Psilocybin-Assisted Therapy: A Double-Blind Randomized Controlled Trial

Alcohol use disorder is one of the most prevalent mental health disorders worldwide, treatment options are limited, and relapse rates are high. There remains an urgent need for effective treatments. Research involving the therapeutic potential of classic hallucinogens has reemerged in recent decades and the hallucinogen psilocybin has shown some promise in early studies. We aim to assess the efficacy of psilocybin in treating alcohol use disorder with a 10-week double blind randomized double dummy crossover control trial comparing psilocybin-assisted psychotherapy to ketamine-assisted psychotherapy in individuals with alcohol use disorder. Our primary outcome will be the mean percent heavy drinking days in the four-week periods following drug administration sessions among participants in both treatment groups. We hope that our results will provide further evidence for the therapeutic role of psilocybin in addiction and that our study design may serve as a model for future randomized controlled trials of psychedelics

Mesenteric-Portal Vein Resection during Pancreatectomy for Pancreatic Cancer

The aim of the present study was to determine the outcome of patients undergoing pancreatic resection with (VR+) or without (VR 12) mesenteric-portal vein resection for pancreatic carcinoma. Between January 1998 and December 2012, 241 patients with pancreatic cancer underwent pancreatic resection: in 64 patients, surgery included venous resection for macroscopic invasion of mesenteric-portal vein axis. Morbidity and mortality did not differ between the two groups (VR+: 29% and 3%; VR 12: 30% and 4.0%, resp.). Radical resection was achieved in 55/64 (78%) in the VR+ group and in 126/177 (71%) in the VR 12 group. Vascular invasion was histologically proven in 44 (69%) of the VR+ group. Survival curves were not statistically different between the two groups. Mean and median survival time were 26 and 15 months, respectively, in VR 12 versus 20 and 14 months, respectively, in VR+ group . In the VR+ group, only histologically proven vascular invasion significantly impacted survival , while, in the VR 12 group, R0 resection and tumor\u2019s grading significantly influenced long-term survival. Vascular resection during pancreatectomy can be performed safely, with acceptable morbidity and mortality. Long-term survival was the same, with or without venous resection. Survival was worse for patients with histologically confirmed vascular infiltration

A Distribution-Based Threshold for Determining Sentence Similarity

We hereby present a solution to a semantic textual similarity (STS) problem in which it is necessary to match two sentences containing, as the only distinguishing factor, highly specific information (such as names, addresses, identification codes), and from which we need to derive a definition for when they are similar and when they are not. The solution revolves around the use of a neural network, based on the siamese architecture, to create the distributions of the distances between similar and dissimilar pairs of sentences. The goal of these distributions is to find a discriminating factor, that we call "threshold", which represents a well-defined quantity that can be used to distinguish vector distances of similar pairs from vector distances of dissimilar pairs in new predictions and later analyses. In addition, we developed a way to score the predictions by combining attributes from both the distributions' features and the way the distance function works. Finally, we generalize the results showing that they can be transferred to a wider range of domains by applying the system discussed to a well-known and widely used benchmark dataset for STS problems

Formare alla competenza narrativa nelle professioni sanitarie: prospettive d’intervento

The NARRAVITA team: Since 2013, the Multi-professional and Multidisciplinary team NARRAVITA (ASLTO4 - IVREA) has been working to raise awareness and spread the use of narrative medicine models to nursing processes. Introduction: National and international scientific literature still has many “grey areas” regarding the concept of narrative competences and how to apply them in heathcare training. Defining the specific competences (and practical skills) which need to be mastered and implemented in order make healthcare more effective has become an imperative. Identifying these skills is essential when designing training courses for students and healthcare staff. Discussion: Training using narrative competences means promoting a fuller awareness and knowledge of a set of communicative, relational, emotional and cognitive skills. Collecting and analysing narratives produced by the assisted person enable heathcare workers and identify which of them can be used to construct an effective and shared care pathway. The Narravita team’s work focuses on an analysis of recent literature on narrative skills training. While the literature contains no clear indications of what narrative competences are exactly, there are recurring nodes that will enable us to outline some indispensable skills and skill sets to be studied. Conclusions: The Narravita team intends to examine both the data emerging from specialised scientific literature as well as related beliefs, knowledge and experiences of operators. The latter will be invaluable in substantiating and/or completing what emerges in the literature. Integrating the two perspectives will help to identify the best criteria for evaluating the effectiveness of healthcare training paths

