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The importance of veteran trees is well recognised nowadays. The sudden breakage of some of these plants in Trentino (Italy), mainly due to Kretzschmaria deusta, prompted a survey of the veteran beeches reported in this area. Visual tree assessment was carried out in 40 sites with either single trees or groups of beeches, for a total of 115 trees evaluated. Most trees showed serious defects or problems in need of management and 19 had a high level of risk of breakage because of the presence of several structural problems. The presence of K. deusta was recorded on 50.4% of the examined trees. The pathogen was also identified in the proximity of investigated trees at 29 sites. Laboratory tests confirmed the identity of K. deusta by microbiological and molecular approaches and also identified Cosmopora berkeleyana as mycoparasite on K. deusta fruiting bodies. Isolates obtained from declining trees and old stumps showed the same pattern of growth at different temperatures. The risk evaluation emphasised how the fungus could affect the survival and safety of these veteran trees; this was confirmed by the collapse of four of the investigated trees in the last years. Therefore, K. deusta, which has been considered as a facultative parasite up to now, could play a more incisive role both in the decline of old beech trees and the natural evolution of aging beech woods.

Vincenzo Monda,1 Francesco Sessa,2 Maria Ruberto,3 Marco Carotenuto,4 Gabriella Marsala,5 Marcellino Monda,1 Maria Teresa Cambria,6 Marinella Astuto,7 Alfio Distefano,6 Giovanni Messina2 1Department of Experimental Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, Caserta 81100, Italy; 2Department of Clinical and Experimental Medicine, University of Foggia, Foggia 71121, Italy; 3CDR Santa Maria del Pozzo, Naples 80049, Italy; 4Clinic of Child and Adolescent Neuropsychiatry, Department of Mental Health, Physical and Preventive Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, Caserta 81100, Italy; 5Struttura Complessa di Farmacia, Azienda Ospedaliero-Universitaria, Ospedali Riuniti di Foggia, Foggia 71121, Italy; 6Section of Medical Biochemistry, Department of Biomedical and Biotechnological Sciences, University of Catania, Catania 95123, Italy; 7Azienda Ospedaliera “Policlinico Vittorio Emanuele”, U.O. di Anestesia e Terapia Intensiva, Catania 95123, ItalyCorrespondence: Francesco SessaDepartment of Clinical and Experimental Medicine, University of Foggia, Foggia 71122, ItalyTel +39 0881 736926Email francesco.sessa@unifg.itBackground: Aerobic exercise can greatly assist in reducing collateral effects of metabolic syndrome (MetS). Moreover, aerobic exercise is associated with sympathetic activation and adaptive responses to sustain muscle engagement, changes in the release of Orexin A, a pleiotropic neuropeptide.Aim: The aim of this study was to analyze the beneficial effects of aerobic exercise without dietary changes, in a cohort of MetS subjects, focusing on the role of sympathetic and orexinergic activity. Several blood parameters linked to MetS ROS production, heart rate, galvanic skin response, d-ROM test, and Orexin A serum levels were evaluated in ten males with MetS (BMI 30– 34.9) before and after a period of 6 months of aerobic exercise compared to ten healthy subjects.Methods: Ten male subjects (aged 54 ± 4.16) with MetS (MetS group) and ten healthy males (aged 49.7 ± 2.79, Healthy group) were told about the study protocol and possible risks, signed the informed consent, and voluntarily participated in the study. Several blood parameters were evaluated in the two tested groups and were re-evaluated in the MetS group after 6 months of training (MetS6M group). The training protocol consisted of more than 30 min/day of walking (average speed of 4.5 km/h) and 3 days/week of aerobic activities (jogging under heart rate control – 120– 140 bpm for 45 min).Results: The results showed that exercise induced a significant increase in GSR and plasma Orexin A but no significant increase in d-ROM values. Significant decreases in the serum ALT enzyme, triglycerides, and total cholesterol were found, while the HDL levels were significantly higher. Finally, a significant reduction of BMI and resting HR were reported.Conclusion: The results of this study confirm that physical activity is associated with sympathetic activation, having a pivotal role against adverse effects linked to MetS. Moreover, this study demonstrates that, in patients with MetS, Orexin A is involved in hormonal adaptations to exercise.Keywords: metabolic syndrome, MetS, Orexin A, body mass index, BMI, heart rate, HR, cholesterol, physical activity

