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Using Proof-Schemes Combined, our extension of Harel and Sowder’s Proof-Schemes taxonomy, we introduce the nascent deductive proof schemes construct (proof-scheme combinations that contain elements of deductive mathematical reasoning) and present evidence of these in written responses to ten items of 85 Year 9 (age 14–15) secondary students. We capture these students’ first encounters with proof in an educational context (mixed-ability, state schools in Greece) where proof is present in lessons and key national examinations. In previous analyses, we identified evidence in the students’ responses of Harel and Sowder’s seven proof schemes and of the eight proof-scheme combinations from our Proof-Schemes Combined taxonomy. Here, we present evidence – found in 383 out of 850 student responses – of five of the fifteen proof schemes that were nascent deductive proof schemes. Our findings contribute to non-deficit discourses about students’ mathematical reasoning potential and provide evidence in favour of proof readiness in early adolescence. [ABSTRACT FROM AUTHOR]

Simple Summary: Cancer pain is often inadequately treated, as shown by several clinical studies. This problem has been confirmed in different clinical settings but the reasons for this phenomenon are unclear. Furthermore, little evidence is available on the adequacy of pharmacological pain management in patients undergoing radiotherapy. Moreover, studies investigating possible predictors of inadequate pain management reported contradictory results. Therefore, in this analysis, we evaluated a large population of cancer patients undergoing radiotherapy. We recorded, similarly to previous studies, a 45% rate of patients with inadequate analgesic therapy. Furthermore, evaluating the characteristics of patients with inadequate analgesic treatment, we noted that the subjects with better general conditions or better prognostic factors are those most frequently receiving inadequate drug therapy. Aim: The frequent inadequacy of pain management in cancer patients is well known. Moreover, the quality of analgesic treatment in patients treated with radiotherapy (RT) has only been rarely assessed. In order to study the latter topic, we conducted a multicenter, observational and prospective study based on the Pain Management Index (PMI) in RT Italian departments. Methods: We collected data on age, gender, tumor site and stage, performance status, treatment aim, and pain (type: CP—cancer pain, NCP—non-cancer pain, MP—mixed pain; intensity: NRS: Numeric Rating Scale). Furthermore, we analyzed the impact on PMI on these parameters, and we defined a pain score with values from 0 (NRS: 0, no pain) to 3 (NRS: 7–10: intense pain) and an analgesic score from 0 (pain medication not taken) to 3 (strong opioids). By subtracting the pain score from the analgesic score, we obtained the PMI value, considering cases with values < 0 as inadequate analgesic prescriptions. The Ethics Committees of the participating centers approved the study (ARISE-1 study). Results: Two thousand one hundred four non-selected outpatients with cancer and aged 18 years or older were enrolled in 13 RT departments. RT had curative and palliative intent in 62.4% and 37.6% patients, respectively. Tumor stage was non-metastatic in 57.3% and metastatic in 42.7% of subjects, respectively. Pain affected 1417 patients (CP: 49.5%, NCP: 32.0%; MP: 18.5%). PMI was < 0 in 45.0% of patients with pain. At multivariable analysis, inadequate pain management was significantly correlated with curative RT aim, ECOG performance status = 1 (versus both ECOG-PS3 and ECOG- PS4), breast cancer, non-cancer pain, and Central and South Italy RT Departments (versus Northern Italy).Conclusions: Pain management was less adequate in patients with more favorable clinical condition and stage. Educational and organizational strategies are needed in RT departments to reduce the non-negligible percentage of patients with inadequate analgesic therapy. [ABSTRACT FROM AUTHOR]

Introduction: An education strategy was employed in our department to increase the rate of patients with uncomplicated painful bone metastases undergoing single fractionation radiotherapy (SFRT). The purpose of this report is to analyze the results of this strategy over a 5 year period. Materials and Methods: In January 2015, two meetings were organized in our department. In the first, data from an audit on the current SFRT rate were shown. In the second, evidence of SFRT efficacy in the relief of pain from uncomplicated bone metastases was presented. In addition, during the weekly discussion of clinical cases, the opportunity to use the SFRT was systematically recalled. Using our institutional database, all patients treated with radiotherapy for uncomplicated painful bone metastases in the period between 2014 (year considered as a reference) and 2019 were retrieved. Data regarding treatment date (year), radiotherapy fractionation, and tumor, patients, and radiation oncologists characteristics were collected. Results: A total of 627 patients were included in the analysis. The rate of patients undergoing SFRT increased from 4.0% in 2014 to 63.5% in 2019 (p < 0.001). At multivariable analysis, the delivery of SFRT was significantly correlated with older patients age (>80 years), lung cancer as the primary tumor, treatment prescribed by a radiation oncologist dedicated to palliative treatments, and treatment date (2014 vs 2015–2019). Conclusions: This retrospective single-center analysis showed that a simple but intensive and prolonged departmental education strategy can increase the rate of patients treated with SFRT by nearly 16 times. [ABSTRACT FROM AUTHOR]

Introduction: An education strategy was employed in our department to increase the rate of patients with uncomplicated painful bone metastases undergoing single fractionation radiotherapy (SFRT). The purpose of this report is to analyze the results of this strategy over a 5 year period. Materials and Methods: In January 2015, two meetings were organized in our department. In the first, data from an audit on the current SFRT rate were shown. In the second, evidence of SFRT efficacy in the relief of pain from uncomplicated bone metastases was presented. In addition, during the weekly discussion of clinical cases, the opportunity to use the SFRT was systematically recalled. Using our institutional database, all patients treated with radiotherapy for uncomplicated painful bone metastases in the period between 2014 (year considered as a reference) and 2019 were retrieved. Data regarding treatment date (year), radiotherapy fractionation, and tumor, patients, and radiation oncologists characteristics were collected. Results: A total of 627 patients were included in the analysis. The rate of patients undergoing SFRT increased from 4.0% in 2014 to 63.5% in 2019 (p < 0.001). At multivariable analysis, the delivery of SFRT was significantly correlated with older patients age (>80 years), lung cancer as the primary tumor, treatment prescribed by a radiation oncologist dedicated to palliative treatments, and treatment date (2014 vs 2015-2019). Conclusions: This retrospective single-center analysis showed that a simple but intensive and prolonged departmental education strategy can increase the rate of patients treated with SFRT by nearly 16 times. [ABSTRACT FROM AUTHOR]

Non-mathematics specialists' competence and confidence in mathematics in their disciplines have been highlighted as in need of improvement. We report from a collaborative, developmental research project which explores the conjecture that greater integration of mathematics and biology in biology study programs, for example through engaging students with Mathematical Modeling (MM) activities, is one way to achieve this improvement. We examine the evolution of 12 first-semester biology students' mathematical discourse as they engage with such activities in four sessions which ran concurrently with their mandatory mathematics course and were taught by a mathematician with extensive experience with MM. The sessions involved brief introductions to different aspects of MM, followed by small-group work on tasks set in biological contexts. Our analyses use the theory of commognition to investigate the tensions between ritualized and exploratory participation in the students' MM activity. We focus particularly on a quintessential routine in MM, assumption building: we trace attempts which start from ritualized engagement in the shape of "guesswork" and evolve into more productively exploratory formulations. We also identify signs of persistent commognitive conflict in the students' activity, both intra-mathematical (concerning what is meant by a "math task") and extra-mathematical (concerning what constitutes a plausible solution to the tasks in a biological sense). Our analyses show evidence of the fluid interplay between ritualized and exploratory engagement in the students' discursive activity and contribute towards what we see as a much needed distancing from operationalization of the commognitive constructs of ritual and exploration as an unhelpfully dichotomous binary. [ABSTRACT FROM AUTHOR]

