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The aim was to correlate specific biological aspects of cumulus cells isolated from individual cumulus-oocyte complexes (COCs) with the clinical outcome of the related embryos.

Psychotic patients with a lifetime history of cannabis use generally show better cognitive functioning than other psychotic patients. Some authors suggest that cannabis-using patients may have been less cognitively impaired and less socially withdrawn in their premorbid life. Using a dataset comprising 948 patients with first-episode psychosis (FEP) and 1313 population controls across 6 countries, we examined the extent to which IQ and both early academic (Academic Factor [AF]) and social adjustment (Social Factor [SF]) are related to the lifetime frequency of cannabis use in both patients and controls. We expected a higher IQ and a better premorbid social adjustment in psychotic patients who had ever used cannabis compared to patients without any history of use. We did not expect such differences in controls. In both patients and controls, IQ was 3 points higher among occasional-users than in never-users (mean difference [Mdiff] = 2.9, 95% CI = [1.2, 4.7]). Both cases and control daily-users had lower AF compared to occasional (Mdiff = -0.3, 95% CI = [-0.5; -0.2]) and never-users (Mdiff = -0.4, 95% CI = [-0.6; -0.2]). Finally, patient occasional (Mdiff = 0.3, 95% CI = [0.1; 0.5]) and daily-users (Mdiff = 0.4, 95% CI = [0.2; 0.6]) had better SF than their never-using counterparts. This difference was not present in controls (Fgroup*frequency(2, 2205) = 4.995, P = .007). Our findings suggest that the better premorbid social functioning of FEP with a history of cannabis use may have contributed to their likelihood to begin using cannabis, exposing them to its reported risk-increasing effects for Psychotic Disorders. © The Author(s) 2019. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center.All rights reserved. For permissions, please email: journals.permissions@oup.com.

To evaluate whether whole-body MR has a predictive role before treatment and may asses the response after two courses of chemotherapy in comparison to FDG-PET/CT

Introduction: Demonstration of the role of persistent infection, with high-risk (HR) human papillomaviruses (HPV) as the causal agent of cervical cancer made the development of first and second generation prophylactic vaccines. Bivalent and quadrivalent HPV vaccines are at the moment available in Europe. In 2014 is licensing a nonavalent HPV vaccine against HPV types: 6/11/16/18/31/33/45/52/58. The aim of our study was to evaluate the potential impact on HPV infection and related low- and high-grade cervical lesions (LSIL, HSIL) of the candidate nonavalent HPV vaccine, compared to the impact of the quadrivalent, in a female population living in Sicily. Materials and Methods: HPV genotypes was identified by Linear Array HPV Genotyping Test (Roche Diagnostics) and with the INNO-LiPA HPV assay (Innogenetics) for ambiguous HPV 52 status. Low estimates of HPV vaccine impact was calculated as prevalence of HPV 6/11/16/18/31/33/45/52/58 genotypes alone or in association but excluding presence of another HPV type; high estimate as prevalence of HPV 6/11/16/18/31/ 33/45/52/58 genotypes alone or in association, in presence of another HPV type. Results:1794 samples had a HPV positive finding. HR HPV types, alone or with LR types, were present in 1466 (81.7%) samples. 584/1794 (32.5%) samples harboured at least one of the four HPV types covered by the quadrivalent vaccine (HPV 6/11/16 and 18), while 984 (54.8%) samples harboured at least one of the genotypes included in nonavalent vaccine, implying a significantly higher estimated coverage of HPV infection from the developing vaccine than the current quadrivalent (54.8% vs 32.5%; p

