Language production impairments in patients with a first episode of psychosis

Language production has often been described as impaired in psychiatric diseases such as in psychosis. Nevertheless, little is known about the characteristics of linguistic difficulties and their relation with other cognitive domains in patients with a first episode of psychosis (FEP), either affective or non-affective. To deepen our comprehension of linguistic profile in FEP, 133 patients with FEP (95 non-affective, FEP-NA; 38 affective, FEP-A) and 133 healthy controls (HC) were assessed with a narrative discourse task. Speech samples were systematically analyzed with a well-established multilevel procedure investigating both micro- (lexicon, morphology, syntax) and macro-linguistic (discourse coherence, pragmatics) levels of linguistic processing. Executive functioning and IQ were also evaluated. Both linguistic and neuropsychological measures were secondarily implemented with a machine learning approach in order to explore their predictive accuracy in classifying participants as FEP or HC. Compared to HC, FEP patients showed language production difficulty at both micro- and macro-linguistic levels. As for the former, FEP produced shorter and simpler sentences and fewer words per minute, along with a reduced number of lexical fillers, compared to HC. At the macro-linguistic level, FEP performance was impaired in local coherence, which was paired with a higher percentage of utterances with semantic errors. Linguistic measures were not correlated with any neuropsychological variables. No significant differences emerged between FEP-NA and FEP-A (p≥0.02, after Bonferroni correction). Machine learning analysis showed an accuracy of group prediction of 76.36% using language features only, with semantic variables being the most impactful. Such a percentage was enhanced when paired with clinical and neuropsychological variables. Results confirm the presence of language production deficits already at the first episode of the illness, being such impairment not related to other cognitive domains. The high accuracy obtained by the linguistic set of features in classifying groups support the use of machine learning methods in neuroscience investigations

Monitoring effectiveness and safety of Tafamidis in transthyretin amyloidosis in Italy: a longitudinal multicenter study in a non-endemic area

open24noTafamidis is a transthyretin (TTR) stabilizer able to prevent TTR tetramer dissociation. There have been a few encouraging studies on Tafamidis efficacy in early-onset inherited transthyretin amyloidosis (ATTR) due to Val30Met mutation. However, less is known about its efficacy in later disease stages and in non-Val30Met mutations. We performed a multi-center observational study on symptomatic ATTR patients prescribed to receive Tafamidis. We followed up patients according to a standardized protocol including general medical, cardiological and neurological assessments at baseline and every 6 months up to 3 years. Sixty-one (42 males) patients were recruited. Only 28 % of enrolled subjects had the common Val30Met mutation, mean age of onset was remarkably late (59 years) and 18 % was in advanced disease stage at study entry. Tafamidis proved safe and well-tolerated. One-third of patients did not show significant progression along 36 months, independently from mutation type and disease stage. Neurological function worsened particularly in the first 6 months but progression slowed significantly thereafter. Autonomic function remained stable in 33 %, worsened in 56 % and improved in 10 %. Fifteen percent of patients showed cardiac disease progression and 30 % new onset of cardiomyopathy. Overall, Tafamidis was not able to prevent functional progression of the disease in 23 (43 %) subjects, including 16 patients who worsened in their walking ability and 12 patients who reached a higher NYHA score during the follow-up period. A higher mBMI at baseline was associated with better preservation of neurological function. In conclusion, neuropathy and cardiomyopathy progressed in a significant proportion of patients despite treatment. However, worsening of neurological function slowed after the first 6 months and also subjects with more advanced neuropathy, as well as patients with non-Val30Met mutation, benefited from treatment. Body weight preservation is an important favorable prognostic factor.openCortese, A.; Vita, G.; Luigetti, M.; Russo, M.; Bisogni, G.; Sabatelli, M.; Manganelli, F.; Santoro, L.; Cavallaro, T.; Fabrizi, G.M.; Schenone, A.; Grandis, M.; Gemelli, C.; Mauro, A.; Pradotto, L.G.; Gentile, L.; Stancanelli, C.; Lozza, A.; Perlini, S.; Piscosquito, G.; Calabrese, D.; Mazzeo, A.; Obici, L.; Pareyson, DCortese, Andrea; Vita, G.; Luigetti, M.; Russo, M.; Bisogni, G.; Sabatelli, M.; Manganelli, F.; Santoro, L.; Cavallaro, T.; Fabrizi, G. M.; Schenone, A.; Grandis, M.; Gemelli, C.; Mauro, A.; Pradotto, L. G.; Gentile, L.; Stancanelli, C.; Lozza, A.; Perlini, Stefano; Piscosquito, G.; Calabrese, D.; Mazzeo, A.; Obici, L.; Pareyson, D