In this paper, we propose an enriched and extended application of Harel and Sowder’s proof schemes taxonomy that can be used as a diagnostic tool for characterizing secondary students’ emergent learning of proof and proving. We illustrate this application in the analysis of data collected from 85 Year 9 (age 14-15) secondary students. We capture these students’ first encounters with proof and proving in an educational context (mixed ability, state schools in Greece) where mathematical proof is explicitly present in algebra and geometry lessons and where proving skills are typically expected, and rewarded, in key national examinations. We analyze student written responses to six questions, soon after the students had been introduced to proof and we identify evidence of six of the seven proof schemes proposed by Harel and Sowder as well as a further eight combinations of the six. We observed these combinations often within the response of the same student and to the same item. Here, we illustrate the eight combinations and we claim that a dynamic use of the proof schemes taxonomy that encompasses sole and combined proof schemes is a potent theoretical and pedagogical tool for mapping students’ multi-faceted and evolving competence in, and appreciation for, proof and proving. [ABSTRACT FROM AUTHOR]

We examine teachers’ use of resources as they prepare to teach the topic of numerical series of real numbers, in order to identify how their personal relationship with mathematical content—and its teaching—interacts with their use of a commonly used textbook. We describe this interplay between textbook and personal relationship, a term coined in the Anthropological Theory of the Didactic (ATD, Chevallard, 2003), in terms of documentation work (resources, aims, rules of action, operational invariants), a key construct from the documentational approach (DA, Gueudet & Trouche, in Educational Studies in Mathematics, 71, 199-218, 2009). We do so in the case of five post-secondary teachers who use the same textbook as a main resource for teaching the topic. Documentational analysis of interviews with the teachers led to the identification of their aims and rules of action (the what and how of their resource use as they organise their teaching of the topic) as well as the operational invariants (the why for this organisation of their teaching). We describe the teachers’ documentation work in two sets of aims/rules of action: scaffolding mathematical content (series as a stepping stone to learning about Taylor polynomials and Maclaurin series), and organising student learning about series through drill exercises, visualisation, examples, and applications. Our bridging (networking) of theoretical constructs originating in one theoretical framework (personal relationship, ATD) with the constructs of a different, yet compatible, framework (documentation work, DA) aims to enrich the latter (teachers’ documentation work) with the individual agency (teachers’ personal relationships with the topic) provided by the former. [ABSTRACT FROM AUTHOR]

This paper is a commentary on the classroom interventions on the teaching and learning of proof reported in the seven empirical papers in this special issue. The seven papers show potential to enhance student learning in an area of mathematics that is not only notoriously difficult for students to learn and for teachers to teach, but also critically important to knowing and doing mathematics. Although the seven papers, and the intervention studies they report, vary in many ways-student population, content domain, goals and duration of the intervention, and theoretical perspectives, to name a few-they all provide valuable insight into ways in which classroom experiences might be designed to positively influence students' learning to prove. In our commentary, we highlight the contributions and promise of the interventions in terms of whether and how they present capacity to change the classroom culture, the curriculum, or instruction. In doing so, we distinguish between works that aim to enhance students' preparedness for, and competence in, proof and proving and works that explicitly foster appreciation for the need and importance of proof and proving. Finally, we also discuss briefly the interventions along three dimensions: how amenable to scaling up, how practicable for curricular integration, and how capable of producing long-lasting effects these interventions are. [ABSTRACT FROM AUTHOR]

While numerous studies examine perceptions of research held by university researchers, studies examining perceptions held by school pupils are rare. To address this gap and following analysis of questionnaire data (N = 2634, KS3/4/5 pupils), we conducted 11 group interviews with 100 pupils in England to investigate their experiences of research during schooling and their perceptions of how research is conceived, conducted and where its utility and significance lie. Thematic analysis of the interview data – informed by Angela Brew’s 4-tier descriptor of perceptions of research (domino, trading, layer, journey), Jenni Stubb's and colleagues' elaboration of this descriptor, Jan Meyer's and colleagues' conceptions of research inventory (CoRI) and Diane Bills’ distinction between Research and research – led to seven themes. Here we elaborate the most significant of these themes: fact finding as research; who formulates and owns a research question; and the friction between uninformed opinion and informed view. We conclude that secondary pupils’ experiences and perceptions of research, while overall relatively rich, vary across different disciplines. We also conclude that pupils would benefit substantially from more comprehensive engagement with research processes, and we observe the role that qualifications such as the Extended Project Qualification can play in fostering said engagement. [ABSTRACT FROM PUBLISHER]

Storytelling is an engaging way through which lived experience can be shared and reflected upon, and a tool through which difference, diversity-and even conflict-can be acknowledged and elaborated upon. Narrative approaches to research bring the richness and vibrancy of storytelling into how data is collected and interpretations of it shared. In this paper, I demonstrate the potency of the narrative approach of re-storying for a certain type of university mathematics education research ( non-deficit, non-prescriptive, context-specific, example-centred and mathematically focused) conducted at the interface of two communities: mathematics education and mathematics. I do so through reference to Amongst Mathematicians (Nardi, ), a study carried out in collaboration with 20 university mathematicians from six UK mathematics departments. The study deployed re-storying to present data and analyses in the form of a dialogue between two fictional, yet entirely data-grounded, characters-M, mathematician, and RME, researcher in mathematics education. In the dialogues, the typically conflicting epistemologies-and mutual perceptions of such epistemologies-of the two communities come to the fore as do the feasibility-of, benefits-from, obstacles-in and conditions-for collaboration between these communities. First, I outline the use of narrative approaches in mathematics education research. Then, I introduce the study and its use of re-storying, illustrating this with an example: the construction of a dialogue from interview data in which the participating mathematicians discuss the potentialities and pitfalls of visualisation in university mathematics teaching. I conclude by outlining re-storying as a vehicle for community rapprochement achieved through generating and sharing research findings-the substance of research-in forms that reflect the fundamental principles and aims that underpin this research. My conclusions resonate with sociocultural constructs that view mathematics teacher education as contemporary praxis and the aforementioned inter-community discussion as taking place within a third space. [ABSTRACT FROM AUTHOR]

The author introduces the research papers in the article, with topics that include the interaction between learners and teachers and their educational resources, communities of practice in mathematics education, and didactical practices used for teaching linear algebra.

