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Two-dimensional transition metal dichalcogenides, particularly MoS 2 , are interesting materials for many applications in aerospace research, radiation therapy and bioscience more in general. Since in many of these applications MoS 2 -based nanomaterials can be placed in an aqueous environment while exposed to ionizing radiation, both experimental and theoretical studies of their behaviour under these conditions is particularly interesting. Here, we study the effects of tiny imparted doses of 511 keV photons to MoS 2 nanoflakes in water solution. To the best of our knowledge, this is the first study in which ionizing radiation on 2D-MoS 2 occurs in water. Interestingly, we find that, in addition to the direct interaction between high-energy photons and nanoflakes, reactive chemical species, generated by γ-photons induced radiolysis of water, come into play a relevant role. A radiation transport Monte Carlo simulation allowed determining the elements driving the morphological and spectroscopical changes of 2D-MoS 2 , experimentally monitored by SEM microscopy, DLS, Raman and UV-vis spectroscopy, AFM, and X-ray photoelectron techniques. Our study demonstrates that radiolysis products affect the Molybdenum oxidation state, which is massively changed from the stable + 4 and + 6 states into the rarer and more unstable + 5. These findings will be relevant for radiation-based therapies and diagnostics in patients that are assuming drugs or contrast agents containing 2D-MoS 2 and for aerospace biomedical applications of 2DMs investigating their actions into living organisms on space station or satellites., (© 2024. The Author(s).)

Objectives: To evaluate the safety and efficacy of human intravenous immunoglobulin in dogs with newly diagnosed malignancy and presumed secondary immune-mediated thrombocytopenia., Materials and Methods: Twelve client-owned dogs with newly diagnosed malignant disease and presumed secondary immune-mediated thrombocytopenia were prospectively enrolled to receive a single infusion of human intravenous immunoglobulin at a dose of 0.5 to 1 mg/kg intravenous over 8 hours. A complete treatment response was defined as a platelet estimation of ≥40,000 platelets/μL within 24 hours and a partial response within 48 hours from the completion of human intravenous immunoglobulin infusion. No treatment response was defined as a platelet estimation remaining <40,000 platelets/μL over 48 hours from the completion of the human intravenous immunoglobulin infusion. This pilot study had a prospective, open-label, uncontrolled design., Results: Out of the 12 enrolled dogs, seven completed the study. A complete treatment response to human intravenous immunoglobulin was identified in one lymphoma dog and a partial response was noted in another lymphoma dog. The remaining 10 dogs had no response to human intravenous immunoglobulin. No clinically relevant adverse reactions to human intravenous immunoglobulin occurred in any of the 12 initially enrolled dogs during the infusion and over a 3-month follow-up period for the seven surviving dogs., Clinical Significance: The results of this study suggest that the use of human intravenous immunoglobulin in dogs with newly diagnosed malignant disease and presumed secondary immune-mediated thrombocytopenia appears safe, but not effective for the treatment of thrombocytopenia. Larger multi-centre, prospective, double-blinded, placebo-controlled, outcome-based, malignancy-specific studies are needed to further evaluate these preliminary findings., (© 2024 British Small Animal Veterinary Association.)