Lopinavir/Ritonavir and Darunavir/Cobicistat in Hospitalized COVID-19 Patients: Findings From the Multicenter Italian CORIST Study

Background: Protease inhibitors have been considered as possible therapeutic agents for COVID-19 patients. Objectives: To describe the association between lopinavir/ritonavir (LPV/r) or darunavir/cobicistat (DRV/c) use and in-hospital mortality in COVID-19 patients. Study Design: Multicenter observational study of COVID-19 patients admitted in 33 Italian hospitals. Medications, preexisting conditions, clinical measures, and outcomes were extracted from medical records. Patients were retrospectively divided in three groups, according to use of LPV/r, DRV/c or none of them. Primary outcome in a time-to event analysis was death. We used Cox proportional-hazards models with inverse probability of treatment weighting by multinomial propensity scores. Results: Out of 3,451 patients, 33.3% LPV/r and 13.9% received DRV/c. Patients receiving LPV/r or DRV/c were more likely younger, men, had higher C-reactive protein levels while less likely had hypertension, cardiovascular, pulmonary or kidney disease. After adjustment for propensity scores, LPV/r use was not associated with mortality (HR = 0.94, 95% CI 0.78 to 1.13), whereas treatment with DRV/c was associated with a higher death risk (HR = 1.89, 1.53 to 2.34, E-value = 2.43). This increased risk was more marked in women, in elderly, in patients with higher severity of COVID-19 and in patients receiving other COVID-19 drugs. Conclusions: In a large cohort of Italian patients hospitalized for COVID-19 in a real-life setting, the use of LPV/r treatment did not change death rate, while DRV/c was associated with increased mortality. Within the limits of an observational study, these data do not support the use of LPV/r or DRV/c in COVID-19 patients

Lack of SARS-CoV-2 RNA environmental contamination in a tertiary referral hospital for infectious diseases in Northern Italy