In this paper we outline the main tenets of the commognitive approach and we exemplify its application in studies that investigate the learning and teaching of mathematics at university level. Following an overview of such applications, we focus on three studies that explore fundamental discursive shifts often occurring in the early stages of studying Calculus. These shifts concern the lecturers' and students' communicative practices, routines of constructing mathematical objects and ways of resolving commognitive conflicts. We then propose that commognitive constructs such as subjectification can be deployed towards ‘scaling-up’ the hitherto fine-grained focus of commognitive analyses. Finally, we conclude with observing how the commognitive approach relates to constructs from other sociocultural approaches to research in university mathematics education, such as “legitimate peripheral participation” from the theory of Communities of Practice and “didactic contract” from the Theory of Didactic Situations. [ABSTRACT FROM PUBLISHER]

In this paper, we propose an approach to analysing teacher arguments that takes into account field dependence-namely, in Toulmin's sense, the dependence of warrants deployed in an argument on the field of activity to which the argument relates. Freeman, to circumvent issues that emerge when we attempt to determine the field(s) that an argument relates to, proposed a classification of warrants ( a priori, empirical, institutional and evaluative). Our approach to analysing teacher arguments proposes an adaptation of Freeman's classification that distinguishes between: epistemological and pedagogical a priori warrants, professional and personal empirical warrants, epistemological and curricular institutional warrants, and evaluative warrants. Our proposition emerged from analyses conducted in the course of a written response and interview study that engages secondary mathematics teachers with classroom scenarios from the mathematical areas of analysis and algebra. The scenarios are hypothetical, grounded on seminal learning and teaching issues, and likely to occur in actual practice. To illustrate our proposed approach to analysing teacher arguments here, we draw on the data we collected through the use of one such scenario, the Tangent Task. We demonstrate how teacher arguments, not analysed for their mathematical accuracy only, can be reconsidered, arguably more productively, in the light of other teacher considerations and priorities: pedagogical, curricular, professional and personal. [ABSTRACT FROM AUTHOR]

The study we report here examines parts of what Chevallard calls the institutional dimension of the students' learning experience of a relatively under-researched, yet crucial, concept in Analysis, the concept of infinite series. In particular, we examine how the concept is introduced to students in texts and in teaching practice. To this purpose, we employ Duval's Theory of Registers of Semiotic Representation towards the analysis of 22 texts used in Canada and UK post-compulsory courses. We also draw on interviews with in-service teachers and university lecturers in order to discuss briefly teaching practice and some of their teaching suggestions. Our analysis of the texts highlights that the presentation of the concept is largely a-historical, with few graphical representations, few opportunities to work across different registers (algebraic, graphical, verbal), few applications or intra-mathematical references to the concept's significance and few conceptually driven tasks that go beyond practising with the application of convergence tests and prepare students for the complex topics in which the concept of series is implicated. Our preliminary analysis of the teacher interviews suggests that pedagogical practice often reflects the tendencies in the texts. Furthermore, the interviews with the university lecturers point at the pedagogical potential of: illustrative examples and evocative visual representations in teaching; and, student engagement with systematic guesswork and writing explanatory accounts of their choices and applications of convergence tests. [ABSTRACT FROM AUTHOR]

We describe a four-level spectrum of pedagogical awareness (SPA) that emerged from the analysis of six undergraduate mathematics tutors' (1) conceptualizations of their first-year students' difficulties; (2) descriptive accounts of their strategies for facilitating the overcoming of these difficulties; and (3) self-reflective accounts regarding their teaching practices. These were recorded in 45 semistructured interviews conducted during the 8-week Oxford University term and following minimally participant observation of their tutorials. We exemplify the four levels of SPA, across these three strands, in 12 characteristic examples where tutors discuss episodes from the observed tutorials. The design and analysis of the study reflect three underlying theoretical perspectives: constructivist, sociocultural, and enactivist. Finally, we draw on participants' comments to suggest that our methodology encouraged reflection, raised awareness, and demonstrated the pedagogical potential of collaboration between mathematicians and mathematics educators. We see such awareness and collaborative goodwill as prerequisites to conceptualizing and implementing reform of pedagogical practice. [ABSTRACT FROM AUTHOR]

Abstract: In this paper we draw on a 16-month study funded by the Learning and Teaching Support Network in the UK and entitled Mathematicians as Educational Co-Researchers. The study''s aims were two-fold. Primarily we intended to explore mathematicians’ reflections on issues identified in the literature as highly topical in the area of teaching and learning of undergraduate mathematics. We also wished to explore the conditions under which mutually effective collaboration between mathematicians and researchers in mathematics education might be achieved. Participants were 20 mathematicians from 6 mathematics departments and the study involved a series of Focus Group Interviews where pre-distributed samples of mathematical problems, typical written student responses, observation protocols, interview transcripts and outlines of relevant bibliography were used to trigger an exploration of pedagogical issues. Here we elaborate the theme ‘On the Pedagogical Insights of Mathematicians’ as it emerged from the data analysis. We do so in two parts: in the first part we present the participants’ reflections on issues of interaction and communication within the context of teaching and learning in higher education. The data suggest that the lecturers believe that mathematical learning is achieved more effectively as an interactive process and recognise that lecturing is not a method generally conducive to interaction. However, they discuss ways in which interaction can be achieved and refer to seminars, tutorials and feedback to students’ writing as other opportunities for interaction that must not be missed. In the second part, we focus on the lecturers’ pedagogical reflections regarding the abstract nature of university mathematics and, in particular, the ways in which teaching can facilitate the transition from the concrete to the abstract. We conclude with a brief evaluation of the project by the mathematicians themselves. [Copyright &y& Elsevier]

Research often focuses on disaffection in the mathematics classroom as evident in disruptive behaviour, absenteeism or special needs: thus, it ignores a group of students whose disaffection is expressed in a tacit, non-disruptive manner, namely as disengagement and invisibility. Ignoring this often large group implies that the mathematical potential of these learners may remain defunct. This article reports on a one-year study of quiet disaffection conducted in three Year 9 mathematics classrooms in Norfolk. Through extensive observation and interviewing of seventy 13/14 year-old pupils, a profile of quiet disaffection from secondary school mathematics was constructed. It is proposed that its characteristics include: Tedium, Isolation, Rote learning (rule-and-cue following), Elitism and Depersonalisation. The proposed characteristics are described and exemplified. Finally, the themes that emerged from the students' statements about their images of effective mathematics teaching (Nature of Classroom Activities -- the notion of 'Fun', Teaching Styles; Role of the Teacher; Role of Stratification Structures such as Setting) are outlined. [ABSTRACT FROM AUTHOR]

Explores the difficulties encountered by novice mathematicians on mathematical abstraction at Oxford College in Atlanta, Georgia. Genesis of group-theoretical concepts; Concepts of coset, order of an elements, and isomorphism; Completion of the learning cycle.

• Mathematical modelling tasks trigger student navigation across disciplines. • Students' graphing activity excessively privileges time as independent variable. • Students' graphing activity privileges data illustration rather than interpretation. • Commognitive analysis traces meta-level learning in students' modelling activity. • Lecturer awareness of student meta-level learning needs improves task design. Through a commognitive lens, we examine twelve first-semester biology students'. engagement with graphing routines as they work in groups, during four sessions of Mathematical Modelling (MM). We trace the students' meta-level learning, particularly as they fluctuate between deploying graphs for mere illustration of data and as sense-making tools. We account for student activity in relation to precedent events in their experiences of graphing and as fluid, if not always productive, interplay between ritualised and exploratory engagement with graph construction and interpretation routines. The students' construal of the task situations is marked by efforts to keep up with lecturer expectations which allow for changing degrees of student agency but do not factor in the influence of precedent events. Our analysis has pedagogical implications for the way MM problems are formulated and also foregrounds the capacity of the commognitive framework to trace de-ritualization and meta-level learning in students' MM activity. [ABSTRACT FROM AUTHOR]