Obiettivi: Dalle analisi dei dati degli studi precedenti effettuati in Sicilia sono emerse diverse indicazioni, per cui è stata avviata un’indagine in Sicilia nel 2013 , grazie ad un finanziamento della LILT nazionale, intesa a: valutare la situazione immunologica ed ematochimica e la sieroprevalenza in persone a stretto contatto con i malati (parente di 1 grado o marito/moglie) o parenti affetti dalla stessa patologia; indagare alcuni fattori di rischio con un questionario;effettuare il follow-up dei malati ogni 6-12-18-24 mesi ; individuare un Centro di Riferimento in Sicilia per la diagnosi e cura di questo tumore raro. Materiali e Metodi: Sono stati arruolati 24 Casi (21M/3F) e 27 Controlli familiari (9M/18F), residenti in Sicilia e solo un caso di sesso maschile residente in Calabria. La casistica non include 3 casi maschi perché arruolati per la seconda volta al follow-up ; inoltre 1 caso M e relativo controllo (moglie) è stato escluso in quanto affetto da altro tipo di Sarcoma. I controlli sono stati familiari consanguinei e/o non consanguinei ( moglie, marito, genero ecc..) di casi in cura presso le Università di Catania e Messina oppure già arruolati negli studi precedenti dalla LILT di Ragusa, alcuni dei quali deceduti. Risultati: Dal confronto tra Controlli HHV8 positivi (n°11) vs. Controlli HHV8 negativi (n°16) non sono state individuate differenze significative a eta’, sesso, livello d’istruzione, occupazione e varie esposizione ambientali (età : >64 vs

Burnout syndrome is a condition that may occur not only for staff in human service sectors/jobs, involving intensive interactions with others, but also people that are engaged in activities psychologically similar to work, such as students. Radiographers in training suffer double stress, first linked to the status of being a university student and secondly as early career workers who have relations with the public of the health system. Aim of our study was to investigate the prevalence and levels of burnout syndrome among radiographers in training in an University Hospital.In order to gain a better understanding of nature of the burnout syndrome a modified version of Maslach's questionnaire (investigating three areas: emotional exhaustion, depersonalization and reduced personal accomplishment), was administered to two groups selected from a cohort of radiographers University students (from the 1st and 3rd year of course).62/62 questionnaires were completed, returned and analysed. The research outcomes highlighted a clear difference between group I and group II in relation to one of the three areas of the Maslach's model: "depersonalization" (p0.001). Moreover, the third year students group presented a significantly higher risk to develop burnout. On the other hand, the third area examined, the reduced personal accomplishment domain, was surprisingly high even among first-year students.The research outcomes seem to suggest that the presence of emotional burnout, or risk of burnout, among third year students is statistically significant, compared to the first year students, being a significant aspect to investigate further in this class of students. It is also assumed that the high degree of "past failures, feeling of self failure" observed among all student, is related to a feeling of poor efficacy and poor self worth that appear to grow from the beginning of the course. This topic needs further investigation in the light of the result of this study.Scopo. Il burnout è una sindrome che può interessare operatori e professionisti che sono impegnati quotidianamente e ripetutamente in attività che implicano le relazioni interpersonali, lavorando a stretto contatto con il pubblico, ma anche persone impegnate in attività psicologicamente simili al lavoro, come gli studenti. Gli studenti di tecniche di radiologia sono sottoposti ad un doppio stress, sia a quello legato allo stato di studente, che a quello legato allo stato di lavoratore a contatto con il pubblico durante il loro periodo di tirocinio professionale. Scopo del nostro studio è stato quello di investigare la prevalenza della sindrome da burnout tra i tecnici di radiologia in formazione in un Ospedale Universitario. Metodi. Per ottenere una migliore comprensione della natura della sindrome da burnout è stato somministrata una versione modificata del questionario di Maslach (che investiga 3 aree: esaurimento emotivo, depersonalizzazione e ridotta realizzazione personale) a 2 sottogruppi selezionati da una coorte di studenti Universitari in tecniche di radiologia (del 1° e 3° anno di corso). Risultati. Sono stati completati, consegnati ed analizzati 62/62 questionari. I risultati della ricerca hanno evidenziato una chiara differenza tra i 2 gruppi in una delle tre aree del modello di Maslach: la “depersonalizzazione”. Inoltre, la terza area esaminata, la ridotta realizzazione personale, è risultata sorprendentemente elevata anche tra gli studenti di primo anno. Conclusioni. I risultati della ricerca suggeriscono che la presenza di burnout emozionale, o il rischio di burnout, tra gli studenti del terzo anno sia statisticamente significativa se confrontata con i risultati degli studenti del primo anno di corso, rendendolo un aspetto da investigare più a fondo in questa classe di studenti. Si suppone che l’alto livello di senso di fallimento personale osservato tra gli studenti, sia correlato con un sentimento di scarsa autostima che sembra crescere dall’inizio del corso.

