Valutazione delle funzioni cognitive e della capacità di automonitoraggio delle emozioni in pazienti con neoplasia mammaria.

ABSTRACT La relazione tra tumore e fattori psicosociali è un’ipotesi molto antica in medicina che è stata a lungo studiata, sia dal punto di vista dell’effetto dei fattori psico- sociali sull' eziologia del tumore sia dal punto di vista dell’effetto di diagnosi e trattamenti sui fattori psicosociali. Questo studio si inscrive nel secondo ambito di ricerca e in particolare il suo scopo è l’analisi degli effetti di due trattamenti farmacologici, chemioterapia e ormonoterapia, sulle funzioni cognitive e sull’ abilità di riconosci- mento e gestione delle emozioni nelle donne a cui è stato diagnosticato un tumore della mammella. In letteratura, il problema dei deficit cognitivi correlati ai trattamenti chemio-terapici (definiti colloquialmente in ambito clinico come chemofog) è molto noto e studiato, ma al momento non siamo a conoscenza di studi che abbiano indagato l’effetto dei trattamenti farmacologici sull’ intelligenza emotiva (IE), ovvero l’abilità cognitiva di riconoscimento e gestione delle emozioni. Fino ad oggi gli studi che hanno indagato la chemofog si sono concentrati su funzioni cognitive “di pensiero logico” quali memoria, attenzione, linguaggio, funzioni esecutive; l'attenzione agli effetti sull’IE può essere utile per le ricadute che vi possono essere sul paziente, in quanto è noto come la popolazione oncologica sia sottoposta ad un forte stress emotivo. Andare ad indagare quanto l'IE venga intaccata dalla neurotossicità legata ai farmaci può dare informazioni utili ad improntare degli interventi terapeutici e riabilitativi per aiutare i pazienti a far fronte al carico di stress emotivo che stanno affrontando; questo nell’ ottica anche di avere un impatto positivo sulla qualità di vita e sulla gestione delle fasi di malattia. La popolazione oggetto di studio è identificata in donne adulte con diagnosi di neoplasia mammaria, afferenti alle Oncologie Mediche di un ospedale regionale; complessivamente sono state contattate 113 donne con diagnosi di neoplasia mammaria di età compresa tra i 33 e i 60 anni. Di queste 65 sono risultate arruolabili se- condo i criteri di inclusione ed esclusione definiti per la partecipazione allo studio. Hanno accettato di partecipare 37 donne ed in seguito ad un drop-out sono state effettivamente valutate 36 partecipanti. 5 Sono stati misurati in quattro tempi di rilevazione (T0-baseline, T1-3 mesi, T2-6 mesi, T3-Follow up a 12 mesi) le abilità cognitive di memoria, attenzione, capacità visuospaziale e linguaggio utilizzando il test RBANS e le capacità di IE utilizzando il questionario self-report SREIS; sono inoltre state misurate quali variabili di controllo le problematiche soggettive, emozionali e comportamentali utilizzando la scala CBA-H. In generale i risultati di questo lavoro confermano quanto riportato in lettera- tura circa gli effetti negativi di chemioterapia e ormonoterapia su alcune capacità cognitive; si evidenzia in particolare non tanto un deficit sulle abilità cognitive, quanto un’interferenza sull’ effetto di apprendimento. Interessanti sono i risultati emersi dalla percezione delle capacità relative all’ intelligenza emotiva, aspetto innovativo dello studio, che, complessivamente, sembrano avere un andamento peggiorativo nelle pazienti che fanno trattamenti chemioterapici, ormonoterapici o una combinazione di entrambi. Sempre relativamente alle competenze di intelligenza emotiva è emerso come le pazienti chemiotrattate riferiscano di percepire maggiormente le emozione e di saperle meglio comprendere rispetto alle altre partecipanti, risultato inatteso rispetto alle ipotesi che andrebbe approfondito in ulteriori studi. La tesi di seguito presentata è articolata in quattro capitoli: nel primo viene fornita una descrizione di epidemiologia, eziologia, diagnosi e tipologia di trattamenti del tumore della mammella. Il secondo capitolo è focalizzato sugli aspetti psicologici interessati dalla malattia, in particolare sulle modalità di reazione emotiva e di adattamento alla diagnosi e ai trattamenti, con i loro effetti collaterali, per la neoplasia mammaria. Nel terzo capitolo viene presentata una rassegna della letteratura circa l’impatto dei trattamenti farmacologici, chemioterapia e ormonoterapia, sulle funzioni cognitive. Infine, nel quarto capitolo viene descritto il lavoro di ricerca: gli obiettivi, gli strumenti e il metodo utilizzati, le analisi statistiche svolte per la verifica delle ipotesi di lavoro, vengono inoltre dettagliati e commentati i risultati emersi.Evaluation of cognitive functions and emotional intelligence in breast cancer patients