Current liquid chromatography-tandem mass spectrometry (LC-MS/MS) applications for circulating androgen measurements are technically diverse. Previously, variable results have been reported for testosterone. Data are scarce for androstenedione and absent for dehydroepiandrosterone sulfate (DHEAS). We assessed the agreement of androstenedione, DHEAS and testosterone LC-MS/MS measurements among nine European centers and explored benefits of calibration system unification. Androgens were measured twice by laboratory-specific procedures in 78 patient samples and in EQA materials. Results were obtained by in-house and external calibration. Intra- and inter-laboratory performances were valued. Intra-laboratory CVs ranged between 4.2–13.2 % for androstenedione, 1.6–10.8 % for DHEAS, and 4.3–8.7 % and 2.6–7.1 % for female and male testosterone, respectively. Bias and trueness in EQA materials were within ±20 %. Median inter-laboratory CV with in-house vs. external calibration were 12.0 vs. 9.6 % for androstenedione (p<0.001), 7.2 vs. 4.9 % for DHEAS (p<0.001), 6.4 vs. 7.6 % for female testosterone (p<0.001) and 6.8 and 7.4 % for male testosterone (p=0.111). Median bias vs. all laboratory median with in-house and external calibration were −13.3 to 20.5 % and −4.9 to 18.7 % for androstenedione, −10.9 to 4.8 % and −3.4 to 3.5 % for DHEAS, −2.7 to 6.5 % and −11.3 to 6.6 % for testosterone in females, and −7.0 to 8.5 % and −7.5 to 11.8 % for testosterone in males, respectively. Methods showed high intra-laboratory precision but variable bias and trueness. Inter-laboratory agreement was remarkably good. Calibration system unification improved agreement in androstenedione and DHEAS, but not in testosterone measurements. Multiple components, such as commutability of calibrators and EQA materials and internal standard choices, likely contribute to inter-laboratory variability. [ABSTRACT FROM AUTHOR]

The article reflects on the successful completion of three years of journal's growth as well as introduction of new editorial arrangements. It discusses the appointment of Lara Alcock and Alf Coles as the editor of the Current Reports section and editor of Book Reviews section, respectively. It offers information on the introduction of Masters and doctoral level mathematics education research and long-term support for new mathematics education researchers and lecturers in different countries.

Simple Summary: Cancer patients frequently experience pain, impacting their quality of life. Unfortunately, pain management in those referred for radiotherapy (RT) is often insufficient, with limited research in this area. This study aimed to assess the adequacy and effectiveness of pain management and identify factors affecting them in cancer patients referred for RT. We observed 1042 cancer outpatients and found that 42.9% did not receive adequate pain management. Specifically, 72% of patients referred for palliative RT and 75% of those referred for curative RT experienced inadequate or ineffective analgesic therapy. Patients undergoing palliative RT, those with poorer general health, those with cancer-related pain, and those treated in Northern Italy had higher odds of receiving adequate pain management. Our findings highlight the need for educational and organizational strategies to address this issue and suggest that early palliative RT referral can improve pain management and treatment outcomes for cancer patients. Background: Pain is a prevalent symptom among cancer patients, and its management is crucial for improving their quality of life. However, pain management in cancer patients referred to radiotherapy (RT) departments is often inadequate, and limited research has been conducted on this specific population. This study aimed to assess the adequacy and effectiveness of pain management when patients are referred for RT. Moreover, we explored potential predictors of adequate pain management. Methods: This observational, prospective, multicenter cohort study included cancer patients aged 18 years or older who were referred to RT departments. A pain management assessment was conducted using the Pain Management Index (PMI), calculated by subtracting the pain score from the analgesic score (PMI < 0 indicated inadequate pain management). Univariate and multivariate analyses were performed to identify predictors of adequate pain management. Results: A total of 1042 cancer outpatients were included in the study. The analysis revealed that 42.9% of patients with pain did not receive adequate pain management based on PMI values. Among patients with pain or taking analgesics and referred to palliative or curative RT, 72% and 75% had inadequate or ineffective analgesic therapy, respectively. The odds of receiving adequate pain management (PMI ≥ 0) were higher in patients undergoing palliative RT (OR 2.52; p < 0.001), with worse ECOG-PS scores of 2, 3 and 4 (OR 1.63, 2.23, 5.31, respectively; p: 0.017, 0.002, 0.009, respectively) compared to a score of 1 for those with cancer-related pain (OR 0.38; p < 0.001), and treated in northern Italy compared to central and southern of Italy (OR 0.25, 0.42, respectively; p < 0.001). Conclusions: In this study, a substantial proportion of cancer patients referred to RT departments did not receive adequate pain management. Educational and organizational strategies are necessary to address the inadequate pain management observed in this population. Moreover, increasing the attention paid to non-cancer pain and an earlier referral of patients for palliative RT in the course of the disease may improve pain response and treatment outcomes. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the editor discusses various reports within the issue on topics including one by Anna Sierpinska on elementary mathematics methods courses in preservice teacher education, another by Markku Hannual on proposed metatheory of mathematics-related affect and one by Maria Alessandra Mariotti on proof and proving in the classroom.

The article focuses on a study being conducted in Great Britain and Canada, to analyze the teaching and learning of infinite series concept in mathematics education. It reports the analysis of pedagogical practices and curriculum content done by the study, and mentions its review of the texts and interviewing of mathematics teachers. It discusses study's findings on coverage of the concept, its historical references, and lack of figural representations in the texts. The study also found the need for using examples, visual representations, and applications for better understanding of the concept.

The article offers information on the contribution of Leone Burton to the field of mathematics in Great Britain and worldwide. She was appointed Professor of Science and Mathematics Education at the University of Birmingham in England where she managed a legion of doctoral students. She has collaborated with Ann Floyd, Nick James and John Mason of the Open University in developing a mathematics course for teachers named Developing Mathematical Thinking. Burton served as convenor for the International Organization of Women and Mathematics Education (IOWME).

The author reflects on the current educational system with regards to the mathematics subject. He takes pride with the introduction of the first issue of "Research in Mathematics Education" (RME) and considers such journal as a new departure in mathematics education publishing system, with the aim to become informative and relevant to researchers worldwide. He also stresses that RME gives way to an exciting new venture with the Taylor & Francis Group PLC under the Routledge imprint.

