Treatment preferences in fibromyalgia patients: A cross‐sectional web‐based survey

Background Therapeutic approaches to fibromyalgia (FM) are shifting towards a combined multi‐treatment approach to tackle the variety of symptoms experienced in FM. Importantly, little is known about FM patients' attitude towards the available treatments. Methods A cross-sectional web survey obtained responses from 464 individuals who satisfied diagnostic criteria for FM. Respondents were asked to report which treatments they adopted in their past, present and intend to adopt in the future. They also rated their level of well-being, depression, anxiety and pain catastrophizing. Results Data revealed a predominantly combined multi-treatment approach in a sample characterized by middle-aged, Caucasian women. Respondents reported pervasive use of pharmacological therapy but had also adopted non-pharmacological treatment in the past. Future intentions clustered on alternative treatment or no treatment. Regression analyses revealed that pharmacological treatment in the past was predictive of both pharmacological and non-pharmacological treatments in the present. However, use of non-pharmacological treatment in the past was uniquely predictive of its reuse in the present and future. This pattern was also accounted for by individual differences in pain magnification and well-being in the past. Conclusions Treatment preferences of FM individuals reveal an ambivalent combination of heavy reliance on pharmacological treatment with lower but consistent reliance on non-pharmacological treatment for those individuals who used it in the past and present. This finding may inform longitudinal research into the relationship between pharmacological and non-pharmacological treatment preference in FM patients, which could in turn inform guidelines for individualized therapeutic plans for clinicians. Significance Individuals with fibromyalgia reported the use of non-pharmacological and pharmacological treatments in the past but a predominant use of a pharmacological approach overall. Patterns of treatment experienced in the past were differentially related to future preferences. Pharmacological treatment in the past was likely to lead to both pharmacological and non-pharmacological choices in the present. However, non-pharmacological treatment in the past was more likely to be chosen again in the present and future, but unlikely to lead to a pharmacological choice

Virtual unfolding of light sheet fluorescence microscopy dataset for quantitative analysis of the mouse intestine

Light sheet fluorescence microscopy has proven to be a powerful tool to image fixed and chemically cleared samples, providing in depth and high resolution reconstructions of intact mouse organs. We applied light sheet microscopy to image the mouse intestine. We found that large portions of the sample can be readily visualized, assessing the organ status and highlighting the presence of regions with impaired morphology. Yet, three-dimensional (3-D) sectioning of the intestine leads to a large dataset that produces unnecessary storage and processing overload. We developed a routine that extracts the relevant information from a large image stack and provides quantitative analysis of the intestine morphology. This result was achieved by a three step procedure consisting of: (1) virtually unfold the 3-D reconstruction of the intestine; (2) observe it layer-by-layer; and (3) identify distinct villi and statistically analyze multiple samples belonging to different intestinal regions. Even if the procedure has been developed for the murine intestine, most of the underlying concepts have a general applicability

SUICIDALITY AND COVID-19: DATA FROM AN EMERGENCY SETTING IN ITALY

Background: Suicidality is a widespread phenomenon with a dramatic burden worldwide. The Coronavirus disease 2019 (Covid- 19) pandemic determined a relevant impact on mental health, due to the infection itself and its socio-economic consequences. The present study is aimed at analyzing the prevalence of suicidality during the Covid-19 pandemic among subjects requiring a psychiatric consultation in an emergency setting. Subjects and methods: Socio-demographic and clinical information was collected at the emergency department of the General Hospital of Perugia from June 1st, 2020 to January 31st, 2021. Data was entered into an electronic datasheet and retrospectively analysed. was performed in order to assess significant associations between suicide-related variables and specific socio-demographic and clinical features (p<0.05). Results: Among 447 subjects included in the analysis, 109 (24.4%) showed suicidality-related phenomena, particularly suicide attempts (SA) (n=44, 9.8%), suicidal ideation (SI) (n=41, 9.2%), non suicidal self-injury (NSSI) (n=31, 6.9%), that in some cases cooccurred. A statistically significant association was detected between NSSI and living with marital family (p=0.024) and between suicidality-related phenomena and adjustment disorders (p=0.018). None of the examined subjects reported a previous positivity for Covid-19 and neither did their relatives. Conclusions: The present study confirms the impact of the Covid-19 pandemic on suicide-related phenomena. Consultation psychiatry fulfills a key role in the early detection and clinical management of these conditions, that require targeted intervention strategies

