357 research outputs found
Borderline personality in patients with poly-diagnoses treated for a Bipolar Disorder
Some patients with dysphoria, explosive behaviour, or suicidal ideation, may receive a diagnosis of, and treatment for Bipolar Disorder (BD) and, not infrequently. The coexistence of these two diagnoses has been explained in different ways. Some authors include the BPD in the bipolar spectrum; others are sceptical about the existence of real comorbidity, suggesting a misdiagnosis. This study aimed to assess the personality of this group of poly-diagnosed patients (PolyD) and hypothesised they had a pathological borderline organisation. Via the administration of the Schedler Westen Assessment Procedure (SWAP-200), we compared PolyD patients with those suffering from BPD or BD only. We performed two different MANCOVAs to test PolyD, BPD and BD patients' differences in PD-factors, Q-traits and age. The sample comprised 45 patients (Mean age=43.3, SD=15.7; Females 57.7%, N=26). BD patients (N=15) did not present any personality disorder, they had a higher functioning and Obsessive Q-traits, and a lower Histrionic PD-factor than both PolyD (N=20) and BPD (N=10) patients. Compared to PolyD patients, BD had inferior PD-Borderline, PD-Antisocial factor and Dependent-Masochistic Q-traits, but there were no other differences with BPD patients. PolyD did not differ from BPD patients in any of the PD-factors and Q-traits. Our results suggest that PolyD patients are different from BD patients and propose to consider the pathological borderline personality as a central core of their disease
Dust survival rates in clumps passing through the Cas A reverse shock -- II. The impact of magnetic fields
Dust grains form in the clumpy ejecta of core-collapse supernovae where they
are subject to the reverse shock, which is able to disrupt the clumps and
destroy the grains. Important dust destruction processes include thermal and
kinetic sputtering as well as fragmentation and grain vaporization. In the
present study, we focus on the effect of magnetic fields on the destruction
processes. We have performed magneto-hydrodynamical simulations using AstroBEAR
to model a shock wave interacting with an ejecta clump. The dust transport and
destruction fractions are computed using our post-processing code Paperboats in
which the acceleration of grains due to the magnetic field and a procedure that
allows partial grain vaporization have been newly implemented. For the
oxygen-rich supernova remnant Cassiopeia A we found a significantly lower dust
survival rate when magnetic fields are aligned perpendicular to the shock
direction compared to the non-magnetic case. For a parallel field alignment,
the destruction is also enhanced but at a lower level. The survival fractions
depend sensitively on the gas density contrast between the clump and the
ambient medium and on the grain sizes. For a low-density contrast of ,
e.g., nm silicate grains are completely destroyed while the survival
fraction of m grains is per cent. For a high-density contrast of
, per cent of the nm grains survive while the survival
fraction of m grains is per cent. Alternative clump sizes or dust
materials (carbon) have non-negligible effects on the survival rate but have a
lower impact compared to density contrast, magnetic field strength, and grain
size.Comment: Accepted by MNRAS. Author accepted manuscript. Accepted on
23/01/2023. 24 pages, 21 Figure
Effects of a 3-Week In-Hospital Body Weight Reduction Program on Cardiovascular Risk Factors, Muscle Performance, and Fatigue : A Retrospective Study in a Population of Obese Adults with or without Metabolic Syndrome
Background: In clinical practice, there is the diffuse conviction that obese subjects with metabolic syndrome may be more difficult to treat.
Objectives and methods: The aim of the present study was that to investigate the effectiveness of a 3-week in-hospital body weight reduction program (BWRP) in a large population of obese subjects with and without metabolic syndrome (n = 1922; 222 men and 1700 women, age range 18-83 yr). Outcomes such as body mass index (BMI), total (TOT) and HDL cholesterol, systolic and diastolic blood pressures (SBP and DBP, respectively), coronary heart disease (CHD) score, fatigue severity score (FSS), and stair climbing test (SCT) time were evaluated before and after the intervention (\u394). A sex-, BMI-, and age-related stratification of the obese population with or without metabolic syndrome was applied.
Results: When compared to obese subjects without metabolic syndrome, at the basal conditions, obese subjects had a poorer cardiometabolic profile, as demonstrated by higher triglycerides, TOT-cholesterol, DBP, SBP, and CHD score, and a more compromised muscle performance (evaluated by SCT), associated with more perception of fatigue (measured by FSS). Nevertheless, obese subjects with metabolic syndrome obtained more benefits from BWRP than those without metabolic syndrome for some outcomes (i.e., \u394TOT-cholesterol, \u394SBP, and \u394CHD score). Despite these differences, the BWRP-induced weight loss was similar between the two groups (i.e., \u394BMI) as well as the gain of muscle performance (i.e., \u394SCT) and the reduction of fatigue (i.e., \u394FSS). Interestingly, the potentially deleterious fall in HDL-cholesterol levels after BWRP was less evident in obese subjects with metabolic syndrome than those without metabolic syndrome. When pooling all data, the \u394CHD score was associated with age, sex, and metabolic syndrome. The remaining outcomes, such as \u394BMI, \u394FSS, and \u394SCT time, were associated with sex and age but not with metabolic syndrome. Finally, \u394BMI was positively correlated with \u394CHD score, \u394FSS, and \u394SCT time in both obese subjects without metabolic syndrome and obese subjects with metabolic syndrome.