Liquid chromatography-tandem mass spectrometry (LC-MS/MS) panels that include glucocorticoid-related steroids are increasingly used to characterize and diagnose adrenal cortical diseases. Limited information is currently available about reproducibility of these measurements among laboratories. The aim of the study was to compare LC-MS/MS measurements of corticosterone, 11-deoxycortisol and cortisone at eight European centers and assess the performance after unification of calibration. Seventy-eight patient samples and commercial calibrators were measured twice by laboratory-specific procedures. Results were obtained according to in-house and external calibration. We evaluated intra-laboratory and inter-laboratory imprecision, regression and agreement against performance specifications derived from 11-deoxycortisol biological variation. Intra-laboratory CVs ranged between 3.3 and 7.7%, 3.3 and 11.8% and 2.7 and 12.8% for corticosterone, 11-deoxycortisol and cortisone, with 1, 4 and 3 laboratories often exceeding the maximum allowable imprecision (MAI), respectively. Median inter-laboratory CVs were 10.0, 10.7 and 6.2%, with 38.5, 50.7 and 2.6% cases exceeding the MAI for corticosterone, 11-deoxycortisol and cortisone, respectively. Median laboratory bias vs. all laboratory-medians ranged from −5.6 to 12.3% for corticosterone, −14.6 to 12.4% for 11-deoxycortisol and −4.0 to 6.5% for cortisone, with few cases exceeding the total allowable error. Modest deviations were found in regression equations among most laboratories. External calibration did not improve 11-deoxycortisol and worsened corticosterone and cortisone inter-laboratory comparability. Method imprecision was variable. Inter-laboratory performance was reasonably good. However, cases with imprecision and total error above the acceptable limits were apparent for corticosterone and 11-deoxycortisol. Variability did not depend on calibration but apparently on imprecision, accuracy and specificity of individual methods. Tools for improving selectivity and accuracy are required to improve harmonization. [ABSTRACT FROM AUTHOR]

Background: The diagnosis of periprocedural myocardial infarction (PMI) after coronary artery bypass graft (CABG) is based on biochemical markers along with clinical and instrumental findings. However, there is not a clear cutoff value of high-sensitivity cardiac troponin (hs-cTn) to identify PMI. We hypothesized that isolated hs-cTn concentrations in the first 24 h following CABG could predict cardiac adverse events (in-hospital death and PMI) and/or left ventricular ejection fraction (LVEF) decrease.Methods: We retrospectively enrolled all consecutive adult patients undergoing CABG, alone or in association with other cardiac surgery procedures, over 1 year. Hs-cTn I concentrations (Access, Beckman Coulter) were serially measured in the post-operative period and analyzed according to post-operative outcomes.Results: 300 patients were enrolled; 71.3% underwent CABG alone, 33.7% for acute coronary syndrome. Most patients showed hs-cTn I values superior to the limit required by the latest guidelines for the diagnosis of PMI. Five patients (1.7%) died, 8% developed a PMI, 10.6% showed a LVEF decrease ≥ 10%. Hs-cTn I concentrations did not significantly differ with respect to death and/or PMI whereas they were associated with LVEF decrease ≥ 10% (p value < 0.005 at any time interval), in particular hs-cTn I values at 9-12 h post-operatively. A hs-cTn I cutoff of 5556 ng/L, a value 281 (for males) and 479 (for females) times higher than the URL, at 9-12 h post-operatively was identified, representing the best balance between sensitivity (55%) and specificity (79%) in predicting LVEF decrease ≥ 10%.Conclusions: Hs-cTn I at 9-12 h post-CABG may be useful to early identify patients at risk for LVEF decrease and to guide early investigation and management of possible post-operative complications. [ABSTRACT FROM AUTHOR]

Aim: To analyze the prevalence of anxiety and depression in a large cohort of adults with autoimmune diabetes, identifying sex-driven associated factors.In this cross-sectional study, we enrolled 553 consecutive adults with Type 1 diabetes mellitus or latent autoimmune diabetes in adults who came to the Division of Endocrinology of the S.Orsola-Malpighi Polyclinic, Bologna (Italy), to receive their second dose of SARS-CoV-2 vaccine. We administered the questionnaires: Hospital Anxiety and Depression Scale, Diabetes Distress Scale, Diabetes-related Quality of Life, Diabetes Treatment Satisfaction Questionnaire. We collected clinical and biochemical data and 14 days glucose metrics in patients with sensor use > 70% in a time span of ± 4 months from the questionnaires’ administration. We excluded 119 patients from our analyses with missing data (final cohort n = 434: 79% of those enrolled).Anxiety and depression prevalence was respectively 30.4% and 10.8%. According to the multivariate analysis, higher diabete-related emotional burden, lower treatment satisfaction, but not physician-related distress, were risk factors for anxiety and depression; female sex was associated with anxiety (OR 0.51, 95% 0.31–0.81; p = 0.005); in women, depression was associated with increasing age (males vs. females OR 0.96 per 1 year increase, 95% CI 0.92–1.00; p = 0.036), whilst in men with HbA1c (OR 1.08 per 1 mmol/mol increase, 95% CI 1.03–1.13; p = 0.002).Nearly 1/3 of patients with autoimmune diabetes suffers from anxiety and 1/10 from depression. These conditions are associated with independent modifiable and non-modifiable characteristics. For depression, these characteristics differ between males and females.Materials and methods: To analyze the prevalence of anxiety and depression in a large cohort of adults with autoimmune diabetes, identifying sex-driven associated factors.In this cross-sectional study, we enrolled 553 consecutive adults with Type 1 diabetes mellitus or latent autoimmune diabetes in adults who came to the Division of Endocrinology of the S.Orsola-Malpighi Polyclinic, Bologna (Italy), to receive their second dose of SARS-CoV-2 vaccine. We administered the questionnaires: Hospital Anxiety and Depression Scale, Diabetes Distress Scale, Diabetes-related Quality of Life, Diabetes Treatment Satisfaction Questionnaire. We collected clinical and biochemical data and 14 days glucose metrics in patients with sensor use > 70% in a time span of ± 4 months from the questionnaires’ administration. We excluded 119 patients from our analyses with missing data (final cohort n = 434: 79% of those enrolled).Anxiety and depression prevalence was respectively 30.4% and 10.8%. According to the multivariate analysis, higher diabete-related emotional burden, lower treatment satisfaction, but not physician-related distress, were risk factors for anxiety and depression; female sex was associated with anxiety (OR 0.51, 95% 0.31–0.81; p = 0.005); in women, depression was associated with increasing age (males vs. females OR 0.96 per 1 year increase, 95% CI 0.92–1.00; p = 0.036), whilst in men with HbA1c (OR 1.08 per 1 mmol/mol increase, 95% CI 1.03–1.13; p = 0.002).Nearly 1/3 of patients with autoimmune diabetes suffers from anxiety and 1/10 from depression. These conditions are associated with independent modifiable and non-modifiable characteristics. For depression, these characteristics differ between males and females.Results: To analyze the prevalence of anxiety and depression in a large cohort of adults with autoimmune diabetes, identifying sex-driven associated factors.In this cross-sectional study, we enrolled 553 consecutive adults with Type 1 diabetes mellitus or latent autoimmune diabetes in adults who came to the Division of Endocrinology of the S.Orsola-Malpighi Polyclinic, Bologna (Italy), to receive their second dose of SARS-CoV-2 vaccine. We administered the questionnaires: Hospital Anxiety and Depression Scale, Diabetes Distress Scale, Diabetes-related Quality of Life, Diabetes Treatment Satisfaction Questionnaire. We collected clinical and biochemical data and 14 days glucose metrics in patients with sensor use > 70% in a time span of ± 4 months from the questionnaires’ administration. We excluded 119 patients from our analyses with missing data (final cohort n = 434: 79% of those enrolled).Anxiety and depression prevalence was respectively 30.4% and 10.8%. According to the multivariate analysis, higher diabete-related emotional burden, lower treatment satisfaction, but not physician-related distress, were risk factors for anxiety and depression; female sex was associated with anxiety (OR 0.51, 95% 0.31–0.81; p = 0.005); in women, depression was associated with increasing age (males vs. females OR 0.96 per 1 year increase, 95% CI 0.92–1.00; p = 0.036), whilst in men with HbA1c (OR 1.08 per 1 mmol/mol increase, 95% CI 1.03–1.13; p = 0.002).Nearly 1/3 of patients with autoimmune diabetes suffers from anxiety and 1/10 from depression. These conditions are associated with independent modifiable and non-modifiable characteristics. For depression, these characteristics differ between males and females.Conclusion: To analyze the prevalence of anxiety and depression in a large cohort of adults with autoimmune diabetes, identifying sex-driven associated factors.In this cross-sectional study, we enrolled 553 consecutive adults with Type 1 diabetes mellitus or latent autoimmune diabetes in adults who came to the Division of Endocrinology of the S.Orsola-Malpighi Polyclinic, Bologna (Italy), to receive their second dose of SARS-CoV-2 vaccine. We administered the questionnaires: Hospital Anxiety and Depression Scale, Diabetes Distress Scale, Diabetes-related Quality of Life, Diabetes Treatment Satisfaction Questionnaire. We collected clinical and biochemical data and 14 days glucose metrics in patients with sensor use > 70% in a time span of ± 4 months from the questionnaires’ administration. We excluded 119 patients from our analyses with missing data (final cohort n = 434: 79% of those enrolled).Anxiety and depression prevalence was respectively 30.4% and 10.8%. According to the multivariate analysis, higher diabete-related emotional burden, lower treatment satisfaction, but not physician-related distress, were risk factors for anxiety and depression; female sex was associated with anxiety (OR 0.51, 95% 0.31–0.81; p = 0.005); in women, depression was associated with increasing age (males vs. females OR 0.96 per 1 year increase, 95% CI 0.92–1.00; p = 0.036), whilst in men with HbA1c (OR 1.08 per 1 mmol/mol increase, 95% CI 1.03–1.13; p = 0.002).Nearly 1/3 of patients with autoimmune diabetes suffers from anxiety and 1/10 from depression. These conditions are associated with independent modifiable and non-modifiable characteristics. For depression, these characteristics differ between males and females. [ABSTRACT FROM AUTHOR]