Aim. The aim of this study was to explore thè defense mechanisms of people with moderate and severe obesity. In fact, thè defensive structure is an effective predictor for thè best management of thè disease. Methods. 204 people (164 F-40 M) bave been recruited: 40 with BMI between 30 and 34.9, with moderate obesity, 36 with BMI between 35 and 39.9, with severe obesity, and 128 with BMI>40, with serious obesity, ali of them pertaining to thè clinic for obesity treatment at University Hospital of Palermo. Ali subjects were administered thè Defense Mechanisms Inventory (DMI), a type of reactive that explores defense mechanisms. The psychiatric comorbidity was excluded by thè DSM (SCIDI and II).semi-structured interview. Resiilts. The DMI profile of thè group of obese people is significantly different from normative people. In fact, thè obese group uses a typically defensive pattern that leads to a faulty management of aggressiveness, either transformed into its opposite (conflict denial-avoidance, thè inability to tolerate negative emotions) or redirected towards themselves (low self-esteem, self-devaluation and idealization of others). Age factors, sex and degree of obesity affect thè defensive shape. Discussion and conclusion. The exploration of thè defense mechanisms in our group of obese people provides some important guidelines for treatment strategies.The prevailing use, in fact, of some specific defensive patterns is both a significant predictor of thè person's inability to adhere to thè cure and, consequently, of thè need to introduce treatment aids which, in some way, can bypass thè subject's compliance.

The aim of this study was to evaluate the level of edentulousness and the prosthetic treatment need in a sample of the over 18-year-old inhabitants of Palermo (Italy). A stratified sample of 385 subjects (183 female and 202 male) was taken to represent the population of the city. Each subject included in the study was examined to record the level of edentulousness (complete edentulousness, partial edentulousness, intact dentition) and the level of denture wearing. Requirement for repair of dentures was recorded according to the marginal fitting for fixed dentures, and to the extension, stability and retention for removable dentures. Complete edentulousness of one or both arches was present in 4,6% of the studied population, whereas 184 (34.8%) of the sample population had intact dentition. Partial edentulousness was present in 60.6% of the subjects surveyed, but only the 45.9% of these was wearing dentures. Loss of structural integrity or incongruous marginal fitting was found in the 37.9% of fixed dentures. The majority of partial and complete removable dentures (74.5%) did not ever undergo relining, and the 51.7% of them needed relining or replacement. Statistical analysis (chi-square test) showed that the level of edentulousness was correlated with age; similarly, the frequency of dental visits significantly impacted on the number of missing tooth (P0.01). The results of the present study show that the adult inhabitants of Palermo had high level of partial edentulousness and low level of denture wearing. The majority of existing removable dentures required relining or replacement.

We aimed to evaluate if in oral squamous cell carcinoma (OSCC) there is a relationship between histological grading (HG), TNM clinical stage and HPV infection; and to study the performance of fuzzy logic compared to traditional statistics, in the analysis of HPV status and correlates of OSCC. In cross-sectional analysis, the study group comprised 63 patients (mean age 68.89 years (SD ± 11.78), range (32–93); males 28 (44.4%), females 35 (55.6%)) with OSCC histologically diagnosed. HPV-DNA was studied in exfoliated oral epithelial cells by nested PCR (MY09/MY11 and GP5+/GP6+ primers). Data were analysed in parallel by traditional statistics with multivariate analysis and a fuzzy logic (FL) technique (membership functions as input, the ANFIS methodology, and the Sugeno’s model of first order). HPV infection was detected in 24/63 (38.1%) of OSCC, as being HPV+ve 14/36 (38.9%) in G1, 7/18 (38.9%) in G2, and 3/9 (33.3%) in G3; HPV+ve 8/33 (24.2%) in Stage I, 9/12 (75.0%) in Stage II, 6/11(54.5%) in Stage III, and 1/7 (14.3%) in Stage IV. In both methods of analysis, no significantly increased risk of HPV infection was found for any HG score; whereas, TNM stage II was significantly associated to HPV infection (p = 0.004; OR = 9.375 (95% CI = 2.030:43.30); OR0 = 11.148 (95% CI = 1.951:43.30)), and, in particular, to primary tumour size T2 (p = 0.0036; OR = 7.812 (95% CI = 1.914:31.890); OR0 = 9.414 (95% CI = 1.846:48.013)); FL (% of prevision: 79.8; Root MeanSquare Error (RMSE): 0.29). No association was found between HPV infection and any demographical variable. Our findings show an association between HPV infection with TNM (stage II – T2), but not with histological grading of OSCC. Also, FL seems to be an additional effective tool in analysing the relationship of HPV infection with correlates of OSCC. c 2005 Elsevier Ltd. All rights reserved.