none140noNAnoneColaneri M.; Seminari E.; Piralla A.; Zuccaro V.; Di Filippo A.; Baldanti F.; Bruno R.; Mondelli M.U.; Brunetti E.; Di Matteo A.; Maiocchi L.; Pagnucco L.; Mariani B.; Ludovisi S.; Lissandrin R.; Parisi A.; Sacchi P.; Patruno S.F.A.; Michelone G.; Gulminetti R.; Zanaboni D.; Novati S.; Maserati R.; Orsolini P.; Vecchia M.; Sciarra M.; Asperges E.; Sambo M.; Biscarini S.; Lupi M.; Roda S.; Chiara Pieri T.; Gallazzi I.; Sachs M.; Valsecchi P.; Perlini S.; Alfano C.; Bonzano M.; Briganti F.; Crescenzi G.; Giulia Falchi A.; Guarnone R.; Guglielmana B.; Maggi E.; Martino I.; Pettenazza P.; Pioli di Marco S.; Quaglia F.; Sabena A.; Salinaro F.; Speciale F.; Zunino I.; De Lorenzo M.; Secco G.; Dimitry L.; Cappa G.; Maisak I.; Chiodi B.; Sciarrini M.; Barcella B.; Resta F.; Moroni L.; Vezzoni G.; Scattaglia L.; Boscolo E.; Zattera C.; Michele Fidel T.; Vincenzo C.; Vignaroli D.; Bazzini M.; Iotti G.; Mojoli F.; Belliato M.; Perotti L.; Mongodi S.; Tavazzi G.; Marseglia G.; Licari A.; Brambilla I.; Daniela B.; Antonella B.; Patrizia C.; Giulia C.; Giuditta C.; Marta C.; Rossana D.; Milena F.; Bianca M.; Roberta M.; Enza M.; Stefania P.; Maurizio P.; Elena P.; Antonio P.; Francesca R.; Antonella S.; Maurizio Z.; Guy A.; Laura B.; Ermanna C.; Giuliana C.; Luca D.; Gabriella F.; Gabriella G.; Alessia G.; Viviana L.; Claudia L.; Valentina M.; Simona P.; Marta P.; Alice B.; Giacomo C.; Irene C.; Alfonso C.; Di Martino R.; Di Napoli A.; Alessandro F.; Guglielmo F.; Loretta F.; Federica G.; Alessandra M.; Federica N.; Giacomo R.; Beatrice R.; Maria S.I.; Monica T.; Nepita Edoardo V.; Calvi M.; Tizzoni M.; Nicora C.; Triarico A.; Petronella V.; Marena C.; Muzzi A.; Lago P.; Comandatore F.; Bissignandi G.; Gaiarsa S.; Rettani M.; Bandi C.Colaneri, M.; Seminari, E.; Piralla, A.; Zuccaro, V.; Di Filippo, A.; Baldanti, F.; Bruno, R.; Mondelli, M. U.; Brunetti, E.; Di Matteo, A.; Maiocchi, L.; Pagnucco, L.; Mariani, B.; Ludovisi, S.; Lissandrin, R.; Parisi, A.; Sacchi, P.; Patruno, S. F. A.; Michelone, G.; Gulminetti, R.; Zanaboni, D.; Novati, S.; Maserati, R.; Orsolini, P.; Vecchia, M.; Sciarra, M.; Asperges, E.; Sambo, M.; Biscarini, S.; Lupi, M.; Roda, S.; Chiara Pieri, T.; Gallazzi, I.; Sachs, M.; Valsecchi, P.; Perlini, S.; Alfano, C.; Bonzano, M.; Briganti, F.; Crescenzi, G.; Giulia Falchi, A.; Guarnone, R.; Guglielmana, B.; Maggi, E.; Martino, I.; Pettenazza, P.; Pioli di Marco, S.; Quaglia, F.; Sabena, A.; Salinaro, F.; Speciale, F.; Zunino, I.; De Lorenzo, M.; Secco, G.; Dimitry, L.; Cappa, G.; Maisak, I.; Chiodi, B.; Sciarrini, M.; Barcella, B.; Resta, F.; Moroni, L.; Vezzoni, G.; Scattaglia, L.; Boscolo, E.; Zattera, C.; Michele Fidel, T.; Vincenzo, C.; Vignaroli, D.; Bazzini, M.; Iotti, G.; Mojoli, F.; Belliato, M.; Perotti, L.; Mongodi, S.; Tavazzi, G.; Marseglia, G.; Licari, A.; Brambilla, I.; Daniela, B.; Antonella, B.; Patrizia, C.; Giulia, C.; Giuditta, C.; Marta, C.; D'Alterio, Rossana; Milena, F.; Bianca, M.; Roberta, M.; Enza, M.; Stefania, P.; Maurizio, P.; Elena, P.; Antonio, P.; Francesca, R.; Antonella, S.; Maurizio, Z.; Guy, A.; Laura, B.; Ermanna, C.; Giuliana, C.; Luca, D.; Gabriella, F.; Gabriella, G.; Alessia, G.; Viviana, L.; Meisina, Claudia; Valentina, M.; Simona, P.; Marta, P.; Alice, B.; Giacomo, C.; Irene, C.; Alfonso, C.; Di Martino, R.; Di Napoli, A.; Alessandro, F.; Guglielmo, F.; Loretta, F.; Federica, G.; Albertini, Alessandra; Federica, N.; Giacomo, R.; Beatrice, R.; Maria, S. I.; Monica, T.; Nepita Edoardo, V.; Calvi, M.; Tizzoni, M.; Nicora, C.; Triarico, A.; Petronella, V.; Marena, C.; Muzzi, A.; Lago, P.; Comandatore, F.; Bissignandi, G.; Gaiarsa, S.; Rettani, M.; Bandi, C

