Attentional development can help us understand the inattentional blindness effect in visual search

Introduction: Inattentional Blindness (IB) is the failure to notice an unexpected, usually salient stimulus while immersed in a different, often demanding attentional task. More than just a laboratory curiosity, IB is an important phenomenon to understand because it may be related to real-world errors such as missed “incidental findings” in medical image or security searches. Interest in individual differences in susceptibility to IB has produced a number of studies showing inconclusive results. Methods: Here, we tested IB in a sample of 277 participants, 4-25 years old performing a visual search task. On two critical trials, an unexpected letter and an unexpected word were presented among photorealistic objects. Results: There was a clear age effect with younger individuals showing higher IB levels. IB correlated with attentional control in visual search and with Continuous Performance Test-CPT for d-prime, response times and attentional shifting measures. These effects disappeared if age was controlled. There were no general effects of intelligence (IQ; RIST) or gender. Younger observers showed a negative correlation of IB for the word with the verbal components of the RIST IQ-proxy (no effect for the letter). Discussion: These results support a relationship between IB and cognitive-developmental changes, showing that maturation of attention and executive processes can help us understand the intriguing phenomenon of (sometimes) missing what is in front of our eyesThis work was supported by the Research Grant Project PSI2015-69358-R (MINECO/FEDER) Ministerio de Economía y Competitividad (MINECO) and Fondo Europeo de Desarrollo Regional (FEDER) and the ongoing project PID2021-122621OBI00 (Ministerio de Ciencia e Innovación de España) granted to BG-G. It was also supported by the Fulbright Commission, and the European Union’s Horizon 2020 Research and Innovation Program, Marie Sklodowska-Curie Actions, FORAGEKID 793268, also granted to BG-G, as well as by the NIH EY017001 granted to J

Comprehending socio-relational factors of mental wellbeing in the oldest old within Nordic and Mediterranean countries

Socio-relational aspects are essential for mental wellbeing (MWB), especially in the oldest old age. Our study aims to explore the socio-relational aspects related to MWB in accord ance with the experiences of the oldest old of four European countries; and to examine how these differ between Mediterranean and Nordic people. A total of 117 participants aged 80+ years old were recruited, and 23 focus groups were performed. Qualitative con tent analysis identified five main themes. Family seemed to be the most important driver of the MWB of the oldest old, followed by relationships with close friends. Participants felt better when they had a sense of being needed, cared for, and connected. Loneliness and isolation negatively affected MWB, although solitude was appreciated. Differences appeared between Mediterranean and Nordic regions. Initiatives to promote positive interactions with family and friends, as well as social activities within the community, may contribute to strengthening MWB in the oldest ol

Increased bronchiolitis burden and severity after the pandemic: a national multicentric study

Background: The coronavirus 2019 (COVID-19) related containment measures led to the disruption of all virus distribution. Bronchiolitis-related hospitalizations shrank during 2020-2021, rebounding to pre-pandemic numbers the following year. This study aims to describe the trend in bronchiolitis-related hospitalization this year, focusing on severity and viral epidemiology. Methods: We conducted a retrospective investigation collecting clinical records data from all infants hospitalized for bronchiolitis during winter (1st September-31th March) from September 2018 to March 2023 in six Italian hospitals. No trial registration was necessary according to authorization no.9/2014 of the Italian law. Results: Nine hundred fifty-three infants were hospitalized for bronchiolitis this last winter, 563 in 2021-2022, 34 in 2020-2021, 395 in 2019-2020 and 483 in 2018-2019. The mean length of stay was significantly longer this year compared to all previous years (mean 7.2 ± 6 days in 2022-2023), compared to 5.7 ± 4 in 2021-2022, 5.3 ± 4 in 2020-2021, 6.4 ± 5 in 2019-2020 and 5.5 ± 4 in 2018-2019 (p < 0.001), respectively. More patients required mechanical ventilation this winter 38 (4%), compared to 6 (1%) in 2021-2022, 0 in 2020-2021, 11 (2%) in 2019-2020 and 6 (1%) in 2018-2019 (p < 0.05), respectively. High-flow nasal cannula and non-invasive respiratory supports were statistically more common last winter (p = 0.001 or less). RSV prevalence and distribution did not differ this winter, but coinfections were more prevalent 307 (42%), 138 (31%) in 2021-2022, 1 (33%) in 2020-2021, 68 (23%) in 2019-2020, 61 (28%) in 2018-2019 (p = 0.001). Conclusions: This study shows a growth of nearly 70% in hospitalisations for bronchiolitis, and an increase in invasive respiratory support and coinfections, suggesting a more severe disease course this winter compared to the last five years

Genome-wide association analyses identify new Brugada syndrome risk loci and highlight a new mechanism of sodium channel regulation in disease susceptibility.