Background: Recent advancements in ultra-high-density mapping (UHDM) featuring automated functionalities have enhanced our understanding of micro-reentrant atrial tachycardias (mAT) circuits and the precise localization of the origin., Purpose: To evaluate the diagnostic support provided by an automated UHDM algorithm in guiding the ablation of mATs., Methods: Consecutive patients eligible for AT ablation in 22 Italian centers were prospectively enrolled. All ATs were comprehensively mapped in either the left or right atrium utilizing the RHYTHMIA mapping system. The LUMIPOINT tool was systematically employed to confirm electrogram fragmentation within this defined area., Results: Among 159 ATs analyzed, 97 (61.0%) were identified as macro-reentrant ATs, 50 (31.4%) as focal ATs and 12 (7.5%) as mATs. Concerning the mAT group, the targeted activity was localized in the anterior wall in 4 cases (33.3%), in proximity to PVs in 3 cases (25%), along the left ridge in 2 cases (16.6%), and at the roof, in the free wall and along the CTI in 1 case (8.3%), respectively. Low voltage areas (< 0.1 mV) were detected in all mAT cases and colocalized with the origin site. Over a median of 288 [248-349] days of follow-up, 5 (3.1%) patients suffered from an AT/AF arrhythmia recurrence: 3 (3.1%) were in the MAT group, 1 (2%) in the focal AT and 1 (8.3%) in the mAT group., Conclusion: A novel automated algorithm for mAT identification, coupled with ORION catheter, enables mAT description and transcatheter ablation of the localized origin of this rare form of AT results in a satisfactory procedural success rate., Trial Registration: Catheter Ablation of Arrhythmias With High-Density Mapping System in the Real World Practice (CHARISMA). http://clinicaltrials.gov/ Identifier: NCT03793998., (© 2025 Wiley Periodicals LLC.)

Aims: The intricate connections between health and the environment are often overlooked globally, yet they play a pivotal role in shaping our well-being., Results: Astonishingly, environmental risk factors contribute to nearly 24% of the global disease burden, underscoring the critical impact of our surroundings on health. At the crossroads of this issue lies Diabetes, a rapidly growing non-communicable disease that highlights the delicate balance between human health and environmental sustainability. This epidemic offers a unique lens through which to explore how environmental factors contribute to the prevalence of Diabetes, revealing the complex interplay at work. Despite growing awareness, healthcare systems worldwide face challenges integrating environmental threats into more effective diabetes care strategies CONCLUSIONS: This perspective highlights the urgent need for collaborative efforts and innovative solutions that address the environmental dimensions of diabetes management. Doing so can build healthier communities and pave the way for a more sustainable future., (© 2024. Springer-Verlag Italia S.r.l., part of Springer Nature.)

Background: Cardiogenic shock with acute hemodynamic decompensation may be one of the most serious risks in patients affected by ventricular tachycardia (VT). Its proper identification may have important implications in terms of pharmacological management, as might procedural planning in case of patients undergoing catheter ablation. Methods: We describe a case series of patients with provisional strategies for circulatory support in VT ablation, including the use of venoarterial extracorporeal membrane oxygenation (VA-ECMO) and vascular accesses in the electrophysiology lab but no initial ECMO activation due to an estimated intermediate pre-procedural risk from the case-series population. Results: In total, 10 patients (mean age 70 ± 11 years old, 9 males) with severe cardiomyopathy were admitted for incessant ventricular arrhythmia episodes, further diagnosis, and therapy planning; 1/10 patients (10%), documenting a PAINESD score of 14, underwent VA-ECMO cannulation due to electromechanical dissociation. All 10 patients were discharged alive. Conclusions: A pre-defined strategy before VT ablation is crucial. In our case series, the use of provisional circulatory support with VA-ECMO during incessant ablation of ventricular arrhythmia was a safe and winning alternative to upfront strategies.

Management of immune thrombocytopenia (ITP) in dogs and cats is evolving, but there are no evidence-based guidelines to assist clinicians with treatment decisions. Likewise, the overall goals for treatment of ITP have not been established. Immunosuppressive doses of glucocorticoids are the first line treatment, but optimal treatment regimens beyond glucocorticoids remain uncertain. Additional options include secondary immunosuppressive drugs such as azathioprine, modified cyclosporine, and mycophenolate mofetil, usually selected based on clinician preference. Vincristine, human IV immunoglobulin (hIVIg), and transfusion of platelet or red blood cell-containing products are often used in more severe cases. Splenectomy and thrombopoietin receptor agonists are usually reserved for refractory cases, but when and in which patient these modalities should be employed is under debate. To develop evidence-based guidelines for individualized treatment of ITP patients, we asked 20 Population Intervention Comparison Outcome (PICO) format questions. These were addressed by 17 evidence evaluators using a literature pool of 288 articles identified by a structured search strategy. Evidence evaluators, using panel-designed templates and data extraction tools, summarized evidence and created guideline recommendations. These were integrated by treatment domain chairs and then refined by iterative Delphi survey review to reach consensus on the final guidelines. In addition, 19 non-PICO questions covering scenarios in which evidence was lacking or of low quality were answered by expert opinion using iterative Delphi surveys with panelist integration and refinement. Commentary was solicited from multiple relevant professional organizations before finalizing the consensus. The rigorous consensus process identified few comparative treatment studies, highlighting many areas of ITP treatment requiring additional studies. This statement is a companion manuscript to the ACVIM Consensus Statement on the Diagnosis of Immune Thrombocytopenia in Dogs and Cats., (© 2024 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.)

