This multicentric randomized controlled trial (RCT), carried out in six Italian University mental health sites, aims to test the efficacy of a six-month psychosocial intervention (LYFESTYLE) on Body ...Mass Index (BMI), body weight, waist circumference, fasting glucose, triglycerides, cholesterol, Framingham and HOmeostasis Model Assessment of insulin resistance (HOMA-IR) indexes in patients with schizophrenia, bipolar disorder, and major depression. Moreover, the efficacy of the intervention has also been tested on several other physical and mental health domains. Patients were randomly allocated to receive the six-month experimental intervention (LIFESTYLE) or a behavioural control intervention. All enrolled patients were assessed at baseline and after one year. We recruited 401 patients (206 in the experimental and 195 in the control group) with a diagnosis of schizophrenia or other psychotic disorder (29.9%), bipolar disorder (43.3%), or major depression (26.9%). At one year, patients receiving the experimental intervention reported an improvement in body mass index, body weight, waist circumference, HOMA-IR index, anxiety and depressive symptoms and in quality of life. Our findings confirm the efficacy of the LIFESTYLE intervention in improving physical and mental health-related outcomes in patients with severe mental illnesses after one year.
Objective
Treatment resistance is a challenge for the management of schizophrenia. It is not always clear whether inadequate response is secondary to medication ineffectiveness, as opposed to ...medication underexposure due to non‐adherence or pharmacokinetic factors. We investigated the prevalence of subtherapeutic antipsychotic plasma levels in patients identified as treatment‐resistant by their treating clinician.
Method
Between January 2012 and April 2017, antipsychotic plasma levels were measured in 99 individuals provisionally diagnosed with treatment‐resistant schizophrenia by their treating clinicians, but not prescribed clozapine. Patients were followed up to determine whether they were subsequently admitted to hospital.
Results
Thirty‐five per cent of plasma levels were subtherapeutic, and of these, 34% were undetectable. Black ethnicity (P = 0.006) and lower dose (P < 0.001) were significantly associated with subtherapeutic/undetectable plasma levels. Individuals with subtherapeutic/undetectable levels were significantly more likely to be admitted to hospital (P = 0.02).
Conclusion
A significant proportion of patients considered treatment‐resistant have subtherapeutic antipsychotic plasma levels, and this is associated with subsequent admission. The presence of subtherapeutic plasma levels may suggest a need to address adherence or pharmacokinetic factors as opposed to commencing clozapine treatment. While antipsychotic levels are not recommended for the routine adjustment of dosing, they may assist with the assessment of potential treatment resistance in schizophrenia.
Through the assistance of trace element and petrographic analyses on 14 samples of mortar aggregates from Roman monuments, including the Porticus Aemilia, the Temple of Concordia, the Temple of the ...Dioscuri, Temple B and other structures of the Area Sacra di Largo Argentina, and the Villa di Livia, we establish the source area and we investigate the chronological employment of the volcanic materials used in ancient Rome's masonry. In contrast to previous inferences, the petrochemical data presented here show that systematic exploitation of the local ‘Pozzolane Rosse’ pyroclastic deposit has occurred since the early development of concrete masonry, at the beginning of the second century bc, through the early Imperial age. Subsequently, exploitation was extended to the overlying Pozzolane Nere and Pozzolanelle deposits. Only during the early phase of development of the concrete masonry in Rome, volcaniclastic sediments outcropping near the construction sites were mixed with the sieved remains of the tuff employed as the coarse aggregate, to produce the fine aggregate. The results of the study on the investigated monuments suggest the possibility of establishing the chronological identification of three different types of mortars, as a function of the composition of the volcanic material employed in the fine aggregate, which, when implemented by future studies, may contribute to the dating of monuments and archaeological structures.
Identification of the volcanic material (pozzolan) stored in a Roman ship of the fourth to third century bce, wrecked in the ancient harbour of Pisa (central Italy), was based on ratios of selected ...trace elements. The compositions of the major volcanic products erupted by the volcanoes of the Roman province, including the volcanic districts of Latium (Vulsini, Vico, Monti Sabatini and the Alban Hills) and Campania (Roccamonfina, the Phlegraean Fields, Ischia, Procida and Vesuvius) are compared with the pozzolan from the Pisa ship. Superposition of the Zr/Y, Nb/Y and Nb/Zr ratios of the pyroclastic material from the wrecked ship (computed from the published literature) allows correlation with the products of the Onano eruption from the Vulsini Volcanic District. The Vulsini rocks outcrop extensively in a sector drained by the hydrographic network of the Fiora River, which has been a well‐developed commercial water trade route since Etruscan times, with a river port and a sea port connected to the important town of Vulci, and, since 273 bce, part of the larger Roman harbour system of Cosa.