Formal Gold- and Rhodium-Catalyzed Regiodivergent C–H Alkynylation of 2‑Pyridones

Formal regiodivergent C–H alkynylation of 2-pyridones bearing different <i>N</i>-substituents has been realized under Au­(I) and Rh­(III) catalysis using a hypervalent iodine alkyne reagent. When catalyzed by Au­(I), the alkynylation occurred at the most electron-rich 5-position via an electrophilic alkynylation pathway. The selectivity was switched to the 6-position under assistance of an <i>N</i>-chelation group when a Rh­(III) catalyst was employed. A rhodacylic complex has been isolated as a key intermediate

Rh(III)- and Ir(III)-Catalyzed C–H Alkynylation of Arenes under Chelation Assistance

An efficient Rh­(III)- and Ir­(III)-catalyzed, chelation-assisted C–H alkynylation of a broad scope of (hetero)­arenes has been developed using hypervalent iodine-alkyne reagents. Heterocycles, <i>N</i>-methoxy imines, azomethine imines, secondary carboxamides, azo compounds, <i>N</i>-nitrosoamines, and nitrones are viable directing groups to entail <i>ortho</i> C–H alkynylation. The reaction proceeded under mild conditions and with controllable mono- and dialkynylation selectivity when both mono- and dialkynylation was observed. Rh­(III) and Ir­(III) catalysts exhibited complementary substrate scope in this reaction. The synthetic applications of the coupled products have been demonstrated in subsequent derivatization reactions. Some mechanistic studies have been conducted, and two Rh­(III) complexes have been established as key reaction intermediates. The current C–H alkynylation system complements those previously reported under gold or palladium catalysis using hypervalent iodine reagents

Aging Effects on the Visual Span for Alphabetic Stimuli

Background: The visual span (i.e., an estimate of the number of letters that can be recognized reliably on a single glance) is widely considered to impose an important sensory limitation on reading speed. With the present research, we investigated adult age differences in the visual span for alphabetic stimuli (i.e., Latin alphabetic letters), as aging effects on span size may make an important contribution to slower reading speeds in older adulthood. Method: A trigram task, in which sets of three letters were displayed randomly at specified locations to the right and left of a central fixation point, was used to estimate the size of the visual span for young (18-30 years) and older (65+years) adults while an eye tracker was used to ensure accurate central fixation during stimulus presentation. Participants also completed tests of visual acuity and visual crowding. Results: There were clear age differences in the size of the visual span. The older adults produced visual spans which were on average 1.2 letters smaller than the spans of young adults. However, both young and older adults produced spans smaller than those previously reported. In addition, span size correlated with measures of both visual acuity and measures of visual crowding. Conclusion: The findings show that the size of the visual span is smaller for older compared to young adults. The age-related reduction in span size is relatively small but may make a significant contribution to reduced parafoveal processing during natural reading so may play a role in the greater difficulty experienced by older adult readers. Moreover, these results highlight the importance of carefully controlling fixation location in visual span experiments

Rh(III)- and Ir(III)-Catalyzed C–H Alkynylation of Arenes under Chelation Assistance

An efficient Rh­(III)- and Ir­(III)-catalyzed, chelation-assisted C–H alkynylation of a broad scope of (hetero)­arenes has been developed using hypervalent iodine-alkyne reagents. Heterocycles, <i>N</i>-methoxy imines, azomethine imines, secondary carboxamides, azo compounds, <i>N</i>-nitrosoamines, and nitrones are viable directing groups to entail <i>ortho</i> C–H alkynylation. The reaction proceeded under mild conditions and with controllable mono- and dialkynylation selectivity when both mono- and dialkynylation was observed. Rh­(III) and Ir­(III) catalysts exhibited complementary substrate scope in this reaction. The synthetic applications of the coupled products have been demonstrated in subsequent derivatization reactions. Some mechanistic studies have been conducted, and two Rh­(III) complexes have been established as key reaction intermediates. The current C–H alkynylation system complements those previously reported under gold or palladium catalysis using hypervalent iodine reagents

