The institutional management of the COVID-19 crisis in Italy: a qualitative study on the socio-cultural context underpinning the citizens’ evaluation

Background: Studies on the citizens’ evaluation of the government’s crisis management in the COVID- 19 pandemic are almost absent. Within the frame of Semiotic Cultural Psycho-social Theory, we argue that better crisis management requires considering the expectations, value systems and questions expressed by the citizens since these criteria organize how they evaluate the actions planned to respond to “their needs”, how legitimate they consider political decisions and their attitude to complying with the measures established by the government. Objectives: This study aimed to explore, with a qualitative approach, the ways ordinary people think and make sense of how Italian institutions responded to the crisis, selected the problems to tackle, and the needs the crisis brought to the fore. Methods: An anonymous online survey was available from 21st February to 26th April 2021. Participants were asked to write about “The institutional management of the pandemic crisis ...”. A total number of 374 texts were collected (respondents’ mean age = 35,87; DS = 14,14; women: 71,7%). The Automated Method for Content Analysis (ACASM) procedure was applied to the collected texts to detect the factorial dimensions underpinning (dis)similarities in the respondents’ narratives. Such factors were interpreted as the markers of latent dimensions of meanings (DS). Results: The two main DS that emerged were characterised by the pertinentization of two different focus of discourse – media communication versus the social system – and two different criteria of evaluation of the crisis management – the institutional responses to the emergency versus the kind of investment for the future. Conclusion: Throughout the narratives, two critical points emerged: the Institutions’ failure to analyse the problems’ complexity and the disparity between what has been said and done by the political system and citizens’ expectations and needs

Native Hypovitaminosis D in CKD Patients : From Experimental Evidence to Clinical Practice

Native hypovitaminosis D (n-hVITD) is frequently found from the early stages of chronic kidney disease (CKD) and its prevalence increases with CKD progression. Even if the implications of n-hVITD in chronic kidney disease-mineral bone disorder (CKD-MBD) have been extensively characterized in the literature, there is a lot of debate nowadays about the so called "unconventional effects" of native vitamin D (25(OH)VitD) supplementation in CKD patients. In this review, highlights of the dimension of the problem of n-hVITD in CKD stages 2-5 ND patients will be presented. In addition, it will focus on the "unconventional effects" of 25(OH)VitD supplementation, the clinical impact of n-hVITD and the most significant interventional studies regarding 25(OH)VitD supplementation in CKD stages 2-5 ND

Weighted Sobolev spaces of radially symmetric functions

We prove dilation invariant inequalities involving radial functions, poliharmonic operators and weights that are powers of the distance from the origin. Then we discuss the existence of extremals and in some cases we compute the best constants.Comment: 38 page

Gut microbiota composition and frailty in elderly patients with Chronic Kidney Disease

Background Frailty is common in older patients affected by chronic kidney disease (CKD). Since gut microbiota (gMB) may contribute to frailty, we explored possible associations between gMB and frailty in CKD. Methods We studied 64 CKD patients (stage 3b-4), categorized as frail (F, 38) and not frail (NF, 26) according to Fried criteria, and 15 controls (C), all older than 65 years. In CKD we assessed serum C-reactive protein, blood neutrophil/lymphocyte ratio, Malnutrition-inflammation Score (MIS); gMB was studied by denaturing gel gradient electrophoresis (DGGE), high-throughput sequencing (16S r-RNA gene), and quantitative real-time PCR (RT-PCR). Results No differences in alpha diversity between CKD and C and between F and NF patients emerged, but high-throughput sequencing showed significantly higher abundance of potentially noxious bacteria (Citrobacter, Coprobacillus, etc) and lower abundance of saccharolytic and butyrate-producing bacteria (Prevotella spp., Faecalibacterium prausnitzii, Roseburia spp.), in CKD respect to C. Mogibacteriaceae family and Oscillospira genus abundance was positively related to inflammatory indices in the whole CKD cohort, while that of Akkermansia, Ruminococcus and Eubacterium genera was negatively related. Compared with NF, in F there was a higher abundance of some bacteria (Mogibacteriacee, Coriobacteriacee, Eggerthella, etc), many of which have been described as more abundant in other diseases. Conclusions These results suggest that inflammation and frailty could be associated to gMB modifications in CKD

Age at Onset and Social Cognitive Impairment in Clinically Stabilized Patients with Schizophrenia : An Ecological Cross-Sectional Study

Objective: Purposes of the present study were to assess the social cognitive impairment in schizophrenia and to detect if some clinical variables (particularly age at onset) are predictive of general/social cognitive deficit in schizophrenia patients. Method: Thirty-five clinically stabilized schizophrenia outpatients were assessed by the Brief Assessment of Cognition in Schizophrenia (BACS) and by Torralva\u2019s social cognition battery. Binary logistic models were performed to find an eventual association between continuous clinical variables and cognitive test failures. The total sample was divided in groups according to dichotomous variables (gender, diagnostic subtypes and type of abuse) and the presence of cognitive deficits was compared between groups by \u3c72 tests. Results: An earlier age at onset was found to be predictive of frontal cognitive impairment (Tower of London p=0.038, OR=0.702). Female gender was more probably associated with mistakes at MET-HV (\u3c72= 4.80, p=0.05, phi=0.40) and HOTEL tests (\u3c72= 5.25, p=0.04, phi=0.4) than male one. Cannabis abusers showed more frequently deficits on verbal fluency (\u3c72= 9.35, p=0.04, phi=0.52) and executive functioning (Tower of London) (\u3c72= 11.67, p=0.02, phi=0.58) than alcohol/cocaine ones. Conclusion: Female patients with an early age at onset and cannabis abuse seem to have the worst general and social cognitive profile among patients suffering from schizophrenia