Raffaele Sperandeo,1,2,* Vincenzo Monda,3,* Giovanni Messina,4 Marco Carotenuto,5 Nelson Mauro Maldonato,1,2 Enrico Moretto,1,2 Elena Leone,1,2 Vincenzo De Luca,6 Marcellino Monda,3 Antonietta Messina3 1Department of Human Sciences, Università Della, Basilicata, 2School of Integrated Gestaltic Psychotherapy, Torre Annunziata, 3Department of Experimental Medicine, Section of Human Physiology and Unit of Dietetic and Sport Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, Naples, 4Department of Clinical and Experimental Medicine, University of Foggia, Foggia, 5Department of Mental Health, Physical and Preventive Medicine, Clinic of Child and Adolescent Neuropsychiatry, Università degli Studi della Campania “Luigi Vanvitelli”, Naples, Italy; 6Department of Psychiatry, University of Toronto, Toronto, Canada *These authors contributed equally to this work Abstract: Dissociative phenomena are common among psychiatric patients; the presence of these symptoms can worsen the prognosis, increasing the severity of their clinical conditions and exposing them to increased risk of suicidal behavior. Personality disorders as long duration stressful experiences may support the development of dissociative phenomena. In 933 psychiatric outpatients consecutively recruited, presence of dissociative phenomena was identified with the Dissociative Experience Scale (DES). Dissociative phenomena were significantly more severe in the group of people with mental disorders and/or personality disorders. All psychopathologic traits detected with the symptom checklist-90-revised had a significant correlation with the total score on the DES. Using total DES score as the dependent variable, a linear regression model was constructed. Mental and personality disorders which were associated with greater severity of dissociative phenomena on analysis of variance were included as predictors; scores from the nine scales of symptom checklist-90-revised, significantly correlated to total DES score, were used as covariates. The model consisted of seven explanatory variables (four factors and three covariates) explaining 82% of variance. The four significant factors were the presence of borderline and narcissistic personality disorder, substance abuse disorders and psychotic disorders. Significant covariates were psychopathologic traits of anger, psychoticism and obsessiveness. This study, confirming Janet’s theory, explains that, mental disorders and psychopathologic experiences of patients can configure the chronic stress condition that produces functional damage to the adaptive executive system. The symptoms of dissociative depersonalization/derealization and dissociative amnesia can be explained, in large part, through their current and previous psychopathologic experiences. Keywords: mental disorders, personality disorders, amnesia, depersonalization/derealization

OBJECTIVE: The aim of this study is to assess whether the touch of osteopathic manipulative treatment (OMT) can affect the endogenous production of oxytocin in fullterm pregnant women and the assessment of well-being following the treatment. PATIENTS AND METHODS: In this study have been enrolled 57 pregnant women at full-term pregnancy (37th-41st week) for evaluation of the concentration of salivary oxytocin 2 minutes before and 2 minutes after a single session of OMT by an osteopath lasting for 30 minutes. Pre-OMT and post-OMT saliva samples were collected with the use of Salivette® salivary swabs. 7 salivary swabs were excluded from the analysis. 50 samples were analyzed with an appropriate ELISA kit. RESULTS: The mean OT salivary concentration pre-OMT was 89.98±16.39, and post-OMT was 100.60±19.13 tends to increase with p=0.0000051. In multivariate analysis, two subgroups show interesting data in the mean difference in OT salivary concentration post-OMT: women with painful contractions (p=0.06) and women under 35 years (p=0.09). CONCLUSIONS: The results of this study demonstrate that the effectiveness of OMT-increasing endogenous oxytocin is statistically significant in full-term pregnant women. The sensation of well-being found in most women indicates that there has been a predominantly central rather than peripheral oxytocin release after OMT. [ABSTRACT FROM AUTHOR]

Vincenzo Monda,1,* Marco La Marra,1,* Raffaella Perrella,2 Giorgio Caviglia,2 Alessandro Iavarone,3 Sergio Chieffi,1 Giovanni Messina,4 Marco Carotenuto,5 Marcellino Monda,1 Antonietta Messina1 1Department of Experimental Medicine, Section of Human Physiology, University of Campania Luigi Vanvitelli, Naples, Italy; 2Neurological and Stroke Unit, CTO Hospital, AORN ‘‘Ospedali dei Colli’’, Naples, Italy; 3Department of Psychology, University of Campania Luigi Vanvitelli, Naples, Italy; 4Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy; 5Clinic of Child and Adolescent Neuropsychiatry, Department of Mental Health, Physical and Preventive Medicine, University of Campania Luigi Vanvitelli, Naples, Italy *These authors contributed equally to this work Abstract: Recent findings showed that obesity represents an additional risk factor to developing brain illness such as cognitive impairments and psychopathological disorders. However, some benefits of overweight in the elderly have been identified and an “obesity paradox” has been shown. Currently, it is still unknown how obesity and brain functioning could be linked, and the process by which body fat independently injures cognitive abilities and psychological well-being remains unclear. To establish the independent role of obesity on cognitive abilities and mental health, clarifying the role played by several factors and understanding their interaction is essential. In this review, we discuss the relationship between obesity and brain illness and underline the role played by confounders and other covariates to determine this link. Keywords: obesity, cognitive decline, mood disorders, obesity paradox