Objective: the purpose of this study was to compare the technical efficiency of Italian hospitals at a regional level and to examine if differences could be explained by organisational and contextual factors. Technical efficiency was defined as the ability of the operating units evaluated to use optimal resource levels for their level of output.Methods: the effect of external factors was explored through a second stage Data Envelopment Analysis (DEA). Efficiency scores were calculated for each hospital using the DEA method (Stage I). Through Tobit regression analysis, the estimated efficiency scores were regressed against a set of organisational and contextual characteristics beyond managerial control, which reflected differences in the population demographics and regional health expenditure (Stage II). Stage I and Stage II efficiency scores were compared in order to indirectly assess managerial contribution in relation to hospital efficiency.Results: the highest efficiency (M±SD) was observed in hospitals in the North-West (75.7±15.1), followed by those in the North-East (75.5±15.1), Central Italy (73.9±16.4) and then Southern Italy (70.6±17.9). Hospital Trusts (HTs) were shown to be more technically efficient than Local Public Hospitals (LPHs). Organisational and contextual indicators were statistically significantly different at Tobit regression analysis for HTs and LPHs. Emilia Romagna and Lombardia were the regions whose management contributed to increased efficiency.Conclusions: in our study, the distribution of regions according to technical efficiency only partly reflected the North-South gradient shown by other studies regarding the gap of expenditure. The important role of organisation and environment in establishing efficiency differences among hospitals was demonstrated.

Objectives The main purpose of this longitudinal study was to elucidate the impact of external job mobility, due to a change of employer, on mental health. Methods A cohort of Belgian employees from the IDEWE occupational medicine registry was followed-up for twenty-seven years, from 1993 to 2019. The use of drugs for neuropsychological diseases was considered as an objective indicator of mental health. The covariates were related to demographic, physical, behavioural characteristics, occupational and work-related risks. Propensity scores were calculated with a Cox regression model with time-varying covariates. The PS matching was used to eliminate the systematic differences in subjects’ characteristics and to balance the covariates’ distribution at every time point. Results The unmatched sample included 11,246 subjects, with 368 (3.3%) that changed their job during the baseline year and 922 (8.2%) workers that left their employer during the follow-up. More than half of the matched sample were males, were aged less than 38 years old, did not smoke, were physically active, and normal weighted, were not exposed to shift-work, noise, job strain or physical load. A strong association between job mobility and neuropsychological treatment was found in the matched analysis (HR = 2.065, 95%CI = 1.397–3.052, P-value P-value Conclusions Our study found that workers with external job mobility have a doubled risk of treatment with neuropsychological medication, compared to workers without job mobility.

Background: To assess inter-reader agreement for US BI-RADS descriptors using S-Detect: a computer-guided decision-making software assisting in US morphologic analysis. Methods: 73 solid focal breast lesions (FBLs) (mean size: 15.9mm) in 73 consecutive women (mean age: 51years) detected at US were randomly and independently assessed according to the BI-RADS US lexicon, without and with S-Detect, by five independent reviewers. US-guided core-biopsy and 24-month follow-up were considered as standard of reference. Kappa statistics were calculated to assess inter-operator agreement, between the baseline and after S-Detect evaluation. Agreement was graded as poor (≤ 0.20), moderate (0.21–0.40), fair (0.41–0.60), good (0.61–0.80), or very good (0.81–1.00). Results: 33/73 (45.2%) FBLs were malignant and 40/73 (54.8%) FBLs were benign. A statistically significant improvement of inter-reader agreement from fair to good with the use of S-Detect was observed for shape (from 0.421 to 0.612) and orientation (from 0.417 to 0.7) (p < 0.0001) and from moderate to fair for margin (from 0.204 to 0.482) and posterior features (from 0.286 to 0.522) (p < 0.0001). At baseline analysis isoechoic (0.0485) and heterogeneous (0.1978) echo pattern, microlobulated (0.1161) angular (0.1204) and spiculated (0.1692) margins and combined pattern (0.1549) for posterior features showed the worst agreement rate (poor). After S-Detect evaluation, all variables but isoechoic pattern showed an agreement class upgrade with a statistically significant improvement of inter-reader agreement (p < 0.0001). Conclusions: S-Detect significantly improved inter-reader agreement in the assessment of FBLs according to the BI-RADS US lexicon but evaluation of margin and echo pattern needs to be further improved, particularly isoechoic pattern.