Brugada syndrome (BrS) is a cardiac arrhythmia disorder associated with sudden death in young adults. With the exception of SCN5A, encoding the cardiac sodium channel Na1.5, susceptibility genes remain largely unknown. Here we performed a genome-wide association meta-analysis comprising 2,820 unrelated cases with BrS and 10,001 controls, and identified 21 association signals at 12 loci (10 new). Single nucleotide polymorphism (SNP)-heritability estimates indicate a strong polygenic influence. Polygenic risk score analyses based on the 21 susceptibility variants demonstrate varying cumulative contribution of common risk alleles among different patient subgroups, as well as genetic associations with cardiac electrical traits and disorders in the general population. The predominance of cardiac transcription factor loci indicates that transcriptional regulation is a key feature of BrS pathogenesis. Furthermore, functional studies conducted on MAPRE2, encoding the microtubule plus-end binding protein EB2, point to microtubule-related trafficking effects on Na1.5 expression as a new underlying molecular mechanism. Taken together, these findings broaden our understanding of the genetic architecture of BrS and provide new insights into its molecular underpinnings

Economic consequences of investing in anti-HCV antiviral treatment from the Italian NHS perspective : a real-world-based analysis of PITER data

OBJECTIVE: We estimated the cost consequence of Italian National Health System (NHS) investment in direct-acting antiviral (DAA) therapy according to hepatitis C virus (HCV) treatment access policies in Italy. METHODS: A multistate, 20-year time horizon Markov model of HCV liver disease progression was developed. Fibrosis stage, age and genotype distributions were derived from the Italian Platform for the Study of Viral Hepatitis Therapies (PITER) cohort. The treatment efficacy, disease progression probabilities and direct costs in each health state were obtained from the literature. The break-even point in time (BPT) was defined as the period of time required for the cumulative costs saved to recover the Italian NHS investment in DAA treatment. Three different PITER enrolment periods, which covered the full DAA access evolution in Italy, were considered. RESULTS: The disease stages of 2657 patients who consecutively underwent DAA therapy from January 2015 to December 2017 at 30 PITER clinical centres were standardized for 1000 patients. The investment in DAAs was considered to equal €25 million, €15 million, and €9 million in 2015, 2016, and 2017, respectively. For patients treated in 2015, the BPT was not achieved, because of the disease severity of the treated patients and high DAA prices. For 2016 and 2017, the estimated BPTs were 6.6 and 6.2 years, respectively. The total cost savings after 20 years were €50.13 and €55.50 million for 1000 patients treated in 2016 and 2017, respectively. CONCLUSIONS: This study may be a useful tool for public decision makers to understand how HCV clinical and epidemiological profiles influence the economic burden of HCV

Loneliness and Subjective Wellbeing During the Covid-19 Pandemic: A Systematic Review

To prevent the transmission of COVID-19, unprecedented measures were implemented, such as community lockdowns. With limited social interactions, the problem of loneliness might have worsened. As loneliness is thought to have a detrimental effect on subjective wellbeing (SWB), the present systematic review aims to better investigate and summarize the existing evidence about the association of loneliness and SWB during the COVID-19 pandemic. A total of 18 articles were included. In all studies, independently of the component of wellbeing assessed or of the instrument used, a negative association between loneliness and SWB was found. The results show an increase in loneliness during times of restrictions on social contacts, with a subsequent association with lower SWB, and underscore the need for developing specific interventions to tackle loneliness and for promoting alternative forms of social interaction if further physical distancing measures are needed. However, the literature had several limitations, since most of the studies followed cross-sectional and descriptive methodologiesThe research leading to these results has received funding from the Spanish Ministry of Science and Innovation (grant PI19/00235). Elvira Lara’s work is supported by Juan de la Cierva postdoctoral programme (Ref. IJC2019-041846-I) from the Spanish Ministry of Science and Innovation. Chiara Castelletti and Blanca Dolz del Castellar’s works are supported by the programme “Contratos predoctorales para Formación de Personal Investigador, FPI-UAM,” Universidad Autónoma de Madrid, Spain. Hannah Mercier is supported by Craig H. Neilsen Foundation (grant 853991) and the National Institute on Disability, Independent Living, and Rehabilitation Research (grant 90SFGE0024-01-00

Water-food-energy-ecosystems nexus in irrigation systems adaptation to climate change: a case study of the Adda basin (Italy)