Annalisa Panico,1 Giovanni Messina,2,3 Gelsy Arianna Lupoli,1 Roberta Lupoli,1 Marianna Cacciapuoti,1 Fiorenzo Moscatelli,2 Teresa Esposito,3 Ines Villano,3 Anna Valenzano,2 Vincenzo Monda,3 Antonietta Messina,3 Francesco Precenzano,4 Giuseppe Cibelli,2 Marcellino Monda,3 Giovanni Lupoli1 1Department of Clinical Medicine and Surgery, University of Napoli Federico II, Naples, Italy; 2Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy; 3Department of Experimental Medicine, Second University of Naples, Naples, Italy; 4Department of Mental and Physical Health, and Preventive Medicine, Child and Adolescent Neuropsychiatry Unit, Second University of Naples, Naples, Italy Objective: Polycystic ovary syndrome (PCOS) is characterized by phenotypic heterogeneity and has a wide variety of consequences. Approximately half of women with PCOS are overweight or obese, and their obesity may be a contributing factor to PCOS pathogenesis through different mechanisms. The aim of this study was to evaluate if PCOS alone affects the patients’ quality of life and to what extent obesity contributes to worsen this disease. Design: To evaluate the impact of PCOS on health-related quality-of-life (HRQoL), 100 Mediterranean women with PCOS (group A), 50 with a body mass index (BMI) >25 kg/m2 (group A1) and 50 with BMI 25 (A1) showed a significant and more marked reduction in scores, suggesting a lower quality of life, compared with controls (B) and with normal-weight PCOS patients (A2). Conclusion: PCOS is a complex disease that alone determines a deterioration of HRQoL. The innovative use of these psychometric questionnaires in this study, in particular the PCOS questionnaire, has highlighted that obesity has a negative effect on HRQoL. It follows that a weight decrease is associated to phenotypic spectrum improvement and relative decrement in psychological distress. Keywords: polycystic ovary syndrome, obesity, normal-weight, health-related quality-of-life, psychological disturbances

Introduction. The COVID-19 pandemic has had a major impact on the Healthcare System, changing the patterns of Emergency Department access. In fact, accesses for trauma and less severe cases decreased significantly. This decline has generally been attributed to both the effects of the lockdown, imposed by the government, and the fear of being infected by SARS-CoV-2 in the hospital. However, the correlation between these elements is not yet clear, since the accesses to the Emergency Department did not increase either at the end of the lockdown or in the summer when the epidemiological situation was more favorable. Aim: To evaluate the association between trends of Emergency Department accesses and COVID-19 incidence in 2020. Methods. Data on Emergency Department accesses, by month and severity triage code, from 14 hospitals in southeastern Tuscany (Italy) were obtained from hospitals' data warehouse. Official data on new cases of COVID-19 infection were used to calculate incidence. Hospitals were classified into 4 categories. Differences in Emergency Department access by month, triage code, and hospital type were investigated using Kruskal-Wallis analysis. Association between Emergency Department accesses and COVID-19 incidence was evaluated using a random-effect panel data analysis, adjusting for hospital type and triage code. Results. The trend of 268,072 Emergency Department accesses decreases substantially at the first pandemic peak; thereafter, it increased and decreased again until the minimum peak in November 2020. COVID-19 incidence appeared to be overlapping with an inverse direction. Monthly differences were significant (p<0.01) except for most severe codes. There was a significant inverse association between Emergency Department accesses and COVID-19 incidence (Coef. =-0.074, p<0.001) except for most severe cases (triage code 1: Coef. =-0.028, p=0.154). Conclusion. Emergency Department admissions trend followed the COVID-19 incidence, except for the most severe cases. Fear of infection seems to discourage patients from accessing Emergency Department for illnesses perceived as not serious. [ABSTRACT FROM AUTHOR]