•The study explored the relationship between temperament and emotional eating.•Different associations were found in subjects with or without restriction, purging, or bingeing.•Subjects with ...restriction had higher Persistence scores.•Binge group reported lower Persistence and higher Novelty Seeking scores.•Purge group showed lower Reward Dependence, Self Directedness, Cooperativeness scores.
Growing evidence shows that temperamental features and emotional dysregulation are linked to Eating Disorders (EDs). Aim of this study was to explore the possible relationship between temperament and emotional eating (EE) from a dimensional standpoint, and the association of specific temperamental dimensions with overeating triggered by specific emotions. We enrolled 253 women with Anorexia Nervosa, Bulimia Nervosa and Binge Eating Disorder. Of those, 189 (74.7%), 73 (28.8%), and 80 (31.6%) reported binge eating, purging, or restrictive behaviors, respectively (the categories are not mutually exclusive). Participants completed the Emotional Eating Scale (EES), the Temperament and Character Inventory, the Eating Disorder Examination Questionnaire (EDE-Q) and the Symptom Checklist 90-Revised (SCL-90-R). Higher Persistence scores were found in the Restriction group, while the Binge group reported lower Persistence and higher Novelty Seeking scores. The Purge group showed lower Reward Dependence, Self Directedness and Cooperativeness scores. Patients with Purge also reported lower BMI and higher scores on EDE-Q restriction and eating concern subscales as well as higher scores for all SCL 90-R subscales. Patterns of association between temperamental traits and specific emotions were found in each group. Therefore, some temperamental features could be considered predictors of specific associations between emotions and the tendency to eat.
A woman's first childbirth is an event of great importance to her life, involving her transition to parenthood. Many studies have analyzed the roles of depression, anxiety and fear of childbirth ...linked to childbirth expectations and the consequent choice of an epidural to avoid pain. Few studies have investigated the predictor role of maternal-fetal attachment on the choice of epidural.
Explore, in a sample of low-risk pregnant nulliparous women, differences regarding the preference, or not, of epidural for vaginal childbirth.
87 nulliparous women, aged 24 to 44 years of age, were recruited in the maternity ward of a public hospital of the metropolitan area of Tuscany (Italy) during the 3rd trimester of gestation. Participants were asked to complete the Pregnancy Related Anxiety Questionnaire-R, Wijma Delivery Expectancy Questionnaire, Centrality of Events Scale, and Prenatal Attachment Inventory.
Multivariate analyses of variance showed that women who chose delivery without epidural reported lower levels of fear of childbirth and anxiety, and higher levels of centrality of pregnancy and prenatal attachment to unborn child, than women who chose epidural.
Our data highlight the importance that medical staff focus on the maternal bond, to help future mothers have the best possible childbirth experience.
The complex nature of stroke sequelae, the heterogeneity in rehabilitation pathways, and the lack of validated prediction models of rehabilitation outcomes challenge stroke rehabilitation quality ...assessment and clinical research. An integrated care pathway (ICP), defining a reproducible rehabilitation assessment and process, may provide a structured frame within investigated outcomes and individual predictors of response to treatment, including neurophysiological and neurogenetic biomarkers. Predictors may differ for different interventions, suggesting clues to personalize and optimize rehabilitation. To date, a large representative Italian cohort study focusing on individual variability of response to an evidence-based ICP is lacking, and predictors of individual response to rehabilitation are largely unexplored. This paper describes a multicenter study protocol to prospectively investigate outcomes and predictors of response to an evidence-based ICP in a large Italian cohort of stroke survivors undergoing post-acute inpatient rehabilitation.
All patients with diagnosis of ischemic or hemorrhagic stroke confirmed both by clinical and brain imaging evaluation, admitted to four intensive rehabilitation units (adopting the same stroke rehabilitation ICP) within 30 days from the acute event, aged 18+, and providing informed consent will be enrolled (expected sample: 270 patients). Measures will be taken at admission (T0), at discharge (T1), and at follow-up 6 months after a stroke (T2), including clinical data, nutritional, functional, neurological, and neuropsychological measures, electroencephalography and motor evoked potentials, and analysis of neurogenetic biomarkers.
In addition to classical multivariate logistic regression analysis, advanced machine learning algorithms will be cross-validated to achieve data-driven prognosis prediction models.
By identifying data-driven prognosis prediction models in stroke rehabilitation, this study might contribute to the development of patient-oriented therapy and to optimize rehabilitation outcomes.