Hybrid fibroin/polyurethane small-diameter vascular grafts: from fabrication to in vivo preliminary assessment

To address the need of alternatives to autologous vessels for small-calibre vascular applications (e.g. cardiac surgery), a bio-hybrid semi-degradable material composed of silk fibroin (SF) and polyurethane (Silkothane (R)) was herein used to fabricate very small-calibre grafts (o(in) = 1.5 mm) via electrospinning. Bio-hybrid grafts were in vitro characterized in terms of morphology and mechanical behaviour, and compared to similar grafts of pure SF. Similarly, two native vessels from a rodent model (abdominal aorta and vena cava) were harvested and characterized. Preliminary implants were performed on Lewis rats to confirm the suitability of Silkothane (R) grafts for small-calibre applications, specifically as aortic insertion and femoral shunt. The manufacturing process generated pliable grafts consisting of a randomized fibrous mesh and exhibiting similar geometrical features to rat aortas. Both Silkothane (R) and pure SF grafts showed radial compliances in the range from 1.37 +/- 0.86 to 1.88 +/- 1.01% 10(-2) mmHg(-1), lower than that of native vessels. The Silkothane (R) small-calibre devices were also implanted in rats demonstrating to be adequate for vascular applications; all the treated rats survived the surgery for three months after implantation, and 16 rats out of 17 (94%) still showed blood flow inside the graft at sacrifice. The obtained results lay the basis for a deeper investigation of the interaction between the Silkothane (R) graft and the implant site, which may deal with further analysis on the potentialities in terms of degradability and tissue formation, on longer time-points

Sarcopenia is Associated with Malnutrition but Not with Systemic Inflammation in Older Persons with Advanced CKD

Background: In patients with chronic kidney disease (CKD), sarcopenia can be determined by a wide spectrum of risk factors. We evaluated the association of sarcopenia with nutritional, behavioral and inflammatory patterns in older patients with advanced CKD. Methods: we cross-sectionally evaluated 113 patients with CKD stages 3b-5. Sarcopenia was defined according to the EWGSOP2 criteria. We assessed: anthropometry, bioelectrical impedance analysis, physical, and psychological performance. Nutritional status was assessed using the Malnutrition Inflammation Score (MIS) and by verifying the eventual presence Protein Energy Wasting syndrome (PEW). Systemic inflammation was assessed by dosing: CRP, IL6, TNF\u3b1, MCP1, IL10, IL17, fetuin, IL12. Results: 24% of patients were sarcopenic. Sarcopenic individuals had lower creatinine clearance (18 \ub1 11 vs. 23 \ub1 19 mL/min; p = 0.0087) as well as lower BMI (24.8 \ub1 3.0 vs. 28.4 \ub1 5.5 Kg/m2; p < 0.0001) and a lower FTI (11.6 \ub1 3.9 vs. 14.4 \ub1 5.1 kg/m2, p = 0.023). Sarcopenic persons had higher prevalence of PEW (52 vs. 20%, p < 0.0001) and a tendency to have higher MIS (6.6 \ub1 6.5 vs. 4.5 \ub1 4.0, p = 0.09); however, they did not show any difference in systemic inflammation compared to non-sarcopenic individuals. Conclusions: CKD sarcopenic patients were more malnourished than non-sarcopenic ones, but the two groups did not show any difference in systemic inflammation

A new critical curve for the Lane-Emden system

We study stable positive radially symmetric solutions for the Lane-Emden system $-\Delta u=v^p$ in $\R^N$, $-\Delta v=u^q$ in $\R^N$, where $p,q\geq 1$. We obtain a new critical curve that optimally describes the existence of such solutions.Comment: 13 pages, 1 figur

Are obstetrical complications really involved in the etiology and course of schizophrenia and mood disorders?

The impact of stressful experiences during gestation or early life, leading to increased psychiatric disorders susceptibility, is currently well described in literature, however, few data are available on the association between obstetrical complications and later development of specific diagnoses or clinical features (e.g. psychotic symptoms). Aim of the present paper was to evaluate obstetrical complications frequency in different psychiatric diagnoses and their association with clinical features. Three hundred and eighty-eight patients with a diagnosis of schizophrenia, bipolar disorder or major depressive disorder were compared in terms of clinical presentation according to the presence, type and severity of obstetrical complications. Seventeen percent of the total sample (N=65) had history of at least one obstetrical complication. Patients with a history of at least one obstetrical complication result in an earlier age of onset (F=3.93, p=0.04) and a current higher GAF score (F=6.46, p=0.01). Lewis-Murray scale score was directly correlated with GAF scores (t=2.9, p=0.004) and inversely correlated with age at onset (t=-2.77, p=0.006). Obstetrical complications are frequently registered in patients with schizophrenia or mood disorders. In our sample, they appear to have an anticipatory effect on illness onset, but they seem not to be associated with a specific psychiatric diagnosis