are not currently available. (3.7% of 604 nationally, 95% Confidence Interval 1.2% to 8.4%, 7 to 50). A greater use of such measures would enable better health gains and safer outcomes. Trial registration ClinicalTrials.gov ID: NCT06018298 Unique Protocol ID: ITAL-EE-REMS.

Severe forms of Anorexia Nervosa (AN) are characterized by medical complications, psychiatric comorbidity, and high mortality. This study investigated potential associations between clinical/biological factors and the severity of AN, measured by the Body Mass Index (BMI). Red and white blood cells, hemoglobin, platelets, iron, vitamins D and B12, folate, and total cholesterol were measured in a mixed sample of 78 inpatients and outpatients. Linear regressions and one-way analyses of variance (ANOVAs) were carried out to evaluate the relationship between BMI and clinical/biochemical variables. BMI was significantly lower in hospitalized patients (F = 4.662; p = 0.034) and in those under pharmacological treatment (F = 5.733; p = 0.019) or poly-therapy (F = 5.635; p = 0.021). Higher vitamin B12 (β = −0.556, p < 0.001), total cholesterol (β = −0.320, p = 0.027), and later age at onset (with a trend towards significance) (β = −0.376, p = 0.058) were associated with a lower BMI. Increased total cholesterol and vitamin B12, later age at onset, current pharmacological treatment, and poly-therapy might be distinctive in patients with a lower BMI. In clinical practice, these findings may contribute to the early identification of AN patients at higher risk of developing complicated or chronic forms of the disorder. Further studies on larger samples are needed to identify potential predictive factors of AN severity in the framework of precision medicine.

The aim of this systematic review was to synthesise the impact of the COVID-19 pandemic on binge eating disorder (BED) the new onset and course. Inclusion criteria: original articles and BED diagnosis; and the main outcomes: relationships between the COVID-19 pandemic and the new onset/clinical changes in BED, and specific results for BED. Exclusion criteria: mixed/inaccurate diagnoses and articles not written in English. We searched four databases and one registry until 5 May 2023. The quality appraisal was conducted using the Effective Public Health Practice Project (EPHPP) tool. Twelve studies with 4326 participants were included. All studies were observational with nine cross-sectional and three longitudinal. Four of the included studies investigated new-onset BED, while eight examined the BED clinical course of patients with a previous diagnosis. With the exception of one study, the available literature indicates both an increase in BED diagnoses and a clinical worsening during COVID-19. Major limitations include study quality (weak-to-moderate) and high heterogeneity in terms of pandemic phase, population, geographical areas, and psychometric tools. Our findings indicate that BED patients are particularly vulnerable to events characterised by social distancing and over-worry, and should be, therefore, carefully monitored. Further studies are needed to corroborate our findings, implement preventive strategies, and promote personalised treatments. PROSPERO registration number: CRD42023434106

Anorexia Nervosa (AN) is a disabling disorder characterized by extreme weight loss and frequent chronicization, especially in its most severe forms. This condition is associated with a pro-inflammatory state; however, the role of immunity in symptom severity remains unclear. Total cholesterol, white blood cells, neutrophils, lymphocytes, platelets, iron, folate, vitamin D and B12 were dosed in 84 female AN outpatients. Mildly severe (Body Mass Index—BMI ≥ 17) versus severe (BMI < 17) patients were compared using one-way ANOVAs or χ2 tests. A binary logistic regression model was run to investigate the potential association between demographic/clinical variables or biochemical markers and the severity of AN. Patients with severe anorexia (compared to mild forms) were older (F = 5.33; p = 0.02), engaged in more frequent substance misuse (χ2 = 3.75; OR = 3.86; p = 0.05) and had a lower NLR (F = 4.12; p = 0.05). Only a lower NLR was predictive of severe manifestations of AN (OR = 0.007; p = 0.031). Overall, our study suggests that immune alterations may be predictive of AN severity. In more severe forms of AN, the response of the adaptive immunity is preserved, while the activation of the innate immunity may be reduced. Further studies with larger samples and a wider panel of biochemical markers are needed to confirm the present results.

In an economic system now dominated by digital interconnection, the toolbox of trade union activity risks being not only obsolete but also rusty. In the era of the Internet and technological innovation, the classic forms of protest alone are not enough. The protection of workers’ rights passes today through the possibility of the union to exploit the ability of the web to amplify the echo of the claim and, at the same time, to affect the employer need to maintain or gain a positive reputation among consumers.

Background: Descemet Membrane Endothelial Keratoplasty (DMEK) has been widely adopted to treat Fuchs endothelial dystrophy (FED) and Bullous keratopathy (BK). Graft detachment (GD) is one of the common earliest post-operatory complications, and it is usually recovered by Air Rebubbling (ARB). Methods: Retrospectively, we investigated predictive factors related to GD between January 2016 and March 2020, a pre-COVID era, in 72 patients, 72 eyes, and their donors' lamellar characteristics, focusing on donor's cause of death. The patients were divided according to the posterior lamellar keratoplasty technique adopted. Results: GD and consequent ARB were most common but not significantly prevalent in DMEK (p = 0.11). It was more common in FED for both surgical approaches. Only in BK treated with DSAEK were host steeper mean astigmatism (p = 0.03) and donors with smaller graft pre-cut diameters (p = 0.02) less likely to be related to GD. Regarding donor's cause of death, only cardiovascular accident could be related to GD in BK treated with DMEK (p = 0.04). Conclusions: Our study shows that the conventional match between pathology and corneal lenticule is not sufficient to prevent ARB. Donor's cause of death can impair graft and host attachment. In particular, cardiovascular death may impair the efficiency of donors' endothelial cells, inducing GD after DMEK in BK. [ABSTRACT FROM AUTHOR]

Parosteal osteosarcoma originates on the surface of long bones. The juxtacortical variety is one of the most common ones and accounts for about 5% of all osteosarcomas. We report the case of a 34-year-old female patient with a rare variant of parosteal osteosarcoma. Because of the less aggressive biological behavior, it is important to know it, in order to recognize and differentiate it from benign osseous lesions. Keywords: Parosteal osteosarcoma, Fatty metaplasia, Surface osteosarcoma

Forensic radiology is a specialized area of medical imaging using radiological techniques to assist physicians and pathologists in matters related to the law. The forensic application of diagnostic medical radiology can be applied in many fields; the prime target of evaluation is the osseous skeleton, but soft tissues and abdominal and thoracic viscera may offer key findings. The technological progress in clinical radiology provides a lot of potential tools to forensic radiology, allowing wider fields of applications in this matter.