Parafoveal Processing of Orthography, Phonology, and Semantics during Chinese Reading: Effects of Foveal Load

The foveal load hypothesis assumes that the ease (or difficulty) of processing the currently fixated word in a sentence can influence processing of the upcoming word(s), such that parafoveal preview is reduced when foveal load is high. Recent investigations using pseudo-character previews reported an absence of foveal load effects in Chinese reading. Substantial Chinese studies to date provide some evidence to show that parafoveal words may be processed orthographically, phonologically, or semantically. However, it has not yet been established whether parafoveal processing is equivalent in terms of the type of parafoveal information extracted (orthographic, phonological, semantic) under different foveal load conditions. Accordingly, the present study investigated this issue with two experiments. Participants’ eye movements were recorded as they read sentences in which foveal load was manipulated by placing a low- or high-frequency word N preceding a critical word. The preview validity of the upcoming word N + 1 was manipulated in Experiment 1, and word N + 2 in Experiment 2. The parafoveal preview was either identical to word N + 1(or word N + 2); orthographically related; phonologically related; semantically related; or an unrelated pseudo-character. The results showed robust main effects of frequency and preview type on both N + 1 and N + 2. Crucially, however, interactions between foveal load and preview type were absent, indicating that foveal load does not modulate the types of parafoveal information processed during Chinese reading

A Copper-Catalyzed Reductive Defluorination of β‑Trifluoromethylated Enones via Oxidative Homocoupling of Grignard Reagents

An efficient copper-catalyzed reductive defluorination of β-trifluoromethylated enones via an oxidative homocoupling of Grignard reagents is reported. The reaction proceeded smoothly with a wide range of substrates, including the ones bearing aromatic heterocycles, such as furyl and thienyl ring systems in high yields (80–92%, except one example) under mild conditions. This provides a practical method for synthesis of <i>gem</i>-difluoroolefin ketones. It is also worth noting that this homocoupling process of Grignard reagents using β-trifluoromethylated enones as “oxidizing reagents” is effective for both the Csp²–Csp² and Csp³–Csp³ bond formations, including for substrates whose β-hydride elimination of the corresponding transition metal alkyl complex is particularly facile, affording coupling products with high yields (83–95%), simultaneously

Divergent Access to 1‑Naphthols and Isocoumarins via Rh(III)-Catalyzed C–H Activation Assisted by Phosphonium Ylide

Rh-catalyzed C–H activation of phenacyl phosphoniums in coupling with α-diazocarbonyl compounds has been realized with the assistance of a mutifunctional phosphonium ylidic directing group, providing expedient accesses to 1-naphthols and isocoumarins. Switchable synthesis of 1-naphthols and isocoumarins was realized by substrate control, where these transformations were enabled by initial C–H activation and subsequent intramolecular Wittig reaction or nucleophilic C–O formation

Regio- and Diastereoselective Access to Fused Isoxazolidines via Ru(II)-Catalyzed C–H Activation of Nitrones and Coupling with Perfluoroalkylolefins

The synthsis of fluorinated isoxazolidines in bicyclic settings has been realized via Ru­(II)-catalyzed C–H activation of aryl nitrones with perfluoroalkyl-substituted olefins as the coupling partner. The reaction proceeded via initial chelation-assisted C­(aryl)–H allylation followed by regio- and diastereoselective intramolecular dipolar addition between the nitrone directing group and the olefin unit

Silver Ions Induce Lateral Etching of Gold Nanorods by K₂PtCl₄

Selective etching is significant for fabrication of novel nanostructures. Here silver ions are introduced to control the lateral etching of gold nanorods by K₂PtCl₄ in a hot solution, producing a number of dumbbell-like PtAu-Au thin gold nanorods. Silver ions control the selective deposition of the reduced Pt⁰ atoms, causing the selective etching of the unprotected Au. The middle diameter of the obtained dumbbell-like nanorods can be adjusted from 12 nm to <10 nm. It is believed that this is an effective method to reduce the diameter of gold nanorods