To determine the absolute and relative value of microvessel density (MVD), p53 and c-erbB-2 protein expression, peritumoral lymphatic vessel invasion (PLVI), and conventional prognosticators in ...predicting relapse-free (RFS) and overall survival (OS) rates in patients with node-negative breast carcinoma (NNBC).
We monitored 254 consecutive patients with NNBC for a median of 62 months. Intratumoral MVD was measured after microvessels were immunostained using anti-CD31 antibody. p53 and c-erbB-2 protein and hormone receptors were also determined immunocytochemically. Results were analyzed by both univariate and multivariate statistical analysis.
Univariate analysis showed that MVD was significantly predictive of both RFS (odds ratio OR, 8.30; P = .0001) and OS (OR, 4.50; P = .012) when tested as a continuous or dichotomous variable. Likewise, tumor size (OR, 3.16; P = .0012), PLVI (OR, 4.36; P = .0009), estrogen receptor (ER) status (OR, 2.35; P = .016), progesterone receptor (PR) status (OR, 2.00; P = .017), and expression of p53 protein (OR, 2.82; P = .004) were significantly associated with RFS. Tumor size (OR, 3.80; P = .0038) and expression of p53 protein (OR, 2.58; P = .024) were significantly associated with OS by univariate analysis. Multivariate analysis showed that MVD (P = .0004), p53 protein expression (P = .0063), tumor size (P = .0144), and PLVI (P = .0033) were all significant and independent prognostic factors for RFS. However, only tumor size (P = .004) and MVD (P = .047) were independent predictors for OS. c-erbB2 expression was not associated with outcome by either univariate or multivariate analysis.
MVD, p53 expression, PLVI, and tumor size are independent prognostic indicators of recurrence, which are useful in selection of high-risk NNBC patients who may be eligible to receive adjuvant therapies.
The COVID-19 poses an ongoing threat to lives around the world and challenges the existing public health and medical service delivery. The lockdown or quarantine measures adopted to prevent the ...spread of COVID-19 has caused the interruption in ongoing care and access to medical care including to patients with existing neurological conditions. Besides the passivity, isolation, and withdrawal, patients with neurodegenerative diseases experience difficulties in communication due to a limited access to leisure opportunities and interaction with friends and relatives. The communication difficulties may exacerbate the burden on the caregivers. Therefore, assistive-technologies may be a useful strategy in mitigating challenges associated with remote communication. The current paper presents an overview of the use of assistive technologies using virtual reality and virtual body ownership in providing communication opportunities to isolated patients, during COVID-19, with neurological diseases and moderate-to-severe communication difficulties. We postulate that the assistive technologies-based intervention may improve social interactions in patients with neurodegenerative diseases and acquired brain injury-thereby reducing isolation and improving their quality of life and mental well-being.
The present study aimed to: (a) validate the factor structures of three scales assessing driving behavior, attitudes toward traffic safety (ATTS) and self-regulation in driving, in a sample of ...Italian older adults, through confirmatory factor analyses and (b) to determine the effectiveness of these measures in predicting the likelihood and the frequency of collision involvements in the following year. A 28-item driver behavior questionnaire (DBQ), a 16-item ATTS, a 21-item extended driving mobility questionnaire (DMQ-A) were administered to 369 active Italian drivers, aged between 60 and 91 years. Results showed a four-factor structure for the DBQ, a five-factor structure for the ATTS and a two-factor structure for the Extended DMQ-A, as the best fitting models. Hurdle model analysis of count data with extra-zeros showed that all factors of DBQ predicted the likelihood of road collisions. Risky behavior, except for aggressive violations, self-regulation and attitudes toward traffic rules were associated with the frequency of collision involvement. The aforementioned three scales seemed to be a useful and concise suite of instruments assessing risky as well as protective factors of driving behavior in elderly.
Montreal cognitive assessment (MoCA) is a test providing a brief screening for people with cognitive impairment due to aging or neurodegenerative syndromes. In Italy, as in the rest of the world, ...several validation studies of MoCA have been carried out. This study compared, for the first time in Italy, a sample of people with probable Alzheimer’s Disease (AD) with healthy counterparts. The study also compared two community-dwelling groups of aged participants with and without probable cognitive impairment, as discriminated by two cut-off points of adjusted MMSE score. All the comparisons were carried out according to ROC statistics. Optimal cutoff for a diagnosis of probable AD was a MoCA score ≤14. Optimal cutoff for the discrimination of probable cognitive impairment was a MoCA score ≤17 (associated to MMSE cutoff of 23.8). Results confirm the substantial discrepancy in cut-off points existing between Italian and other international validation studies, showing that Italian performance on MoCA seems to be globally lower than that in other Countries. Characteristics of population might explain these results.
•ASD are characterized by a large variability in social, adaptive and communication skills.•To promote independent engagement in high functioning children with ASD is a crucial issue.•Two functional ...activities to promote constructive engagement were compared and assessed.•Results showed an increasing of constructive engagement and a decreasing of stereotypies.•Behavioral interventions were useful in classroom setting for involved participants with ASD.
We assessed a behavioral intervention-based strategy to promote constructive engagement and to reduce stereotyped behaviors by two boys with autism spectrum disorders and high functioning. The program included two functional activities for each participant (i.e. coloring and using a personal computer with a multimedia software for reading and writing) according to a multi-elements baseline design, during classroom. Both participants showed a preference for the computer activity during the choice phase. Results showed an increasing of constructive engagement, according to both functional activities, and a reduction of stereotyped behaviors during intervention phases for both participants. Psychological as well as practical implications of the findings are discussed.
Prolonged periods of restrictions on people's freedom of movement during the first massive wave of the COVID-19 pandemic meant that most people engaged in all their daily activities at home. This ...suggested the need for the spatial features of the home and its occupants' perception of them to be investigated in terms of people's wellbeing.
The present study was conducted on a large sample (N = 1354) drawn from different Italian regions. It examined the relationship between the “objective” and “subjective” dimensions of the home, measured in terms of objective home crowding and satisfaction with the space at home, in relation to perceived stress and the perceived risk of COVID-19 infection during the lockdown. The results showed that perceived stress is influenced by objective home crowding through the mediation of satisfaction with the space at home. These associations were more pronounced in younger generations. The negative association between satisfaction with the space at home and perceived stress was higher, the lower the perceived COVID-19 risk.
•Data were collected during the first national lockdown in Italy (2020).•The greater the objective crowding, the lower the satisfaction with the space at home.•The lower the satisfaction with the space at home, the higher the perceived stress.•This latter association was stronger when the perceived COVID-19 risk was lower.•All these associations were stronger in younger generations than in older people.
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