Oocyte-cumulus cell interaction is essential for oocyte maturation and competence. The bidirectional crosstalk network mediated by gap junctions is fundamental for the metabolic cooperation between these cells. As cumulus cells exhibit a more glycolytic phenotype, they can provide metabolic substrates that the oocyte can use to produce ATP via oxidative phosphorylation. The impairment of mitochondrial activity plays a crucial role in ovarian aging and, thus, in fertility, determining the success or failure of assisted reproductive techniques. This review aims to deepen the knowledge about the electro-metabolic coupling of the cumulus-oocyte complex and to hypothesize a putative role of potassium channel modulators in order to improve fertility, promote intracellular Ca 2+ influx, and increase the mitochondrial biogenesis and resulting ATP levels in cumulus cells.

Intrinsic hand muscles play a fundamental role in tuning the fine motricity of the hand and may be affected by several pathologic conditions, including traumatic injuries, atrophic changes induced by denervation, and space-occupying masses. Modern hand surgery techniques allow to target several hand muscle pathologies and, as a direct consequence, requests for hand imaging now carry increasingly complex diagnostic questions. The progressive refinement of ultrasound technology and the current availability of high and ultra-high frequency linear transducers that allow the investigation of intrinsic hand muscles and tendons with incomparable resolution have made this modality an essential tool for the evaluation of pathological processes involving these tiny structures. Indeed, intrinsic hand muscles lie in a superficial position and are amenable to investigation by means of transducers with frequency bands superior to 20 MHz, offering clear advantages in terms of resolution and costs compared to magnetic resonance imaging. In addition, ultrasound allows to perform dynamic maneuvers that can critically enhance its diagnostic power, by examining the questioned structure during stress tests that simulate the conditions eliciting clinical symptoms. The present article aims to review the anatomy, the ultrasound scanning technique, and the clinical application of thenar, hypothenar, lumbricals and interossei muscles imaging, also showing some examples of pathology involving these structures., Competing Interests: Conflict of interest The authors do not report any financial or personal connections with other persons or organizations which might negatively affect the contents of this publication and/or claim authorship rights to this publication., (© 2023 Riccardo Picasso et al., published by Sciendo.)

Plantar intrinsic muscles play a pivotal role in posture control and gait dynamics. They help maintain the longitudinal and transverse arches of the foot, and they regulate the degree and velocity of arch deformation during walking or running. Consequently, pathologies affecting the plantar intrinsic muscles (for instance, acquired and inherited neuropathies) lead to foot deformity, gait disorders, and painful syndromes. Intrinsic muscle malfunctioning is also associated with multifactorial overuse or degenerative conditions such as pes planus, hallux valgus, and plantar fasciitis. As the clinical examination of each intrinsic muscle is challenging, ultrasound is gaining a growing interest as an imaging tool to investigate the trophism of these muscular structures and the pattern of their alterations, and potentially to follow up on the effects of dedicated rehabilitation protocols. The ten plantar intrinsic muscles can be dived into three groups (medial, central and lateral) and four layers. Here, we propose a regional and landmark-based approach to the complex sonoanatomy of the plantar intrinsic muscles in order to facilitate the correct identification of each muscle from the superficial to the deepest layer. We also summarize the pathological ultrasound findings that can be encountered when scanning the plantar muscles, pointing out the patterns of alterations specific to certain conditions, such as plantar nerves mononeuropathies., Competing Interests: Conflict of interest The authors do not report any financial or personal connections with other persons or organizations which might negatively affect the contents of this publication and/or claim authorship rights to this publication., (© 2023 Federico Zaottini et al., published by Sciendo.)