Textile electrodes: strategy for the improvement of durability and washability through the use of nanofibres

This thesis work has been carried out at the company AB Tech Lab S.R.L., which is a start-up focused on the study and the development of functional textiles for healthcare, sport, and fashion sectors. The purpose of this work is the evaluation of the state of art of ECG textile electrodes and the development of a possible strategy to overcome the problems related to the industrial production and the marketing of this product. ECG textile electrodes consist of textile fibers, usually made of cotton, polyester, or nylon, coated with a conductive biocompatible material and they could be used for long-term ECG monitoring, solving the discomfort problems of disposable electrodes. The main limit of this technology is the low durability and washability caused by the delamination of the coating from the substrate under harsh conditions. A theoretical possible solution has been proposed based on the miniaturization of the textile substrate, using nanofibres instead of conventional fibers. Based on the new design to produce, technologies already implemented on industrial level and materials with suitable properties have been investigated. Electrospinning proved to be the most suitable technology for the objective, due to the possibility of developing different ordered and oriented structures of the nanofibres. The substrate material was evaluated among the ones already used in textile field, that could be electrospun: the most promising ones are the nylon and the polyester. The coating material has been chosen among the conductors already used for the realization of textile electrode and PEDOT:PSS, that is a conductive polymer, shows suitable capabilities for the impregnation of the substrate. The compatibility of these materials has been investigated based on available results in literature. In the end, new materials with promising properties, that need further investigations, has been described

Effects of a Bioavailable Arabinoxylan-enriched White Bread Flour on Postprandial Glucose Response in Normoglycemic Subjects

The beneficial effects of soluble fibers on carbohydrate metabolism are well documented. In this regard, we tested an arabinoxylan-enriched white bread flour, obtained by a patented process by which the bran extracted from the milling process is enzymatically hydrolyzed in order to separate the soluble fraction fiber from the insoluble fiber. We recruited 24 healthy normoglycemic volunteers [Age 34-61 +/- 12.5 y; Body Mass Index (BMI) 22.1 +/- 2.5 kg/m(2); Waist circumference (WC) 84.43 +/- 8.0 cm; Fat Mass (FM) 22.7 +/- 8.0%] attending the Dietetics Outpatient Clinic of the Internal Medicine Department at IRCCS Policlinico S. Matteo Foundation, University of Pavia, Pavia, Italy. Subjects acutely consumed arabinoxylan-enriched white bread (weight: 100 g) or isoenergetic control breads, in a double-blind crossover study design. Plasma glucose levels were measured just before bread administration and 30 minutes afterwards. The 30-minute peak postprandial glucose concentrations after arabinoxylan-enriched meals were significantly lower than after the control meal (107+/-4.6 mg/dL vs. 121 +/- 5.2 mg/dL; p < 0.05). The here-reported results show how postprandial glucose responses were improved by ingestion of the arabinoxylan-enriched meal. Further studies are needed to clarify whether daily consumption of arabinoxylan-enriched bread will benefit patients with type 2 diabetes mellitus

