The Kids Are Alright (?). Infants’ Development and COVID-19 Pandemic: A Cross-Sectional Study

Objectives: The study aimed to assess and compare the global development in six-month-old infants before and during the pandemic restrictive social distancing measures. Methods: This cross-sectional nested study involved infants assessed through the Griffiths Scales of Child Development (GSCD) between September 2019 and April 2021. Infants were classified in a pre-COVID or a COVID group, considering the evaluation date and the restrictive measures in place. GSCD subscales and General Development Scores (GDS) were calculated and compared. Results: One hundred and four healthy term-born infants were evaluated. GDS in the COVID group (n:70; median: 94; IQR: 90–100) appeared significantly lower than in the pre-COVID group (n:34; median: 98; IQR: 97–103; p < 0.001). Language and personal-social-emotional subareas scores appeared the most affected. A decreasing trend of GDS along with the severity of restriction was observed. Conclusion: A reduction in infant development scores was observed during pandemic social distancing. Further studies are needed to systematize these findings and to address effective public health policies for infants and families during long-term forced isolation periods

Identifying the factors that influence surgeon's compliance with excisional margins of non-melanoma skin cancer

The rising incidence of Non Melanoma Skin Cancers (NMSC) leads to a high number of surgical procedures worldwide. The strict compliance with international guidelines with regard to excisional margins may help decrease the number of re-excision procedures and reduce the risk of NMSC recurrence. The aim of this study was to investigate the prevalence of excisional margins as recommended by the European Academy of Dermatology and Venereology (EADV) and the European Dermatology Forum (EDF) guidelines, and the factors (demographic or clinical) that influence surgeons' compliance with these guidelines.This was a prevalence study looking at surgical excisions of NMSCs performed over a period of 2 years (2011-2012). A sample size of 1669 patients was considered. Definition of excisional margins recommended by the international guidelines (EADV and EDF) were used as point of reference for the analysis. Tumor and histologic specimen size were calculated ex vivo by 5 different pathologists. The size of skin specimens was measured with a major axis and a minor axis. The same was done for the tumor present on the skin specimens. The differences between the major and minor axes of surgical specimen and tumor were calculated. These differences were subsequently divided by two, hypothesizing that the lesion had the same distance from the margins of the surgical specimen. The differences obtained were named "Delta", the formulas applied being the following: Delta major = (major axis specimen-major axis tumor)/2; Delta minor = (minor axis specimen -minor axis tumor)/2.Results show a significant statistical difference, associated with factors such as: Age of the patient, anatomical localization of the tumor, histological diagnosis, and surgeons' experience.The identification of these factors sheds light on clinicians' practice and decision-making regarding excisional margins. Hopefully a higher level of adherence to the guidelines can be achieved in the future

Perinatal and postnatal exposure to phthalates and early neurodevelopment at 6 months in healthy infants born at term

BackgroundPhthalates are non-persistent chemicals largely used as plasticizers and considered ubiquitous pollutants with endocrine disrupting activity. The exposure during sensible temporal windows as pregnancy and early childhood, may influence physiological neurodevelopment.Aims and ScopeThe aim of this study is to analyze the relationship between the urinary levels of phthalate metabolites in newborn and infants and the global development measured by the Griffiths Scales of Children Development (GSCD) at six months.MethodsLongitudinal cohort study in healthy Italian term newborn and their mothers from birth to the first 6 months of life. Urine samples were collected at respectively 0 (T0), 3 (T3), 6 (T6) months, and around the delivery for mothers. Urine samples were analyzed for a total of 7 major phthalate metabolites of 5 of the most commonly used phthalates. At six months of age a global child development assessment using the third edition of the Griffith Scales of Child Development (GSCD III) was performed in 104 participants.ResultsIn a total of 387 urine samples, the seven metabolites analyzed appeared widespread and were detected in most of the urine samples collected at any time of sampling (66-100%). At six months most of the Developmental Quotients (DQs) falls in average range, except for the subscale B, which presents a DQ median score of 87 (85-95). Adjusted linear regressions between DQs and urinary phthalate metabolite concentrations in mothers at T0 and in infants at T0, T3 and T6 identified several negative associations both for infants’ and mothers especially for DEHP and MBzP. Moreover, once stratified by children’s sex, negative associations were found in boys while positive in girls.ConclusionsPhthalates exposure is widespread, especially for not regulated compounds. Urinary phthalate metabolites were found to be associated to GSCD III scores, showing inverse association with higher phthalate levels related to lower development scores. Our data suggested differences related to the child’s sex