In recent years, sewage treatment plants did not effectively remove emerging water pollutants, leaving potential threats to human health and the environment. Advanced oxidation processes (AOPs) have emerged as a promising technology for the treatment of contaminated wastewater, and the addition of catalysts such as heavy metals has been shown to enhance their effectiveness. This review focuses on the use of rare earth elements (REEs) as catalysts in the AOP process for the degradation of organic pollutants. Cerium and La are the most studied REEs, and their mechanism of action is based on the oxygen vacancies and REE ion concentration in the catalysts. Metal oxide surfaces improve the decomposition of hydrogen peroxide to form hydroxide species, which degrade the organics. The review discusses the targets of AOPs, including pharmaceuticals, dyes, and other molecules such as alkaloids, herbicides, and phenols. The current state-of-the-art advances of REEs-based AOPs, including Fenton-like oxidation and photocatalytic oxidation, are also discussed, with an emphasis on their catalytic performance and mechanism. Additionally, factors affecting water chemistry, such as pH, temperature, dissolved oxygen, inorganic species, and natural organic matter, are analyzed. REEs have great potential for enhancing the removal of dangerous organics from aqueous solutions, and further research is needed to explore the photoFenton-like activity of REEs and their ideal implementation for wastewater treatment.

Background: The gold standard for the treatment of cardiac implantable electronic devices (CIEDs)-related infection and lead malfunction is transvenous lead extraction (TLE). To date, the risk of mortality directly related to TLE procedures is relatively low, but data on post-procedural and long-term mortality are limited, even more in the aging population., Methods: Consecutive patients with CIEDs who underwent TLE were retrospectively studied. The primary outcome was the endpoint of death, considering independent predictors of long-term clinical outcomes in the TLE aging population comparing patients with and without infection., Results: One hundred nineteen patients (male 77%; median age 76 years) were included in the analysis. Eighty-two patients (69%) documented infection, and thirty-seven (31%) were extracted for a different reason. Infected patients were older (80 vs. 68 years, p -value > 0.001) with more implanted catheters ( p -value < 0.001). At the last follow-up (FU) available (median FU 4.1 years), mortality reached 37% of the patient population, showing a statistically significant difference between infected versus non-infected groups. At univariable analysis, age at TLE, atrial fibrillation, and anemia remained significant correlates of mortality; at multivariable analysis, only patients with anemia and atrial fibrillation have a 2.3-fold (HR 2.34; CI 1.16-4.75) and a 2.5-fold (HR 2.46; CI 1.33-4.54) increased rate of death, respectively., Conclusion: Our long-term data showed that aging patients who underwent TLE for CIED-related infection exhibit a high mortality risk during a long-term follow-up, potentially leading to a rapid and effective procedural approach in this patient population.

This review represents the first contribution of a research diptych which stems from the activities implemented in the framework of the H2020 ARESIBO project (Augmented Reality Enriched Situation awareness for Border security). The general objective of ARESIBO is to improve the efficiency of border surveillance systems by providing the operational teams, as well as the tactical command and control level with accurate and comprehensive information related to border control considering different issues and perspectives. These perspectives also include the analysis of the level of engagement and the (possible) enhancement of citizens' involvement in the development and decision making related to border surveillance. The principal human rights and migration International Organisations (IOs), as well as EU institutions dealing with security and external borders (i.e., Frontex), agree and state that human rights groups (HRGs) and civil society organisations (CSOs) should be more involved and integrated in border surveillance. That stated, the main goal of this paper is to analyse this perceived marginalisation of CSOs and HRGs, as it emerges from several HRGs' and CSOs' statements on that regard in order to explore the reasons of this perceived marginalisation, as well as the elements that on the contrary seem to make this marginalisation less substantial. The results of this non-systematic review in the framework of ARESIBO led to the elaboration of an innovative participatory model that will be analysed in detail in the second article of this research diptych, entitled "Towards the engagement of citizens in SOSTs decision-making: participatory models setting a common ground for border surveillance and respect of fundamental rights. The case of ARESIBO H2020 project"., Competing Interests: No competing interests were disclosed., (Copyright: © 2023 De Sabbata L et al.)