Water resources planning at the basin scale is the keystone to adaptation of water resources systems to socio-economic and climate changes. Simulation and optimization models can provide a useful support to the planning process. Besides including all significant processes, they need to incorporate the contribution of the relevant stakeholders from the early stages of their development, particularly in areas where multiple concurring uses of water resources occur and where surface water-groundwater interactions are important. This is the case of the plain of the Lombardy Region, Italy, where an ancient system of irrigation canals has been successfully used for centuries to supply huge amounts of water to a large irrigated area, which is also one of the most industrialized in Europe (Lombardy is one of the “Four Motors for Europe”, a transnational network of highly industrialized regions including Rhône-Alpes, Baden-Württemberg and Catalonia). Indeed, the Lombardy water resources have suffered recurrent crisis in the last years and a huge pressure has been raising on irrigation water use, which is by far the main consumptive use. We illustrate here an integrated approach to the analysis of different strategies of adaptation of irrigation systems to changing conditions, which accounts for the links between water use, crop production, energy consumption and hydrological conditions (as a proxy of the ecosystems quality). We will consider the case study of the Adda river basin, an 8,000 km2 basin including lake Como, where the requirements of hydropower production and irrigation supply need to strike a balance with lake tourism, flood protection and environment conservation. The approach is based on a combination of simulation models (of upstream sub-basin, lake and downstream sub-basin) and optimization model (of lake regulation policy) that allow assessing the effects of different climate and technological scenarios. The former scenarios were obtained downscaling the regional climate projections provided by the CORDEX project till 2100, while for the latter we focused on measures to increase the efficiency of irrigation systems, that emerged as priority from the discussions with the stakeholders. Specifically, we considered different degrees of reconversion of irrigation methods from surface irrigation to more efficient methods (sprinkler or drip). The effects of the reconversion, under different climate projections, were assessed by running simulations with the IdrAgra spatially distributed agro-hydrological model, which provided the estimated values of crop water use, groundwater recharge, return flows, as well as of crop production and energy consumption. The comparison of different reconversion intensities was carried out considering indicators for the satisfaction of crop water requirements, the energy consumption, the groundwater recharge, and the river hydrological regime. A number of remarks can be made from the analysis of the results, among which it clearly emerged that under the current trend of increasing temperature already at the mid of the century irrigation deficits and impacts on the river hydrological regime will be intolerable unless the irrigation system efficiency will increase significantly in vast portions of the study area. Finally, a preliminary estimate of the cost of interventions is provided

Direct acting antivirals (DAAs) for the treatment of HCV infection in HIV/HCV coinfected patients: a clinical experience.

Background HIV/hepatitis C virus (HCV) coinfection has an unfavourable influence on the natural history of HCV, resulting in an increased rate of progression to cirrhosis, HCC and end stage liver disease. Although direct acting antivirals (DAAs) have proven to be effective in eradicating HCV infection in coinfected individuals, few data on cost effectiveness in clinical practice are available to date. Purpose This prospective study aims to assess efficacy and costs of DAAs in an outpatient population of HIV/HCV coinfected subjects. Material and methods A database for DAA prescription monitoring was created, including information on the overall cost of the anti-­‐HCV regimen for each patient. Patients were treated according to the local prescription regulations. Virologic response to DAAs was assessed at weeks 4, 12 and 24 after treatment initiation. Additional clinical and laboratory data were obtained from the medical records. Results 35 subjects were studied (males 80%, mean age 51 years), 23 undergoing a 12 week treatment course and 12 a 24 week course. Prior to initiation, 74% of patients had HIV plasma viral load below the detection limit. 80% changed at least one HIV medication to minimise the risk of drug-­‐drug interactions; eventually, 71% switched to an integrase inhibitor based regimen. 87% of patients undergoing a 12 week DAA regimen had HCV genotype 1 infection whereas 67% of patients on a 24 week regimen had genotype 3. An interferon free regimen was chosen for 91% of patients. Ribavirin was used in combination with DAAs in 57% of subjects. Preferred combinations were simeprevir/sofosbuvir for the treatment of genotype 1 and sofosbuvir/ribavirin or daclatasvir/sofosbuvir for genotype 3. Other combinations were paritaprevir/dasabuvir/ombitasvir/ritonavir and ledipasvir/sofosbuvir. 55% of patients showed undetectable HCV viraemia at week 4 and 86% at week 12. To date, 22 patients have completed the full treatment course (19 patients 12 weeks, 3 patients 24 weeks), all showing undetectable HCV viraemia. Among these, 23% experienced mild side effects, all related to ribavirin co-­administration (anaemia, fatigue). Mean treatment cost was approximately 55,000€ per patient. Conclusion This prospective study shows the effectiveness and safety of DAA therapy in HIV/HCV coinfected individuals in the clinical setting, despite the high cost. Data collection on sustained virologic response after treatment discontinuation is still ongoing