ClinicalTrials.gov, NCT03968627. https://www.clinicaltrials.gov/ct2/show/NCT03968627?term=Cecchi&cond=Stroke&draw=2&rank=2.
Objective: The present work aimed to evaluate: (a) the psychometric properties of the Centrality of Event Scale in Italian primiparous and multiparous women; (b) individual differences in those ...demographic variables that influence change in women's identity and the maternal role acquisition during pregnancy; (c) the association between the extent to which pregnancy has an impact on woman's life story and identity and prenatal attachment; (c) how the centrality of the pregnancy event is related to the experience of PTSD during pregnancy.
Background: Pregnancy is a crucial phase in women's life that involves many changes for a woman's role and identity.
Methods 319 pregnant women were assessd during the third trimester of pregnancy.
Results: Exploratory Factor Analyses confirmed a one-factor solution of the CES. Moreover, the perception of pregnancy as central in women's lives is significantly related to prenatal attachment. Finally, the perception of pregnancy as central in women's lives is positively correlated to PTSD symptoms.
Conclusion: Our findings provide evidence on the validity of the scale with pregnant women samples, which may contribute for a better understanding of the impact of pregnancy on women's identity and life story, as well as the underlying psychological challenges related to pregnancy.
Most cases of pancreatic ductal adenocarcinoma (PDAC) are asymptomatic in early stages, and the disease is typically diagnosed in advanced phases, resulting in very high mortality. Tools to identify ...individuals at high risk of developing PDAC would be useful to improve chances of early detection.
We generated a polygenic risk score (PRS) for PDAC risk prediction, combining the effect of known risk SNPs, and carried out an exploratory analysis of a multifactorial score.
We tested the associations of the individual known risk SNPs on up to 2851 PDAC cases and 4810 controls of European origin from the PANcreatic Disease ReseArch (PANDoRA) consortium. Thirty risk SNPs were included in a PRS, which was computed on the subset of subjects that had 100% call rate, consisting of 839 cases and 2040 controls in PANDoRA and 6420 cases and 4889 controls from the previously published Pancreatic Cancer Cohort Consortium I-III and Pancreatic Cancer Case-Control Consortium genome-wide association studies. Additional exploratory multifactorial scores were constructed by complementing the genetic score with smoking and diabetes.
The scores were associated with increased PDAC risk and reached high statistical significance (OR=2.70, 95% CI 1.99 to 3.68, p=2.54×10
highest vs lowest quintile of the weighted PRS, and OR=14.37, 95% CI 5.57 to 37.09, p=3.64×10
, highest vs lowest quintile of the weighted multifactorial score).
We found a highly significant association between a PRS and PDAC risk, which explains more than individual SNPs and is a step forward in the direction of the construction of a tool for risk stratification in the population.
Persisting limitations in respiratory function and gas exchange, cognitive impairment, and mental health deterioration have been observed weeks and months after acute SARS-CoV-2 (COVID-19). The ...present study aims at assessing the impairment at three-months in patients who successfully recovered from acute COVID-19. We collected data from May to July 2020. Patients underwent a multidimensional extensive assessment including pulmonary function test, psychological tests, thoracic echo scan, and functional exercise capacity. A total of 21 patients (M:13; Age 57.05 ± 11.02) completed the global assessment. A considerable proportion of patients showed symptoms of post-traumatic stress disorder (28.6%), moderate depressive symptoms (9.5%), and clinical insomnia (9.5%); 14.3% of patients exhibited moderate anxiety. A total of eleven patients (52.4%) showed impaired respiratory gas exchange capacity (P-DLCO, DLCO ≤ 79% pred). Compared to patients with normal gas exchange, the P-DLCO subgroup perceived a significant worsening in quality of life (QoL) after COVID-19 (
= 0.024), higher fatigue (
= 0.005), and higher impact of lung disease (
= 0.013). In P-DLCO subgroup, higher echo score was positively associated with hospitalization length of stay (
= 0.047), depressive symptoms (
= 0.042), fatigue (
= 0.035), impairment in mental health (
= 0.035), and impact of lung disease in health status (
= 0.020). Pulmonary function and echo scan lung changes were associated to worsened QoL, fatigue, and psychological distress symptoms.