Urinary tract infections (UTI), which are among the most frequent cases of infectious diseases, mainly affect women. The most common treatment approach involves the use of antibiotics, although this solution is not always the most suitable, mainly because of the resistance that bacterial strains develop. Proanthocyanidins are a class of polyphenols, abundantly contained in cranberry extracts, which have shown beneficial effects in the treatment of urinary tract infections, due to their anti-adhesive properties toward bacteria, with respect to the membranes of the cells of the urothelium and intestine, thus reducing their virulence. In this work, we demonstrate via microscopy and scattering measurements how a mixture of cranberry and chondroitin sulfate can form a crosslinked structure with barrier properties. By using a design of experiment (DOE), we optimized the mass ratio to obtain a precipitate between cranberry extract and chondroitin sulfate in the presence of N-acetylcysteine and hyaluronic acid. By using transepithelial electrical resistance (TEER) chambers, we confirmed the barrier properties of the best mixture obtained with the DOE. Lastly, the antibiofilm action was investigated against five strains of Escherichia coli with different antibiotic sensitivity. The precipitate displayed a variable inhibitory effect in biofilm formation with major effects in UTI with an antibiotic resistance profile.

Purpose: To analyze the responsiveness and the minimally clinical important change (MCIC) of the EuroQol (EQ) 5D-5 L score in patients that had undergone foot/ankle surgery., Methods: Patients that underwent elective foot/ankle surgery from January 2019 to December 2020 were included. They were assessed with the EQ-5D-5L, visual analogue pain scale and Manchester Oxford Foot Questionnaire (MOXFQ) preoperatively and 1 year postoperatively. The pre-post differences of all variables, Effect Size (ES) and MCIC were analyzed., Results: 167 patients. All variables showed a significant pre-post improvement. The ES for EQ-index and EQ-VAS were 0.61 and 0.33 respectively. MCIC for EQ-index was 0.17 and EQ-VAS was 8.54. MOXFQ index ES was 1.46 and the MCIC was 23.8. VAS decreased from 59.4 to 26.62., Conclusion: The EQ-5D-5L is a sensitive test to detect changes after elective foot and ankle surgery with good responsiveness relative to the ES values in the EQ-index., Level of Evidence: II., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier Ltd.)

Space missions with humans expose the crews to ionizing radiation, mainly due to the galactic cosmic radiation (GCR). All radiation protection programs in space aim to minimize crews' exposure to radiation. The radiation protection of astronauts can be achieved through the use of shields. The shields could serve as a suit to reduce GCR exposure and, in an emergency, as a radiation shelter to perform necessary interventions outside the space habitat in case of a solar proton event (SPE). A space radiation shielding that is suitable for exploration during space missions requires particular features and a proper knowledge of the radiation type. This study shows the results of numerical simulations performed with the Geant4 toolkit-based code DOSE. Calculations to evaluate the performance of Nomex, an aramidic fiber with high mechanical resistance, in terms of dose reduction to crews, were performed considering the interaction between protons with an energy spectrum ranging from 50 to 1100 MeV and a target slab of 20 g/cm 2 . This paper shows the properties of secondary products obtained as a result of the interaction between space radiation and a Nomex target and the properties of the secondary particles that come out the shield. The results of this study show that Nomex can be considered a good shield candidate material in terms of dose reductions. We also note that the secondary particles that provide the greatest contribution to the dose are protons, neutrons and, in a very small percentage, α-particles and Li ions.