With the ageing population, equitable access to medical care has proven to be paramount for the effective and efficient management of all diseases. Healthcare access can be hindered by cost barriers for drugs or exams, long waiting lists or difficult access to the place where the needed healthcare service is provided. The aim of this paper is to investigate whether the probability of facing one of these barriers varies among individuals with different socio-economic status and care needs, controlling for geographical variability. Methods. The sample for this study included 9629 interviews with Italian individuals, aged 15 and over, from the second wave (2015) of the European Health Interview Survey, which was conducted in all EU Member States. To model barriers to healthcare, two-level variance components of logistic regression models with a nested structure given by the four Italian macro-areas were considered. Results. Of the barriers considered in this study, only two were found to be significantly associated with healthcare utilization. Specifically, they are long waiting lists for specialist service accessibility (adjOR = 1.20, 95% CI (1.07; 1.35)) and very expensive exams for dental visit accessibility (adjOR = 0.84, 95% CI (0.73; 0.96)). Another important result was the evidence of an increasing north–south gradient for all of the considered barriers. Conclusion. In Italy, healthcare access is generally guaranteed for all of the services, except for specialist and dental visits that face a waiting time and financial barriers. However, barriers to healthcare were differentiated by income and sex. The north–south gradient for healthcare utilization could be explained through the existing differences in organizational characteristics of the several regional healthcare services throughout Italy.

To compare microvascular flow imaging (MVFI) to conventional Color-Doppler (CDI) and Power-Doppler (PDI) imaging in the detection of vascularity of Focal Breast Lesions (FBLs). A total of 180 solid FBLs (size: 3.5–45.2 mm) detected in 180 women (age: 21–87 years) were evaluated by means of CDI, PDI, and MVFI. Two blinded reviewers categorized lesion vascularity in absent or present, and vascularity pattern as (a) internal; (b) vessels in rim; (c) combined. The presence of a “penetrating vessel” was assessed separately. Differences in vascularization patterns (chi2 test) and intra- and inter-observer agreement (Fleiss method) were calculated. ROC analysis was performed to assess performance of each technique in differentiating benign from malignant lesions. About 103/180 (57.2%) FBLs were benign and 77/180 (42.8%) were malignant. A statistically significant ( p

The key role of statistical modeling in epidemiology and public health is unquestionable [...]

Background. Craniofacial anomalies and minor neurological dysfunction (MNDs) have been identified, in literature, as risk factors for neurodevelopmental disorders. They represent physical indicators of embryonic development suggesting a possible contributory role of complications during early, even pre-conceptional, phases of ontogeny in autism spectrum disorders (ASD). Limited research has been conducted about the co-occurrence of the two biomarkers in children with ASD. This study investigates the associative patterns of cranio-facial anomalies and MNDs in ASD children, and whether these neurodevelopmental markers correlate with intensity of ASD symptoms and overall functioning. Methods. Caucasian children with ASD (n = 33) were examined. Measures were based on five anthropometric cranio-facial indexes and a standardized and detailed neurological examination according to Touwen. Relationships between anthropometric z-scores, MNDs and participant characteristics (i.e., age, cognitive abilities, severity of autistic symptoms measured using the Childhood Autism Rating Scale (CARS) checklist) were assessed. Results. With respect to specific MNDs, significant positive correlations were found between Cephalic Index and Sensory deficits (p-value &lt, 0.001), which did not correlate with CARS score. Importantly, CARS score was positively linked with Intercanthal Index (p-value &lt, 0.001), and negatively associated with posture and muscle tone (p-value = 0.027) and Facial Index (p-value = 0.004). Conclusion. Our data show a link between a specific facial phenotype and anomalies in motor responses, suggesting early brain dysmaturation involving subcortical structures in cerebro-craniofacial development of autistic children. This research supports the concept of a &ldquo, social brain functional morphology&rdquo, in autism spectrum disorders.