Para-aortic node involvement is not an independent predictor of survival after resection for pancreatic cancer

AIM To analyze the importance of para-aortic node status in a series of patients who underwent pancreaticoduodenectomy (PD) in a single Institution. METHODS Between January 2000 and December 2012, 151 patients underwent PD with para-aortic node dissection for pancreatic adenocarcinoma in our Institution. Patients were divided into two groups: patients with negative PALNs (PALNs-), and patients with metastatic PALNs (PALNs+). Pathologic factors, including stage, nodal status, number of positive nodes and lymph node ratio, invasion of para-aortic nodes, tumor\u2019s grading, and radicality of resection were studied by univariate and multivariate analysis. Survival curves were constructed with Kaplan-Meier method and compared with Log-rank test: significance was considered as P < 0.05. RESULTS A total of 107 patients (74%) had nodal metastases. Median number of pathologically assessed lymph nodes was 26 (range 14-63). Twenty-five patients (16.5%) had para-aortic lymph node involvement. Thirty-three patients (23%) underwent R1 pancreatic resection. One-hundred forty-one patients recurred and died for tumor recurrence, one is alive with recurrence, and 9 are alive and free of disease. Overall survival was significantly influenced by grading (P = 0.0001), radicality of resection (P = 0.001), stage (P = 0.03), lymph node status (P = 0.04), para-aortic nodes metastases (P = 0.02). Multivariate analysis showed that grading was an independent prognostic factor for overall survival (P = 0.0001), while grading (P = 0.0001) and radicality of resection (P = 0.01) were prognostic parameters for disease-free survival. Number of metastatic nodes, node ratio, and para-aortic nodes involvement were not independent predictors of disease-free and overall survival. CONCLUSION In this experience, lymph node status and para-aortic node metastases were associated with poor survival at univariate analysis, but they were not independent prognostic factors

Strutture portanti - Aspetti progettuali e normativi

Comitato tecnico scientifico in materia di rischio sismico (istituito con Delibera Giunta Regionale n. 606 del 21/6/2010) Orientamenti interpretativi in merito a interventi locali o di riparazione in edifici esistenti (modifica e sostituisce quello ratificato nella seduta CTS del 21.7.2010. Aggiornamento del 3/10/2012 - Parte 1/

Subclinical myopathy and colorectal cancer: identification and role of new muscle damage and regeneration biomarkers

Background Skeletal muscle is the major reservoir of body proteins and it can be affected in conditions associated to altered protein turnover and metabolism such as cancer. Although severe wasting is seen primarily in patients with advanced malignancy, some of them present degree of wasting at the onset of disease. Autophagy has been recently described to play a relevant role in muscle wasting. Materials and Methods We performed morphometric studies and immunohistochemical analyses on intraoperative rectus abdominis muscle biopsies from 50 consecutive weight stable colorectal patients and 25 weight-stable patients operated for non-inflammatory benign diseases with no clinical signs of myopathies. Biochemical and molecular analyses have been performed in order to evaluate protein profile, the presence of autophagy induction and their correlation with clinical outcome. Results In cancer patients, we observed a subclinical myopathy characterized by an abnormal distribution of myonuclei relocated from the periphery inside the myofiber. The percentage of myofibers with abnormally located myonuclei was significantly higher in patients compared to controls. Analyses on serum samples showed that, in the absence of systemic inflammation, in the prevalence of cancer patients the levels of albumin and prealbumin were below the normal range and the mean value was significantly lower compared to that detected in controls. Molecular analyses showed an accumulation of p62, a typical marker of autophagy induction, significantly higher in cancer patients compared to controls. We found an inverse correlation between the number of abnormally nucleated myofibers and the presence of lymph node metastasis. Cancer relapse was correlated with low serum levels of prealbumin and high levels of p62 in myofibers of cancer patients. Conclusions Colorectal cancer patients have a subclinical myopathy characterized by myofibers with internally located myonuclei. In the absence of inflammation, cancer patients show low levels of prealbumin and albumin as markers of altered protein turnover and persistent high levels of p62 in myofibers as expression of autophagy induction with an impairment in physiological autophagic flux. Up to now our data indicate that skeletal muscle fibers show nuclear abnormalities that seems to be associated to a better prognosis, while the presence of an altered protein turnover at an early stage of disease, with an impairment in the physiological autophagic flux, that could be predictive of cancer relapse and onset of cancer cachexia