Graphene Oxide has been proposed as a potential adjuvant to develop improved anti-TB treatment, thanks to its activity in entrapping mycobacteria in the extracellular compartment limiting their entry in macrophages. Indeed, when administered together with linezolid, Graphene Oxide significantly enhanced bacterial killing due to the increased production of Reactive Oxygen Species. In this work, we evaluated Graphene Oxide toxicity and its anti-mycobacterial activity on human peripheral blood mononuclear cells. Our data show that Graphene Oxide, different to what is observed in macrophages, does not support the clearance of Mycobacterium tuberculosis in human immune primary cells, probably due to the toxic effects of the nano-material on monocytes and CD4+ lymphocytes, which we measured by cytometry. These findings highlight the need to test GO and other carbon-based nanomaterials in relevant in vitro models to assess the cytotoxic activity while measuring antimicrobial potential.

ARESIBO is an H2020 project aiming to improve the efficiency of border surveillance systems by providing the operational teams, as well as the tactical command and control level with accurate and comprehensive information related to border control by different perspectives. Human Rights Groups' (HRGs) and Civil Society Organisations' (CSOs) involvement and participation in decision making related Surveillance-Oriented Security Technologies (SOSTs) for border surveillance is considered as a key-factor to ensure the coexistence of two only apparently opposite needs: security and respect of fundamental rights (i.e., privacy, refugees etc.). Starting from this general approach, the paper represents the second part of a research diptych dedicated to present the main achievements and methods proposed by ARESIBO to enhance participation in border surveillance. It outlines the ARESIBO Participatory Model (APM) as a tool to improve HRGs, CSOs, and ultimately citizens' involvement related to border surveillance in general and the adoption of specific SOSTs for borders' control. The first part of the paper introduces some key elements included in the ARESIBO desk research that led to the elaboration of the APM (i.e., literature review, semantic analysis), describing who were the targets of that approach (i.e., stakeholders, end-users, actors ). After a contextualization on the three interlaced dimensions of surveillance, security and privacy related borders' control, the paper presents the three components of the methodological framework within which this citizens' involvement process has been developed (i.e., ARESIBO Participation Framework, ARESIBO Participation Strategy, ARESIBO Participation Action Plan). In the conclusions, by outlining the first partial application of the model within the ARESIBO framework, the paper argues that APM can represent a pilot for a more structured and duplicable participatory model, also through additional research regarding participatory models applied to SOSTs development processes., Competing Interests: No competing interests were disclosed., (Copyright: © 2023 Laterza R et al.)

Individualized dosimetry in nuclear medicine is currently at least advisable in order to obtain the best risk-benefit balance in terms of the maximal dose to lesions and under-threshold doses to radiosensitive organs. This article aims to propose a procedure for fast dosimetric calculations based on planar whole-body scintigraphy (WBS) images and developed to be employed in everyday clinical practice., Methods: For simplicity and legacy reasons, the method is based on planar imaging dosimetry, complemented with some assumptions on the radiopharmaceutical kinetics empirically derived from single-photon emission tomography/computed tomography (SPECT/CT) image analysis. The idea is to exploit a rough estimate of the time-integrated activity as has been suggested for SPECT/CT dosimetry but using planar images. The resulting further reduction in dose estimation accuracy is moderated by the use of a high-precision Monte-Carlo S-factor, such as those available within the OpenDose project., Results: We moved the problem of individualized dosimetry to a transformed space where comparing doses was imparted to the ICRP Average Male/Female computational phantom, resulting from an activity distribution related to patient's pharmaceutical uptake. This is a fast method for the personalized dosimetric evaluation of radionuclide therapy, bearing in mind that the resulting doses are meaningful in comparison with thresholds calculated in the same framework., Conclusion: The simplified scheme proposed here can help the community, or even the single physician, establish a quantitative guide-for-the-eye approach to individualized dosimetry.