Liquid chromatography-tandem mass spectrometry (LC-MS/MS) is recommended for measuring circulating steroids. However, assays display technical heterogeneity. So far, reproducibility of corticosteroid LC-MS/MS measurements has received scant attention. The aim of the study was to compare LC-MS/MS measurements of cortisol, 17OH-progesterone and aldosterone from nine European centers and assess performance according to external quality assessment (EQA) materials and calibration. Seventy-eight patient samples, EQA materials and two commercial calibration sets were measured twice by laboratory-specific procedures. Results were obtained by in-house (CAL1) and external calibrations (CAL2 and CAL3). We evaluated intra and inter-laboratory imprecision, correlation and agreement in patient samples, and trueness, bias and commutability in EQA materials. Using CAL1, intra-laboratory CVs ranged between 2.8–7.4%, 4.4–18.0% and 5.2–22.2%, for cortisol, 17OH-progesterone and aldosterone, respectively. Trueness and bias in EQA materials were mostly acceptable, however, inappropriate commutability and target value assignment were highlighted in some cases. CAL2 showed suboptimal accuracy. Median inter-laboratory CVs for cortisol, 17OH-progesterone and aldosterone were 4.9, 11.8 and 13.8% with CAL1 and 3.6, 10.3 and 8.6% with CAL3 (all p<0.001), respectively. Using CAL1, median bias vs. all laboratory-medians ranged from −6.6 to 6.9%, −17.2 to 7.8% and −12.0 to 16.8% for cortisol, 17OH-progesterone and aldosterone, respectively. Regression lines significantly deviated from the best fit for most laboratories. Using CAL3 improved cortisol and 17OH-progesterone between-method bias and correlation. Intra-laboratory imprecision and performance with EQA materials were variable. Inter-laboratory performance was mostly within specifications. Although residual variability persists, adopting common traceable calibrators and RMP-determined EQA materials is beneficial for standardization of LC-MS/MS steroid measurements. [ABSTRACT FROM AUTHOR]

Coronary artery ectasia (CAE) is associated with ascending aortic (AA) ectasia. The purpose of this study is to evaluate the diagnostic performance of different echocardiographic parameters (EP) in predicting the presence of CAE. Four hundred-eighteen patients with AA ectasia candidate to coronary angiography were identified and divided in two groups in respect of the presence of CAE. Receiver-operating characteristic curves areas (AUC) were used to assess the discrimination power of the following EP: aortic annulus diameter, sinuses of Valsalva (SV) diameter, sino-tubular junction (STJ) diameter, AA diameter, STJ to SV ratio (STJ-to-SV) and STJ to AA ratio (STJ-to-AA). All these parameters were indexed by body surface area. The relationship between the best EP and the presence of CAE was investigated by means of multivariable logistic regression. The rate of CAE in the study population was 32%. On univariable logistic regression, aortic annulus, STJ, STJ-to-SV and STJ-to-AA were associated with the presence of CAE after Bonferroni correction. STJ-to-SV emerged as the parameter with the best discrimination power (AUC = 0.81) compared to STJ (AUC = 0.69), STJ-to-AA (AUC = 0.68), aortic annulus (AUC = 0.59), AA (AUC = 0.56) and SV (AUC = 0.55); (p for comparison <0.01). An 89.6% value for STJ-to-SV ratio emerged as the best cut-off to diagnose CAE with a sensitivity = 75%, specificity = 82%, positive predictive value = 66% and negative predictive value = 88%. On multivariable analysis, STJ-to-SV was still associated with the presence of CAE (OR = 1.15;95%CI:1.11–1.19; p < 0.01). In patients with dilated aorta, STJ-to-SV sampled by transthoracic echocardiography shows a good diagnostic performance in predicting the presence of CAE. Non invasive predictor of coronary artery ectasia: sino-tubular junction diameter to sinus of Valsava diameter ratio at transthoracic echocardiography is a good tool to prognosticate the presence of coronary artery ectasia at coronary angiography in patients with ascending aorta dilatation. [Display omitted] • Coronary ectasia (CAE) is linked to ascending aortic aneurysms, but not all of them are affected by CAE. • Coronary angiography is the gold standard for CAE diagnosis. • Echo assessment was done in all patients candidate to coronary angiography with ascending aorta ≥4 mm. • Angiography presence of CAE let us to compare the two groups. • The sino-tubular junction to sinus of Valsalva ratio is the best echo predictor of CAE. [ABSTRACT FROM AUTHOR]

Background: Although a 1-year duration of dual antiplatelet therapy (DAPT) is used in many patients after drug-eluting stent (DES) implantation, the evidence supporting this duration is uncertain.Objectives: The authors investigated the risk-benefit profile of 1-year vs ≤6-month DAPT after DES using 2 novel scores to risk stratify bleeding and ischemic events.Methods: Ischemic and bleeding risk scores were generated from ADAPT-DES (Assessment of Dual Antiplatelet Therapy With Drug-Eluting Stents), a multicenter, international, "all-comers" registry that enrolled 8,665 patients treated with DES. The risk-benefit profile of 1-year vs ≤6-month DAPT was then investigated across risk strata from an individual patient data pooled dataset of 7 randomized trials that enrolled 15,083 patients treated with DES.Results: In the derivation cohort, the ischemic score and the bleeding score had c-indexes of 0.76 and 0.66, respectively, and both were well calibrated. In the pooled dataset, no significant difference was apparent in any ischemic endpoint between 1-year and ≤6-month DAPT, regardless of the risk strata. In the overall dataset, there was no significant difference in the risk of clinically relevant bleeding between 1-year and ≤6-month DAPT; however, among 2,508 patients at increased risk of bleeding, 1-year compared with ≤6-month DAPT was associated with greater bleeding (HR: 2.80; 95% CI: 1.12-7.13) without a reduced risk of ischemic events in any risk strata, including those with acute coronary syndromes. These results were consistent in a network meta-analysis.Conclusions: In the present large-scale study, compared with ≤6-month DAPT, a 1-year duration of DAPT was not associated with reduced adverse ischemic events in any risk strata (including acute coronary syndromes) but was associated with greater bleeding in patients at increased risk of bleeding. [ABSTRACT FROM AUTHOR]