We use trace element discrimination diagrams to provide a geochemical fingerprint for Tufo Lionato, the volcanic rock most commonly used in the ancient Roman dimension stone technique. Based on the ...comparison of their geochemical signatures, we identify different rock facies of Tufo Lionato employed since the fourth to third centuries and through the second century bce in the construction of the temples of the Area Sacra di Largo Argentina. These rock facies correspond to two previously identified building stones: Aniene Tuff and Monteverde Tuff, named after their supposed source areas located in the Aniene River Valley and in the homonymous locality of the Tiber River Valley, respectively. However, the results of our study demonstrate previous misidentification of these volcanic rocks in the different construction phases of Temple C, providing a revision of the dating system currently accepted for the diffusion of Tufo Lionato architecture. We show that the Aniene facies has been exploited since the end of the fourth century bce and that it was employed along with Tufo Giallo della Via Tiberina in the podium and staircase of Temple C, whereas observations at Largo Argentina suggest that the ‘Monteverde Tuff’ was only sporadically used in the early phases of the dimension stone construction technique.
Genetic risk for schizophrenia (SCZ) is determined by many genetic loci whose compound biological effects are difficult to determine. We hypothesized that co-expression pathways of SCZ risk genes are ...associated with system-level brain function and clinical phenotypes of SCZ. We examined genetic variants related to the dopamine D2 receptor gene DRD2 co-expression pathway and associated them with working memory (WM) behavior, the related brain activity and treatment response. Using two independent post-mortem prefrontal messenger RNA (mRNA) data sets (total N=249), we identified a DRD2 co-expression pathway enriched for SCZ risk genes. Next, we identified non-coding single-nucleotide polymorphisms (SNPs) associated with co-expression of this pathway. These SNPs were associated with regulatory genetic loci in the dorsolateral prefrontal cortex (P<0.05). We summarized their compound effect on co-expression into a Polygenic Co-expression Index (PCI), which predicted DRD2 pathway co-expression in both mRNA data sets (all P<0.05). We associated the PCI with brain activity during WM performance in two independent samples of healthy individuals (total N=368) and 29 patients with SCZ who performed the n-back task. Greater predicted DRD2 pathway prefrontal co-expression was associated with greater prefrontal activity and longer WM reaction times (all corrected P<0.05), thus indicating inefficient WM processing. Blind prediction of treatment response to antipsychotics in two independent samples of patients with SCZ suggested better clinical course of patientswith greater PCI (total N=87; P<0.05). The findings on this DRD2 co-expression pathway are a proof of concept that gene co-expression can parse SCZ risk genes into biological pathways associated with intermediate phenotypes as well as with clinically meaningful information.
Selected experiments in fundamental physics have been proposed for many years at the Tandem Accelerator of the University of Napoli 'Federico II's Department of Physics as a part of a one-semester ...laboratory course for graduate students. The aim of this paper is to highlight the educational value of the experimental realization of the nuclear reaction 19F(p, )16O. With the purpose of verifying the mass-energy equivalence principle, different aspects of both classical and modern physics can be investigated, e.g. conservation laws, atomic models, nuclear physics applications to compositional analysis, nuclear cross-section, Q-value and nuclear spectroscopic analysis.
Purpose. To evaluate the peripapillary RNFL (p-RNFL) thickness changes after vitrectomy for epiretinal membrane (ERM). The relationship between p-RNFL thickness change and visual function was ...assessed. Methods. Thirty-five eyes from 35 patients with ERM who underwent vitrectomy with internal limiting membrane (ILM) removal were included. Average p-RNFL and the four quadrants thickness were measured by spectral-domain optical coherence tomography (SD-OCT) before and at one, three, and six months after surgery. Results. At six months after surgery, p-RNFL thickness of the temporal and inferior quadrant was decreased in the operated eyes compared with fellow eyes (p<0.05). Pattern standard deviation (PSD) was higher than that of fellow eyes (p = 0.002). The temporal and inferior quadrant p-RNFL thickness showed a relationship with both best-corrected visual acuity (BCVA) outcome and the six-month PSD (p<0.05, respectively). Conclusions. The selective decrease in the temporal and inferior p-RNFL thickness after vitrectomy for ERM removal could indicate inner retinal damage related to ILM peeling.
Direct metal laser sintering (DMLS) is an additive manufacturing technique for the fabrication of near net-shaped parts directly from computer-aided design data by melting together different layers ...with the help of a laser source. This paper presents an investigation of the surface roughness of aluminum samples produced by DMLS. A model based on an L
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orthogonal array of Taguchi design was created to perform experimental planning. Some input parameters, namely laser power, scan speed, and hatching distance were selected for the investigation. The upper surfaces of the samples were analyzed before and after shot peening. The morphology was analyzed by means of field emission scanning electron microscope. Scan speed was found to have the greatest influence on the surface roughness. Further, shot peening can effectively reduce the surface roughness.
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