Background : Radioactive 131 I (RAI) therapy is used in patients with differentiated thyroid cancer (DTC) after total thyroidectomy for remnant ablation, adjuvant treatment or treatment of persistent disease. 131 I retention data, which are used to indicate the time at which a 131 I treated DTC patient can be released from the hospital, may bring some insights regarding clinical factors that prolong the length of hospitalization. The aim of this study was to investigate the 131 I whole-body retention in DTC patients during 131 I therapy. Methods : We monitored 166 DTC patients to follow the 131 I whole-body retention during 131 I therapy with a radioactivity detector fixed on the ceiling of each protected room. A linear regression fit permitted us to estimate the whole-body 131 I effective half-life in each patient, and a relationship was sought between patients' clinical characteristics and whole-body effective 131 I half-life. Results: The effective 131 I half-life ranged from 4.08 to 56.4 h. At multivariable analysis, longer effective 131 I half-life was related to older age and extensive extra-thyroid disease. Conclusions: &nbsp; 131 I effective half-life during 131 I treatment in DTC patients is highly variable among patients and is significantly longer in older and in patients with RAI uptake in large thyroid remnants or in extrathyroidal disease that significantly prolongs the whole-body retention of 131 I.

For medical and health professions, students learning to respond to others' distress with well-regulated empathy is an important developmental skill linked to positive health outcomes and professionalism. Our study aimed to investigate the sociodemographic, psychological, and psychosocial differences between medical (MS) and health professional (HPS) students and their empathic abilities, since both populations share common stressors, namely, dealing with suffering people. Additionally, we were interested in assessing the psychological and psychosocial predictors of empathy of MS compared to HPS. One hundred thirty MS and 86 HPS were administered the Patient Health Questionnaire-9, Interpersonal Reactivity Index, Integrative Hope Scale, and UCLA Loneliness Scale. The two groups showed differences in their contextual characteristics, with the HPS group having larger families, lower parents' education levels, and lower family income compared to the MS group. In both groups, ~15% of students reported previous contact for psychological problems. A higher proportion of HPS (23.3%) reported depressive symptoms than MS (10%), and female HPS reported more intense feelings of loneliness than other subgroups of students. No differences were found between the two groups in self-assessed cognitive and affective empathy. In both groups, women showed greater affective scores than men and, at the same time, seemed to be particularly prone to personal distress. The cognitive empathic dimension of "perspective taking" was predicted by young age (OR, 612; 95% CI, 1.395-15.242) and the overall socioeconomic status (OR, 3.175; 95% CI, 1.154-8.734) of the HPS. Self-assessed affective competence was predicted by female gender (OR, 3.112; 95% CI, 1.328-7.288), depressive symptomatology (OR, 2.777; 95% CI, 1.004-7.681), higher mother's level of education (OR, 2.764; 95% CI, 1.147-6.659), and feeling of hope related to social relationships (OR, 1.367; 95% CI, 1.152-1.622). Risk factors for poor self-assessed affective emphatic skills were previous contact for psychological problems (OR, 3.263; 95% CI, 1.238-8.601) and feelings of loneliness (OR, 1.18; 95% CI, 1.09-1.276). Our findings emphasize the need to test psychosocial models to better understand empathic skills., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Giusti, Mammarella, Salza, Ussorio, Bianco, Casacchia and Roncone.)

Calcaneal fracture is unusual and carries high costs at long term because its associated morbidity. Surgical treatment of this fracture by extended lateral approach has risks like wound healing up to 20%. One of the causes of chronic pain is subtalar arthropathy, but it is important to rule out other causes as implant associated infection. The aim of this study is to demonstrate the presence of germs in the implant through extraction, sonication and culture. Cases with evident infection, subtalar arthropathy, non union or subtalar fusion concomitant surgery were excluded. The data includes open fracture history, wound healing complication, time between surgeries, cause to implant extraction and cultures results. A positive culture rate of 33.3% was obtained. We consider it is important to have in mind the implant associated infection as a cause of pain in these patients, with the aim to study microbiologically each case and choose the right strategy of treatment.