Background: Sexual abstinence is considered one of the several factors that influence sperm quality. Recent studies show that a shortening of the abstinence period could be beneficial mostly in oligoasthenoteratozoospermic (OAT) patients. Objective: Retrospective study to verify the efficacy of a second semen sample after a short abstinence to treat severe OAT infertile patients. Materials and methods: 127 couples treated between May 2014 and May 2018 were divided into two groups. Study Group 1 (75 cycles): severe OAT characteristics: count <0.2 × 106/mL no progressive motility; count ≥0.2 × 106/mL and no total or progressive motility; 0% normal morphology; a second semen sample was requested after abstinence of 2 h. Control Group 0 (52 cycles): normozoospermic or mild OAT; only one sample was requested. Intracytoplasmic sperm injection was utilized in all cases. Results: All semen parameters were significantly different between Group 0 vs both samples of Group 1 (p < 0.001), excluding volume between Group 0 and 1st sample of Group 1 (p = 0.682). The comparison between 1st and 2nd samples from Group 1 showed significant differences in volume, total and progressive motility and morphology (p < 0.001, p < 0.001, p < 0.020) but not in total sperm count (p = 0.970). Fertilization, pregnancy rate/transfer, implantation and miscarriage rates were 85.9% and 61.1% (p < 0.001), 30.6% and 35.8% (p = 0.700), 17.5% and 24.0 (p = 0.292), 20.0% and 25.0% (p = 0.017) in Group 0 and Group 1 respectively. Discussion and conclusion: The results show that a short abstinence in severe OAT patients allows us to obtain spermatozoa with better motility. The request for a second semen sample in couples with extreme semen parameters is a valid and simple strategy that helps to achieve the same probability of pregnancy compared to a Control Group. Furthermore, it allows us to utilize fresh spermatozoa avoiding the need to resort to cryopreserved reserves or testicular surgery. [ABSTRACT FROM AUTHOR]

This paper looks back over a number of exploratory studies which have researched young children's construction of meanings for graphs, produced from data entered in spreadsheets. In this paper we discuss children's use of normalising, an activity in which children `correct' data towards some perceived norm. Through normalising, children construct meanings for trend in data and in graphs. We discuss how particular aspects of the pedagogical setting including task design encourage the use of normalising. [ABSTRACT FROM AUTHOR]

Purpose: The main purpose and research question of the study are to compare the efficacy of high-security closed versus open devices for human oocytes' vitrification. Methods: A prospective randomized study was conducted. A total of 737 patients attending the Infertility and IVF Unit at S.Orsola University Hospital (Italy) between October 2015 and April 2020 were randomly assigned to two groups. A total of 368 patients were assigned to group 1 (High-Security Vitrification™ - HSV) and 369 to group 2 (Cryotop® open system). Oocyte survival, fertilization, cleavage, pregnancy, implantation, and miscarriage rate were compared between the two groups. Results: No statistically significant differences were observed on survival rate (70.3% vs. 73.3%), fertilization rate (70.8% vs. 74.9%), cleavage rate (90.6% vs. 90.3%), pregnancy/transfer ratio (32.0% vs. 31.8%), implantation rate (19.7% vs. 19.9%), nor miscarriage rates (22.1% vs. 21.5%) between the two groups. Women's mean age in group 1 (36.18 ± 3.92) and group 2 (35.88 ± 3.88) was not significantly different (P =.297). A total of 4029 oocytes were vitrified (1980 and 2049 in groups 1 and 2 respectively). A total of 2564 were warmed (1469 and 1095 in groups 1 and 2 respectively). A total of 1386 morphologically eligible oocytes were inseminated by intracytoplasmic sperm injection (792 and 594 respectively, P =.304). Conclusions: The present study shows that the replacement of the open vitrification system by a closed one has no impact on in vitro and in vivo survival, development, pregnancy and implantation rate. Furthermore, to ensure safety, especially during the current COVID-19 pandemic, the use of the closed device eliminates the potential samples' contamination during vitrification and storage. [ABSTRACT FROM AUTHOR]

Prevention is essential to reduce Colorectal Cancer (CRC) mortality. We previously reported a panel of four genes: CEACAM6, LGALS4, TSPAN8, COL1A2 (CELTiC) able to discriminate patients with CRC. Here, we assessed the CELTiC panel by quantitative polymerase chain reaction, in the blood of 174 healthy subjects, who resulted negative to the faecal immunochemical test (FITN). Using non-parametric statistic and multinomial logistic models, the FITN were compared to previously analysed subjects: 36 false positive FIT (NFIT), who were negative at colonoscopy, 36 patients with low risk lesions (LR) and 92 patients with high risk lesions or CRC (HR/CRC). FITN showed a significantly lower expression of the four genes when compared to HR/CRC. Moreover, FITN showed a significantly lower expression of TSPAN8 and COL1A2 compared to NFIT and LR patients. The multinomial logistic model confirmed that TSPAN8 alone specifically discriminated FITN from NFIT, LR and HR/CRC, while LGALS4 was able to differentiate FITN from false positive FIT. Finally, ROC curves analysis of the comparisons between FITN and HR/CRC, LR or NFIT reported AUC greater than 0.87, with a sensitivity and specificity of 83% and 76%, respectively. The CELTiC panel was confirmed a useful tool to identify CRC patients and to discriminate false FIT positive subjects. [ABSTRACT FROM AUTHOR]

Objective: We investigated the contribution to sporadic focal epilepsies (FE) of ultrarare variants in genes coding for the components of complexes regulating mechanistic Target Of Rapamycin (mTOR)complex 1 (mTORC1). Methods: We collected genetic data of 121 Italian isolated FE cases and 512 controls by Whole Exome Sequencing (WES) and single‐molecule Molecular Inversion Probes (smMIPs) targeting 10 genes of the GATOR1, GATOR2, and TSC complexes. We collapsed "qualifying" variants (ultrarare and predicted to be deleterious or loss of function) across the examined genes and sought to identify their enrichment in cases compared to controls. Results: We found eight qualifying variants in cases and nine in controls, demonstrating enrichment in FE patients (P = 0.006; exact unconditional test, one‐tailed). Pathogenic variants were identified in DEPDC5 and TSC2, both major genes for Mendelian FE syndromes. Interpretation: Our findings support the contribution of ultrarare variants in genes in the mTOR pathway complexes GATOR and TSC to the risk of sporadic FE and a shared genetic basis between rare and common epilepsies. The identification of a monogenic etiology in isolated cases, most typically encountered in clinical practice, may offer to a broader community of patients the perspective of precision therapies directed by the underlying genetic cause. [ABSTRACT FROM AUTHOR]