TRPV4 Inhibition and CRISPR-Cas9 Knockout Reduce Inflammation Induced by Hyperphysiological Stretching in Human Annulus Fibrosus Cells

Mechanical loading and inflammation interact to cause degenerative disc disease and low back pain (LBP). However, the underlying mechanosensing and mechanotransductive pathways are poorly understood. This results in untargeted pharmacological treatments that do not take the mechanical aspect of LBP into account. We investigated the role of the mechanosensitive ion channel TRPV4 in stretch-induced inflammation in human annulus fibrosus (AF) cells. The cells were cyclically stretched to 20% hyperphysiological strain. TRPV4 was either inhibited with the selective TRPV4 antagonist GSK2193874 or knocked out (KO) via CRISPR-Cas9 gene editing. The gene expression, inflammatory mediator release and MAPK pathway activation were analyzed. Hyperphysiological cyclic stretching significantly increased the IL6, IL8, and COX2 mRNA, PGE2 release, and activated p38 MAPK. The TRPV4 pharmacological inhibition significantly attenuated these effects. TRPV4 KO further prevented the stretch-induced upregulation of IL8 mRNA and reduced IL6 and IL8 release, thus supporting the inhibition data. We provide novel evidence that TRPV4 transduces hyperphysiological mechanical signals into inflammatory responses in human AF cells, possibly via p38. Additionally, we show for the first time the successful gene editing of human AF cells via CRISPR-Cas9. The pharmacological inhibition or CRISPR-based targeting of TRPV4 may constitute a potential therapeutic strategy to tackle discogenic LBP in patients with AF injury

Sampling and characterization of micro-and nanoparticles from gas tungsten arc welding (GTAW) fumes

Riassunti / absract presentati al XXV Congresso della Divisione di Chimica Analitica della Societ\ue0 Chimica Italian

Parenting stress: socio-economic determinants before and during the covid-19 pandemic. results of an italian cross-sectional study

Background and objective: Parenting can be a stressful experience and in the context of a pandemic it can represent a challenge for many families. The aim of this study was to investigate socio-demographic factors related to parenting stress before and after the SARS-CoV-2 outbreak in Italian parents living in Modena (Italy). Methods: From September 2019 to May 2021, 80 parents of 6 months healthy children were enrolled in a prospective cohort study at the local University Hospital and filled in the Parenting Stress Index Short Form (PSI-SF), a validated questionnaire measuring parenting stress, well-known in clinical practice for its reliability and simplicity of use. PSI scores over the 90th percentile of the Italian population distribution were considered indicative of a highly stressful condition. The role played by different socio-demographic factors in increasing PSI score was tested by chi-square test in the whole sample and by stratifying parents according to the evaluation time (PRE-COVID and COVID period). Results: Overall, 11% of parents reported high stress scores and prevalence was higher during lockdown (15% vs 6%). In the COVID group, higher scores were observed in younger mothers (17%), higher educated parents (16% and 23% of mothers and fathers respectively), having only one child (18%) and living in the urban environment (23%), regardless of infant’s gender. In the PRE-COVID group higher stress scores were reported mainly by parents with more than one child (10%), with male children (9%), and by mothers with lower education (8%). Nevertheless, differences were often not statistically significant. Conclusion: Different socio-demographic factors appear to be related to higher parenting stress and our results suggest that they could show inverse trends in different conditions. Parenting stress in difficult circumstances must be addressed carefully and promptly and specific public health interventions for families with special needs must be planned and implemented

Early life exposure to phthalates and risk assessment: are we doing enough?