To identify a peculiar genetic combination predisposing to differentiated thyroid carcinoma (DTC), we selected a set of single nucleotide polymorphisms (SNPs) associated with DTC risk, considering ...polygenic risk score (PRS), Bayesian statistics and a machine learning (ML) classifier to describe cases and controls in three different datasets. Dataset 1 (649 DTC, 431 controls) has been previously genotyped in a genome-wide association study (GWAS) on Italian DTC. Dataset 2 (234 DTC, 101 controls) and dataset 3 (404 DTC, 392 controls) were genotyped. Associations of 171 SNPs reported to predispose to DTC in candidate studies were extracted from the GWAS of dataset 1, followed by replication of SNPs associated with DTC risk (P < 0.05) in dataset 2. The reliability of the identified SNPs was confirmed by PRS and Bayesian statistics after merging the three datasets. SNPs were used to describe the case/control state of individuals by ML classifier. Starting from 171 SNPs associated with DTC, 15 were positive in both datasets 1 and 2. Using these markers, PRS revealed that individuals in the fifth quintile had a seven-fold increased risk of DTC than those in the first. Bayesian inference confirmed that the selected 15 SNPs differentiate cases from controls. Results were corroborated by ML, finding a maximum AUC of about 0.7. A restricted selection of only 15 DTC-associated SNPs is able to describe the inner genetic structure of Italian individuals, and ML allows a fair prediction of case or control status based solely on the individual genetic background.
Mortality rate from COVID-19 in Italy is among the world's highest. We aimed to ascertain whether there was any reduction of in-hospital mortality in patients hospitalised for COVID-19 in the ...second-wave period (October 2020-January 2021) compared to the first one (February-May 2020); further, we verified whether there were clusters of hospitalised patients who particularly benefitted from reduced mortality rate.
Data collected related to in-patients' demographics, clinical, laboratory, therapies and outcome. Primary end-point was time to in-hospital death. Factors associated were evaluated by uni- and multivariable analyses. A flow diagram was created to determine the rate of in-hospital death according to individual and disease characteristics.
A total of 1561 patients were included. The 14-day cumulative incidence of in-hospital death by competing risk regression was of 24.8% (95% CI: 21.3-28.5) and 15.9% (95% CI: 13.7-18.2) in the first and second wave. We observed that the highest relative reduction of death from first to second wave (more than 47%) occurred mainly in the clusters of patients younger than 70 years.
Progress in care and supporting therapies did affect population over 70 years to a lesser extent. Preventive and vaccination campaigns should focus on individuals whose risk of death from COVID-19 remains high.
Purpose
To evaluate the clinical and aesthetic outcome of percutaneous injection of sclerosant agents to treat head and neck cystic malformations (HNCM) and to assess their recurrence rate based on ...histology and site.
Methods
Fifty-four subjects (mean age 46 years) with HNCM treated by percutaneous injection of sclerosant agents between January and December 2017 were included. Imaging and clinical data before and after the procedure were collected. Quality of Life Index, Pain Visual Analogue Scale, and Aesthetic Scale scores were measured to assess clinical and aesthetic outcomes. A size reduction of ≥ 70% assessed through the visual scale was considered significant.
Results
Of the 54 HNCM, there were 26 (48%) lymphatic malformations (LM), 13 (24%) salivary epithelial duct cysts of the parotid gland, 12 (22%) salivary mucoceles, and 3 (5%) branchial cysts. A significant size reduction and a satisfactory clinical-aesthetic outcome were observed in all types of LM. The number of reinterventions was significantly associated with the number of lesions (
p
< 0.001). The lowest number of interventions was observed in macrocystic lymphatic malformations (average of 1.2 interventions). All salivary epithelial duct cysts showed a significant reduction in size, a satisfactory clinical-aesthetic outcome, and an average of 1.16 interventions per patient. Mucoceles had a worse response, with only 3/14 patients showing a satisfactory and long-lasting clinical outcome (average of 1.16 interventions). Treatment of branchial cysts showed the worst outcome with a limited clinical response (3/3).
Conclusion
Percutaneous injection of sclerosant agents may be considered as a first-line treatment for LM and salivary epithelial duct cysts.
Autosomal recessive spastic paraplegia 52 is caused by biallelic mutations in AP4S1 which encodes a subunit of the adaptor protein complex 4 (AP‐4). Using next‐generation sequencing, we identified ...three novel unrelated SPG52 patients from a cohort of patients with cerebral palsy. The discovered variants in AP4S1 lead to reduced AP‐4 complex formation in patient‐derived fibroblasts. To further understand the role of AP4S1 in neuronal development and homeostasis, we engineered the first zebrafish model of AP‐4 deficiency using morpholino‐mediated knockdown of ap4s1. In this model, we discovered several phenotypes mimicking SPG52, including altered CNS development, locomotor deficits, and abnormal neuronal excitability.
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