Background: The effectiveness of a homeopathic syrup on cough has been demonstrated in an adult population in a previous double-blind randomized study. The present prospective observational study investigated children affected by wet acute cough caused by non-complicated URTIs, comparing those who received the homeopathic syrup versus those treated with the homeopathic syrup plus antibiotic. Objectives: The aims were: 1) to assess whether the addition of antibiotics to a symptomatic treatment had a role in reducing the severity and duration of acute cough in a pediatric population, as well as in improving cough resolution; 2) to verify the safety of the two treatments. Methods: Eighty-five children were enrolled in an open study: 46 children received homeopathic syrup alone for 10 days and 39 children received homeopathic syrup for 10 days plus oral antibiotic treatment (amoxicillin/clavulanate, clarithromycin, and erythromycin) for 7 days. To assess cough severity we used a subjective verbal categorydescriptive (VCD) scale. Results: Cough VCD score was significantly (P<0.001) reduced in both groups starting from the second day of treatment (-0.52 ± 0.66 in the homeopathic syrup group and -0.56 ± 0.55 in children receiving homeopathic syrup plus oral antibiotic treatment). No significant differences in cough severity or resolution were found between the two groups of children in any of the 28 days of the study. After the first week (day 8) cough was completely resolved in more than one-half of patients in both groups. Two children (4.3 %) reported adverse effects in the group treated with the homeopathic syrup alone, versus 9 children (23.1 %) in the group treated with the homeopathic syrup plus antibiotics (P = 0.020). Conclusions: Our data confirm that the homeopathic treatment in question has potential benefits for cough in children as well, and highlight the strong safety profile of this treatment. Additional antibiotic prescription was not associated with a greater cough reduction, and presented more adverse events than the homeopathic syrup alone. [ABSTRACT FROM AUTHOR]

Background: The effectiveness of a homeopathic syrup on cough has been demonstrated in an adult population in a previous double-blind randomized study. The present prospective observational study investigated children affected by wet acute cough caused by non-complicated URTIs, comparing those who received the homeopathic syrup versus those treated with the homeopathic syrup plus antibiotic. Objectives: The aims were: 1) to assess whether the addition of antibiotics to a symptomatic treatment had a role in reducing the severity and duration of acute cough in a pediatric population, as well as in improving cough resolution; 2) to verify the safety of the two treatments. Methods: Eighty-five children were enrolled in an open study: 46 children received homeopathic syrup alone for 10 days and 39 children received homeopathic syrup for 10 days plus oral antibiotic treatment (amoxicillin/clavulanate, clarithromycin, and erythromycin) for 7 days. To assess cough severity we used a subjective verbal category-descriptive (VCD) scale. Results: Cough VCD score was significantly (P<0.001) reduced in both groups starting from the second day of treatment (-0.52 ± 0.66 in the homeopathic syrup group and -0.56 ± 0.55 in children receiving homeopathic syrup plus oral antibiotic treatment). No significant differences in cough severity or resolution were found between the two groups of children in any of the 28 days of the study. After the first week (day 8) cough was completely resolved in more than one-half of patients in both groups. Two children (4.3 %) reported adverse effects in the group treated with the homeopathic syrup alone, versus 9 children (23.1 %) in the group treated with the homeopathic syrup plus antibiotics (P = 0.020). Conclusions: Our data confirm that the homeopathic treatment in question has potential benefits for cough in children as well, and highlight the strong safety profile of this treatment. Additional antibiotic prescription was not associated with a greater cough reduction, and presented more adverse events than the homeopathic syrup alone. [ABSTRACT FROM AUTHOR]

Objective: During the last decades, an increase in the prevalence of asthma and other allergic diseases has been recorded, together with modifications in the living environment and consequent changes in the quality of indoor air. Indoor environment is favorable to the proliferation of allergens such as: house dust mites, fungal spores and cockroaches. The primary action to be undertaken for an effective eradication of infectious agents constitutes in modifying the house environmental conditions, which make it favorable to infestations. Ozone can play a sanitize role, but at the same time it can cause inflammation, especially in the lung. The aim of this study was to verify the role and safety of ozone in the sanitation of the bedroom of a subject suffering from asthma. Methods: A daily ozone treatment was carried during a 14-day time period in the bedroom of an asthmatic patient. Aerobiological sampling in indoor air, microbiological sampling and detection of ATP bioluminescence on the surface were performed before and after treatment at the first day, as well as after treatment at the 7th and 14th day of the study. An aerobiological measurement was also performed outdoor of the patient's bedroom only for the first day. Results: Our analysis confirms that low ozone levels induced a marked reduction of indoor air microbiological pollution without adverse effects on lung functionality of the asthmatic patient we considered. Conclusion: Our observations warrant further investigation on the role that ozone-based sterilization might have in controlling asthmatic symptoms. [ABSTRACT FROM AUTHOR]

Colorectal cancer (CRC) develops over several years, thus, early diagnosis and prevention are fundamental to reduce CRC burden. A new non-invasive blood test based on 4 mRNAs encompassing adhesion molecules such as CEACAM6, as well as a member of the collagen I superfamily, namely COL1A2, combined with LGALS4 and TSPAN8, was recently discovered and referred to as CELTIC panel [1]. The expression of the CELTiC panel was measured by quantitative PCR. The panel of putative biomarkers was subsequently evaluated in 101 subjects resulted positive to fecal immunochemical screening test (FIT) highlighting the potential to distinguish colonoscopy negative-FIT positive patients (NFIT, n=36), patients with low risk lesions (LR, n=36) and with high risk lesions or CRC (HR/CRC, n=92) [2]we searched for mRNA blood markers (CELTiC panel. In this study 174 healthy FIT negative subjects (FITN) were analysed [3] and compared to previous groups, evaluating also the influence of age and sex. Within the FITN group, CEACAM6 and COL1A2 display significantly lower expression in female than in male, confirming this sex difference of CEACAM6, a differentiation marker in normal colonocytes, also in the older groups (60-70 y.o.) and supporting current data on the importance of gender- and age-specific reference intervals for the early diagnosis of CRC [4,5]. The four genes showed significantly lower expression in FITN than in HR/CRC. Interestingly, TSPAN8 and COL1A2 were significantly lower expressed in FITN also than in NFIT and LR patients. TSPAN8, an integral membrane protein which upregulation promotes metastasis [6], was confirmed by logistic model as able to discriminate FITN from NFIT, LR and HR/CRC. Interestingly, also LGALS4, involved in cell-cell interaction and studied in CRC patients [7,8], was able to differentiate FITN from NFIT (false FIT positive). TSPAN8 and galectins have been described also in exosomes [9] suggesting the origin of the mRNAs of the CELTiC panel. Finally, the CELTIC panel showed good sensitivity (84-90%), specificity (76-81%) and AUC (0.87-0.89) to discriminate FITN from the other groups. The CELTiC panel was confirmed as a useful tool to diagnose CRC highlighting the importance of sex and age. A multicenter cross-sectional study will enroll 800 FIT positive subject at the Universities of Amsterdam and Bologna to better estimates the performances of the CELTiC panel and to further validate its robustness and usefulness in the early diagnosis of CRC and to exclude false FIT positive subjects. [ABSTRACT FROM AUTHOR]