The potential role of EMDR on trauma in affective disorders: A narrative review

BACKGROUND: Eye Movement Desensitization and Reprocessing (EMDR) is a psychotherapeutic approach that has originally been developed to treat post-traumatic stress disorder (PTSD). Recently it has been suggested as a complementary therapy in a wide range of clinical conditions. In particular, affective disorders as bipolar disorder (BD) and major depressive disorder (MDD) have a higher lifetime prevalence of traumatic or stressful life events (SLEs) compared to the general population, which makes them good candidates for the application of EMDR. METHODS: A bibliographic search on PUBMED, Scopus, and ScienceDirect of studies applying EMDR to people with a primary diagnosis of bipolar disorder (BD) and major depressive disorder (MDD) (with or without a comorbid PTSD) was conducted. RESULTS: Literature search retrieved 15 studies, of which 3 were focused on BD and 12 on MDD. Overall, they suggest EMDR as an effective tool in reducing trauma-related but also manic and depressive symptoms, with few effect sides and high adherence rates. LIMITATIONS: Few small studies exist with heterogeneous and not gold-standard methodology, especially for BD. CONCLUSIONS: Overall, retrieved studies can be considered as first attempts at investigating the applicability of EMDR in affective disorders. Although far to be conclusive, preliminary evidence suggests EMDR as a useful adjunctive approach in the treatment of BD and MDD, especially when other treatments have failed. It is now the time to implement such trauma-focused therapy to larger samples of patients using more rigorous methods

Cognitive remediation in schizophrenia: the earlier the better?

Impairments in neuro and social cognition are considered core features of schizophrenia (SCZ) since they affect patients' functioning and contribute to poor socio-occupational outcomes. Therefore, the improvement of cognitive performances has become a primary goal in the care of patients with SCZ, especially in the first phases of the disease, as early interventions may favour better long-term outcomes. Cognitive remediation (CR) is a behavioural training aimed at improving cognitive functions with the goal of durability and generalisation in everyday life. Neuroimaging studies suggest that CR leads to neuroplasticity in chronic SCZ, whereas only a few studies tested the neural effects of CR in the early phase of the disease. Thus, in this review, we aimed at summarising CR-induced structural and functional brain changes in early SCZ. Existing evidence showed a protective effect of CR on grey matter volume in selected medial-temporal (i.e. hippocampus, parahippocampus and amygdala) and thalamic regions whereas functional changes affected mostly dorsolateral prefrontal and insular cortices both associated with improvements in cognitive performance and emotion regulation. Overall, CR in early SCZ appears to be associated with neural adaptations mostly allocated in prefrontal and limbic regions, however future longitudinal studies are needed to clarify whether the positive effects of cognitive training persist over time. It may also be interesting to investigate whether the application of CR in the early v. the late stage of the disease may lead to incremental benefits

The use of mindfulness-based stress reduction and mindfulness-based cognitive therapy in psychosis

INTRODUCTION: Psychosis is a complex and severe psychiatric condition whose treatment has recently included psychotherapeutic interventions. Among the evidence-based approaches, mindfulness-based interventions (MBIs) have been receiving a growing interest albeit studies on their feasibility and effectiveness on psychosis are relatively recent. The present review aims at investigating the application of the two main manualized MBIs known as mindfulness-based stress reduction (MBSR) and mindfulness based cognitive therapy (MBCT) to psychosis. EVIDENCE ACQUISITION: Data search was conducted in March 2022 on the PubMed database. After thorough research, we finally included twelve studies examining the efficacy and feasibility of MBSR and MBCT or very similar interventions in terms of structure and content. EVIDENCE SYNTHESIS: Overall, our review suggests that the use of MBSR/MBCT adapted for psychosis is safe and acceptable in this population of patients. Included studies showed that structured mindfulness protocols positively impact on clinical, psychological, and socio-occupational measures, compared to treatment as usual or other treatments. Patients’ stress, positive and negative symptomatology were reduced. As for cognitive measures, formal mindfulness practice appeared to improve cognitive flexibility, whereas it has been hypothesized to reduce attention, working memory and social cognition deficits. CONCLUSIONS: Despite the examined studies are favorable to the use of manualized mindfulness protocols in psychosis, further studies in larger and better-characterized samples are warranted, particularly to explore the impact of mindfulness on the cognitive dimensions, and the associated neural correlates. Also, longitudinal randomized controlled trial, differentiating between affective and non-affective psychoses and limiting clinical and methodological heterogeneity, are needed