Francesco Margari,1 Francesco Craig,2 Lucia Margari,2 Emilia Matera,2 Anna Linda Lamanna,2 Paola Alessandra Lecce,2 Donatella La Tegola,3 Felice Carabellese3 1Psychiatry Unit, 2Child Neuropsychiatry Unit, Department of Basic Medical Sciences, Neurosciences and Sense Organs of the Aldo Moro University of Bari, 3Section of Criminology and Forensic Psychiatry, Department of Internal Medicine and Public Medicine, University of Bari, Bari, Italy Background: The aim of this study was to assess the prevalence of potential environmental and psychopathological risk factors, with special focus on symptoms of attention-deficit/hyperactivity disorder (ADHD), in a sample of adolescent offenders in relation to the type of crime committed.Methods: The assessment included data collection and administration of clinical standardized scales such as the Youth Self-Report and Conners’ Adolescent Self-Report Scale. A total of 135 juvenile offenders participated in the study. In relation to the type of crime committed, we identified three groups matched for age and sex (crimes against people, property crimes, and alcohol-drug-related crimes).Results: Fifty-two percent of juvenile offenders reported educational achievement problems and 34% reported a family history of psychiatric disorders. We detected a statistically significant difference between the three groups with regard to ADHD (P=0.01) and conduct problems (P=0.034). Juvenile offenders who had committed crimes against people showed more ADHD symptoms (18%) and conduct problems (20%) than adolescents who had committed property crimes and alcohol-drug-related crimes. Sixty percent of the juvenile offenders who had committed property crimes and 54% of those who had committed alcohol-drug-related crimes showed problems in academic achievement.Conclusion: These findings suggest the need to implement specific interventions for prevention and treatment of specific criminal behavior. Keywords: juvenile offenders, attention-deficit/hyperactivity disorder, conduct problems, academic achievement problems, peer relationships, family problems

The aim of the study was to evaluate the relationship between dietary magnesium (Mg) intake and prevalence of knee osteoarthritis (OA), a topic poorly explored in the literature. Overall, 783 people participating in the Osteoarthritis Initiative (59.8% females; mean age: 62.3 years) and having an MRI assessment were enrolled in this cross-sectional study. Mg intake was measured with a semi-quantitative food frequency questionnaire, and its association with knee OA was evaluated for an increased intake of 100 mg/day. Using an adjusted linear regression analysis, a higher Mg intake (i.e., increase of 100 mg/day) corresponded to a significant increase in mean cartilage thickness, cartilage volume at medial tibia, cartilage volume and mean cartilage thickness at central medial femur, and cartilage volume and mean cartilage thickness in the central medial tibiofemoral compartment. In conclusion, an increased Mg dietary intake is associated with a better knee cartilage architecture, also when adjusting for potential confounders, suggesting a potential role of Mg in the prevention and treatment of knee OA.

The organization of Expo 2015 in the city of Milan has prompted massive organizational efforts to set up a new fair district in one of the largest Italian cities. The urban layout of the metropolitan city has been redesigned in order to accommodate all participating nations event. Expo 2015 established through guidelines the necessity to adopt sustainable solutions for the temporary buildings of the exhibition. The article aims to see how the concepts of sustainability and recyclability have been interpreted in the language of 40 designers from different countries. Through data provided by information papers of the exhibition, a valuation of materials used in buildings was made. This research led to an analysis of different building typology involved and the materials most used to reach the goals of guidelines drawn up by Expo 2015. The perception of an event characterized by green constructions was achieved, but not every construction was aimed to be a nearly zero emission building.

Polyethylene (PE) is the most used thermoplastic commodity as a consequence of its convenient cost-processing-performance relationship and it can be used in the form of films for food, goods and farming packaging. On the other hand, sepiolite is a high surface area and porosity hydrated magnesium silicate with both remarkable adsorptive and absorptive properties. Thus, PE and sepiolite can combine their properties synergetically to obtain new materials with enhanced properties. In this work, a systematic study of final properties of PE-sepiolite nanocomposite films was performed to investigate the influence of the sepiolite content and modification on the PE properties. Nanocomposites films with 1, 3, 5 and 10 wt % of sepiolite, with and without surface modification, were prepared by cast film extrusion and tested. The filler dispersion and distribution were evaluated by Transmission Electron Microscopy (TEM) and Fourier Transform Infrared Spectroscopy (FTIR), whereas the film crystalline morphology was analyzed using Atomic Force Microscopy (AFM), Differential Scanning Calorimetry (DSC) and X-ray Diffraction (XRD). Final properties as mechanical ones, oxygen permeability and transparency were also studied and related with the film structure. Mechanical properties, crystallization and oxygen permeability were increased maintaining good film translucency. POLYM. ENG. SCI., 54:1931-1940, 2014., INTRODUCTION The introduction of inorganic nanoparticles into polymer systems results in polymer nanocomposites exhibiting multifunctional and high-performance polymer characteristics [1], By developing these new materials, it is possible to reach [...]