Conclusions: When comparing obese subjects undergoing a BWRP, metabolic syndrome is not a negative predictive factor affecting the effectiveness of this intervention in terms of weight loss, muscle performance, and psychological well-being
The histopathological correlate of peri-vascular adipose tissue attenuation on computed tomography in surgical ascending aorta aneurysms: Is this a measure of tissue inflammation?
On computed tomography (CT) imaging, a peri-vascular adipose tissue attenuation (pVAT) measure has been proposed as a non-invasive correlate of inflammation in the coronary artery vessels, and a single research group provided histopathological demonstration of this radiologi-cal/pathological correspondence. Our group has shown that patients with surgical-grade ascending aorta (AA) aneurysm display higher pVAT compared with patients with smaller aneurysms or normal AA. Based on histopathological studies on coronary arteries, we speculated that this correlation may be related to a non-otherwise specified aortic inflammatory process. However, since adipose tissue around the AA is often scant, and there are no histopathological studies confirming such hypothesized association between higher pVAT and inflammation around the AA, we cannot exclude that this pVAT change is secondary to different mechanisms, unrelated to the actual presence of peri-vascular inflammation. We performed a retrospective clinical/radiological/pathological study in 78 patients who underwent AA surgery with the aim to correlate pre-operatory pVAT on CT with histopathological findings from the surgical specimens. Histopathological review and immunohisto-chemistry were performed on the surgical aortic samples. The AA adventitial/periadventitial adipose tissue had higher pVAT by an increasing collagen fiber deposition, which progressively makes the fat hypotrophic and, in the late stages of this process, it replaces the normal soft tissue composition in this location. In the ascending aorta, pVAT on CT imaging is probably not a proxy for the presence of current vascular inflammation, although it may track changes involving the progressive substitution of perivascular adipose cells by higher-pVAT tissues, mainly fibrotic replacement
Acute respiratory muscle unloading improves time-to-exhaustion during moderate- and heavy-intensity cycling in obese adolescent males
Obesity significantly impairs breathing during exercise. The aim was to determine, in male obese adolescents (OB), the effects of acute respiratory muscle unloading, obtained by switching the inspired gas from ambient air (AIR) to a normoxic helium + oxygen gas mixture (HeO2) (AIR \u2192 HeO2) during moderate [below gas exchange threshold (GET)] and heavy [above GET] constant work rate cycling. Ten OB [age 16.0 \ub1 2.0\ua0years (mean \ub1 SD); body mass index (BMI) 38.9 \ub1 6.1\ua0kg/m2] and ten normal-weight age-matched controls (CTRL) inspired AIR for the entire exercise task, or underwent AIR \u2192 HeO2 when they were approaching volitional exhaustion. In OB time to exhaustion (TTE) significantly increased in AIR \u2192 HeO2 vs. AIR during moderate [1524 \ub1 480\ua0s vs. 1308 \ub1 408 (P = 0.024)] and during heavy [570 \ub1 306\ua0s vs. 408 \ub1 150 (P = 0.0154)] exercise. During moderate exercise all CTRL completed the 40-min task. During heavy exercise no significant differences were observed in CTRL for TTE (582 \ub1 348\ua0s [AIR \u2192 HeO2] vs. 588 \ub1 252 [AIR]). In OB, but not in CTRL, acute unloading of respiratory muscles increased TTE during both moderate- and heavy-exercise. In OB, but not in CTRL, respiratory factors limit exercise tolerance during both moderate and heavy exercise
Cardiometabolic Index (CMI) and Visceral Adiposity Index (VAI) Highlight a Higher Risk of Metabolic Syndrome in Women with Severe Obesity
Recent evidence shows that simple and inexpensive anthropometric measurements can be used to identify, at an early stage, women with obesity at increased risk of developing metabolic syndrome (MetS). Thus, the aim of this study was to compare the accuracy of five different indexes of adiposity and/or body composition in identifying MetS in a group of 876 women (mean age ± SD: 52.1 ± 13.8 years; body mass index (BMI): 43.6 ± 6.1 kg m−2). The following indexes were determined for each subject: waist-to-hip ratio (WHR), waist-to-height ratio (WtHR), body mass fat index (BMFI), visceral adiposity index (VAI), and cardiometabolic index (CMI). Overall, the presence of MetS was detected in 544 patients (62%). Pearson correlation coefficients were calculated to evaluate the relationships between body composition indexes and metabolic characteristics of the women. Receiver operating characteristic (ROC) analysis was used to determine the best predictor for each adiposity index among metabolic risk factors. The ROC analysis showed VAI (AUC = 0.84) and CMI (AUC = 0.86) showed the best performance in predicting MetS. Differences were found between the ROC area of CMI and VAI with all other indexes (p 0.92 for WHR, >0.76 for WtHR, >30.1 kg m−1 for BMFI, >1.94 for VAI, and >0.84 for CMI. In addition, VAI and CMI were the most sensitive and specific indexes compared with other indexes. In conclusion, VAI and CMI represent the most useful and reliable indexes to be used for detecting MetS in women suffering from obesity in clinical practice
The role of different game-genres in predicting internet gaming disorder (IGD)
Introduction: Internet gaming disorder (IGD) is a new diagnosis in
DSM 5 worth of research. New potentially addictive features are
emerging in pay- and free-to-play videogames, involving different
at-risk populations of gamers. However, few studies have examined
whether and how different game-genres can contribute to the risk
of IGD.