Background and Objective: Phthalates, potential endocrine disruptors with antiandrogenic effects, are widely used in several everyday products and are ubiquitous pollutants. Since 1999 European Authorities enacted several regulations to limit phthalate use and prevent exposure, mainly for more susceptible populations such as infants. This study aims to evaluate the estimated daily intake (EDI) of phthalates and to perform risk assessment evaluation in an Italian pediatric cohort. Methods: Between 2019 and 2020, 197 mother-child couples were enrolled in a prospective cohort study at the University Hospital of Modena (Italy). Urine samples were collected at birth, 3 and 6-months. 8 phthalates metabolites were analyzed. EDI was estimated and Risk quotients (RQ) were calculated using tolerable daily intake levels, (RQ(TDI)) as determined by the European Food Safety Authority, and the revised reference doses for anti-androgenicity RQ(RfD-AA), recently proposed. Finally, combined Hazard Indexes (HI) were calculated to assess synergic effect of different phthalates. Results: Most EDI and RQ(TDI) were lower than the acceptable values. The highest levels were found for Diethyl-phthalate (DEP), followed by Di-2-ethylhexyl-phthlate (DEHP). Newborns showed the highest values, followed by 6-months infants. Values exceeding the risk levels were observed for DEHP or di-n-butyl-phthalate (DnBP) in 5.5% and 10% of the newborns, respectively for RQ(RfDAA) and HI. Overall, HI higher values than threshold were observed at each follow-up visit. Conclusion: Since the European Union has a strict regulation policy regarding the most critical phthalates, these findings raise concern: exposure affecting children in Modena is still spread and includes phthalates banned in childcare products, such as DEHP and DnBP. Notably, few infants (especially newborns) exceeded the risk threshold for antiandrogenic effects. Further, exposure patterns seem to change over time during their first months of life. More extensive public health measures need to be planned to efficiently protect the most sensitive subgroups, including infants

Mpox Outbreak 2022: A Comparative Analysis of the Characteristics of Individuals Receiving MVA-BN Vaccination and People Diagnosed with Mpox Infection in Milan, Italy

Mpox caused a worldwide outbreak in 2022, disproportionately affecting MSM reporting high-risk sexual behaviors. The aim of this study was to compare the characteristics of people receiving MVA-BN vaccination with those of individuals diagnosed with mpox to guide future vaccination policies. This was a retrospective study on people with mpox infection or vaccination at San Raffaele Scientific Institute, Milan, Italy, from May to November 2022. Characteristics were compared using Mann–Whitney or chi-square/Fisher’s exact tests; multivariable logistic regression and classification tree analysis were applied. Overall, 473 vaccinated individuals and 135 with mpox were included; 472/473 and 134/135 were MSM. People with mpox were more frequently living with HIV (48.9% vs. 22.4%, p p p p p p p = 0.001), those with previous syphilis (aOR = 4.11, 95%CI = 2.22–7.72, p 10 partners (aOR = 11.56, 95%CI = 6.60–21.09, p < 0.001) had a higher risk of infection. This study underscores the importance of prioritizing MSM with prior STIs and multiple partners as well as chemsex users in vaccination policies to curb mpox spread. A destigmatized assessment of sexual history is vital for comprehensive sexual health strategies

Identifying the factors that influence surgeon's compliance with excisional margins of non-melanoma skin cancer

The rising incidence of Non Melanoma Skin Cancers (NMSC) leads to a high number of surgical procedures worldwide. The strict compliance with international guidelines with regard to excisional margins may help decrease the number of re-excision procedures and reduce the risk of NMSC recurrence. The aim of this study was to investigate the prevalence of excisional margins as recommended by the European Academy of Dermatology and Venereology (EADV) and the European Dermatology Forum (EDF) guidelines, and the factors (demographic or clinical) that influence surgeons' compliance with these guidelines.This was a prevalence study looking at surgical excisions of NMSCs performed over a period of 2 years (2011-2012). A sample size of 1669 patients was considered. Definition of excisional margins recommended by the international guidelines (EADV and EDF) were used as point of reference for the analysis. Tumor and histologic specimen size were calculated ex vivo by 5 different pathologists. The size of skin specimens was measured with a major axis and a minor axis. The same was done for the tumor present on the skin specimens. The differences between the major and minor axes of surgical specimen and tumor were calculated. These differences were subsequently divided by two, hypothesizing that the lesion had the same distance from the margins of the surgical specimen. The differences obtained were named "Delta", the formulas applied being the following: Delta major = (major axis specimen-major axis tumor)/2; Delta minor = (minor axis specimen -minor axis tumor)/2.Results show a significant statistical difference, associated with factors such as: Age of the patient, anatomical localization of the tumor, histological diagnosis, and surgeons' experience.The identification of these factors sheds light on clinicians' practice and decision-making regarding excisional margins. Hopefully a higher level of adherence to the guidelines can be achieved in the future