On March 10, 2020, Italy announced its lockdown caused by the novel coronavirus (COVID-19) pandemic, and home confinement exposed individuals to a stressful situation of unknown duration. Our study aimed to analyze the emotional and cognitive experiences and the psychopathological symptoms of young Italian University students seeking help from our University student Counseling and Consultation Service during the COVID-19 lockdown. Also, our study aimed to identify the predictors of traumatic psychological distress, investigating variables that could influence the students' well-being, related to their socio-demographic and clinical condition, to the "exposition" to the social distancing, and related to their cognitive thinking style. One-hundred and three University students were included in our study. The traumatic impact was assessed by the Impact of Event Scale-Revised (IES-R). A digital platform was used in our study, focused on narrative dimensions analyses. Our results showed that 21.4% of our help-seeking students experienced lockdown as a traumatic experience. The main stressful factors reported by students were: adjustment to the new academic activities (23.3 %), lack of autonomy (19.4%), and conflicts with family members (6.8%). The three main areas impaired were: changes in the sleeping pattern (68%), difficulty in concentration (67%), and loss of energy (58.6%). Furthermore, 36% of our student sample reported being suffering from anxiety symptoms, whereas 26% showed depressive symptomatology. Students having previous psychological and psychiatric contacts with mental health services (23%) showed a more severe traumatic and depressive symptomatology. The problematic thinking style "all or nothing" was predominantly associated with psychological distress, anxiety, depression, and posttraumatic symptoms. "Everything Will Be Fine" could be identified by the "optimistic style" (27.2%), inversely correlated with the psychopathological measures and concentration problems. The results of the logistic regression analysis indicated that the length of home confinement (second month) seemed to increase by over 3 times the likelihood of experience posttraumatic symptomatology, and a thinking style "all or nothing" was the final strongest predictor increasing the risk by over 5 times. The implementation of psychological interventions to improve the mental health of vulnerable young subgroups to contain the structuring of psychopathological profiles represent a fundamental challenge., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2020 Giusti, Salza, Mammarella, Bianco, Ussorio, Casacchia and Roncone.)

Context: The etiology of central diabetes insipidus (CDI) in children is often unknown. Clinical and radiological features at disease onset do not allow discrimination between idiopathic forms and other conditions or to predict anterior pituitary dysfunction., Objective: To evaluate the evolution of pituitary stalk (PS) thickening and the pattern of contrast-enhancement in relation with etiological diagnosis and pituitary function., Methods: We enrolled 39 children with CDI, 29 idiopathic and 10 with Langerhans cell histiocytosis (LCH). Brain magnetic resonance images taken at admission and during follow-up (332 studies) were examined, focusing on PS thickness, contrast-enhancement pattern, and pituitary gland size; T2-DRIVE and postcontrast T1-weighted images were analyzed., Results: Seventeen of 29 patients (58.6%) with idiopathic CDI displayed "mismatch pattern," consisting in a discrepancy between PS thickness in T2-DRIVE and postcontrast T1-weighted images; neuroimaging findings became stable after its appearance, while "mismatch" appeared in LCH patients after chemotherapy. Patients with larger PS displayed mismatch more frequently (P = 0.003); in these patients, reduction of proximal and middle PS size was documented over time (P = 0.045 and P = 0.006). The pituitary gland was smaller in patients with mismatch (P < 0.0001). Patients with mismatch presented more frequently with at least one pituitary hormone defect, more often growth hormone deficiency (P = 0.033)., Conclusions: The PS mismatch pattern characterizes patients with CDI, reduced pituitary gland size, and anterior pituitary dysfunction. The association of mismatch pattern with specific underlying conditions needs further investigation. As patients with mismatch show stabilization of PS size, we assume a prognostic role of this peculiar pattern, which could be used to lead follow-up., (© Endocrine Society 2020. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)