Objectives: This study aimed to investigate how game-genres can
predict IGD, accounting for alexithymia scores, time-related play-
ing habits, and other predictors.
Methods: Participants were gamers joining online communities,
surveyed about which games they played more than 20 hours in
their lifetime, time-variables, other stressors and alexithymia
scores. A six-steps linear regression with IGD scores and a post
hoc logistic regression (outcome: IGD>=21) were performed.
Results: 5,979 subjects (88.7% males, 14-18 years), playing at
different games (Figure-1). The game-genre explained the 1% of
variation only. WoW and similar MMORPGs confirmed their
potentiality in promoting IGD, regardless of alexithymia features
(B=0.50, p=0.005). However, time-variables completely absorbed
the WoW effect (B=0.01, p=0.951). LoL resulted addictive, even if
considering time-variables and alexithymia (B=0.88, p<0.001).
Minecraft emerged when time-variables were inserted (B=0.359,
p=0.041) and stayed significant if removing alexithymia scores
(B=0.48, p=0.010). Playing at Diablo3 and similar RPG did not
increase IGD (B=-0.99, p>0.001). None of the different game-
genres was able to push the subject over the threshold of IGD,
because other characteristics interacted as additive risk-factors.
Conclusions: Alexithymia traits and time-related playing habits
mostly moderated the effect of different games in increasing IGD
risk. A videogame could engage people with specific characteristics
that may, in turn, differentially predispose to IGD
Differences between female and male gamers and gender-specific risk-factors for internet gaming disorder (IGD)
Introduction: Videogames have become more popular across
females, although their widespread diffusion among males. How-
ever, few studies have examined differences between female and
male gamers and gender-specific risk factors for Internet Gaming
Disorder (IGD).
Objectives: The study aimed to describe males and females’ differ-
ences in a sample of gamers, and to identify gender-specific risk-
factors for IGD, accounting for alexithymia, playing habits, and
other perceived stressors.
Methods: Participants were gamers joining online communities,
tested by IGDS-SF9 and TAS-20 for alexithymia. To explore
isk-factors for IGD (outcome: IGD>=21), we set a binary logistic
regression stratified by gender.
Results: 5,305 males and 674 females differed in most of the descrip-
tive characteristics (Figure-1) and game-genres preferences (Figure-
2). Higher DIF scores increased the risk of IGD in both males
(OR=1.8 95% C.I. 1.6, 2) and females (OR=1.3 95% C.I. 1.1, 1.7)
while higher EOT in males only (OR=1.2 95% C.I. 1.1, 1.3). Having
another hobby apart from gaming was protective for males (OR=0.5,
95% C.I. 0.4, 0.6). Having started playing before their ten-years was a
risk factor for females (OR=2.3 95% C.I. 1.2, 4.6). Loneliness and
boredom feelings predicted IGD in males (OR=1.7 95% C.I. 1.5, 2)
and, even more, in females (OR=2.7 95% C.I. 1.8, 4.2). Playing more
than six hours/per day increased IGD-risk up to seven times in males
(OR=7.3 95% C.I. 5.1, 10.3) and of almost sixteen times in females
(OR=15.9 95% C.I. 5.4, 46.7) (Figure-3).
Conclusions: Female gamers presented specific characteristics and
a greater vulnerability to the increased time spent playing as a risk-
factor for IG
Pathological gambling in adolescence: A narrative review
Pathological gambling is an emerging and increasing phenomenon in Western counties. This work is aimed at reviewing the existing literature on this topic, paying special attention to its development, course and outcome in adolescence. We will explore epidemiological data, the instruments for the diagnostic and clinical assessment, the course and the outcome of the disorder, the comorbidity with other psychiatric syndromes and disorders. The main risk factors will be described at individual, social and community level. We provide an overview of the available pharmacological and psychological treatments and we report a clinical vignette in order to describe the psychological and psychopathological features of pathological gambling in adolescence
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