SUICIDALITY AND COVID-19: DATA FROM AN EMERGENCY SETTING IN ITALY

Background: Suicidality is a widespread phenomenon with a dramatic burden worldwide. The Coronavirus disease 2019 (Covid- 19) pandemic determined a relevant impact on mental health, due to the infection itself and its socio-economic consequences. The present study is aimed at analyzing the prevalence of suicidality during the Covid-19 pandemic among subjects requiring a psychiatric consultation in an emergency setting. Subjects and methods: Socio-demographic and clinical information was collected at the emergency department of the General Hospital of Perugia from June 1st, 2020 to January 31st, 2021. Data was entered into an electronic datasheet and retrospectively analysed. was performed in order to assess significant associations between suicide-related variables and specific socio-demographic and clinical features (p<0.05). Results: Among 447 subjects included in the analysis, 109 (24.4%) showed suicidality-related phenomena, particularly suicide attempts (SA) (n=44, 9.8%), suicidal ideation (SI) (n=41, 9.2%), non suicidal self-injury (NSSI) (n=31, 6.9%), that in some cases cooccurred. A statistically significant association was detected between NSSI and living with marital family (p=0.024) and between suicidality-related phenomena and adjustment disorders (p=0.018). None of the examined subjects reported a previous positivity for Covid-19 and neither did their relatives. Conclusions: The present study confirms the impact of the Covid-19 pandemic on suicide-related phenomena. Consultation psychiatry fulfills a key role in the early detection and clinical management of these conditions, that require targeted intervention strategies

Forecasting COVID-19-Associated Hospitalizations under Different Levels of Social Distancing in Lombardy and Emilia-Romagna, Northern Italy: Results from an Extended SEIR Compartmental Model

The outbreak of coronavirus disease 2019 (COVID-19) was identified in Wuhan, China, in December 2019. As of 17 April 2020, more than 2 million cases of COVID-19 have been reported worldwide. Northern Italy is one of the world's centers of active coronavirus cases. In this study, we predicted the spread of COVID-19 and its burden on hospital care under different conditions of social distancing in Lombardy and Emilia-Romagna, the two regions of Italy most affected by the epidemic. To do this, we used a Susceptible-Exposed-Infectious-Recovered (SEIR) deterministic model, which encompasses compartments relevant to public health interventions such as quarantine. A new compartment L was added to the model for isolated infected population, i.e., individuals tested positives that do not need hospital care. We found that in Lombardy restrictive containment measures should be prolonged at least until early July to avoid a resurgence of hospitalizations; on the other hand, in Emilia-Romagna the number of hospitalized cases could be kept under a reasonable amount with a higher contact rate. Our results suggest that territory-specific forecasts under different scenarios are crucial to enhance or take new containment measures during the epidemic

PSYCHIATRIC COMORBIDITY IN BARIATRIC SURGERY: A RETROSPECTIVE STUDY IN A GENERAL HOSPITAL

Background: Candidates for bariatric surgery undergo a multidisciplinary evaluation in the pre-operative phase, including a psychiatric visit aimed at the screening for psychiatric comorbidities, including feeding and eating disorders (FEDs), which are shortcomings to the intervention or predictors of worse prognosis. The presence of FEDs, such as Binge Eating Disorder (BED) and Bulimia Nervosa (BN), is associated with higher rates of other psychiatric disorders. Furthermore, there is evidence of the association between obesity and Depressive Disorders, as well as B and C Cluster Personality Disorders. The aim of this study was to evaluate the presence of psychiatric comorbidities among a population of candidates for bariatric surgery. Subjects and methods: Subjects were recruited at the outpatient service of the Section of Psychiatry, Clinical Psychology and Rehabilitation of the General Hospital/University of Perugia after being referred by surgeons. Psychiatric comorbidities were investigated by means of the Structured Clinical Interview for DSM-5 Disorders. Subjects underwent specific assessment with scales for the evaluation of FEDs, namely Binge Eating Scale, Obesity Questionnaire, Bulimia Test-Revised and Body Shape Questionnaire. Results: The sample consisted of 101 subjects: 43 (42.6%) were diagnosed with at least one psychiatric disorder, including FEDs. In particular, 30 subjects (29.7%) presented at least one FED, among which the most frequent were FED not otherwise specified (24.1%) and BED (6.8%). Moreover, 26 subjects (25.7%) were diagnosed with at least one psychiatric disorder other than FEDs, such as Personality Disorders (17.1%), with a higher prevalence of B and C Cluster Disorders. Depressive Disorders were detected in 5% of the sample. Conclusions: Subjects undergoing bariatric surgery often display psychiatric comorbidities, more frequently one or more FEDs. The systematic screening of these conditions should be implemented in the clinical practice in order to provide early intervention strategies and adequate monitoring

A Novel Mutation in Lamin A/C Gene: Phenotype and Consequences on the Protein Structure and Flexibility

n/

Selectivity of the CUBAN domain in the recognition of ubiquitin and NEDD8

Among the members of the Ubiquitin‐like (Ubl) protein family, Neural precursor cell expressed developmentally down‐regulated protein 8 (NEDD8) is the closest in sequence to ubiquitin (57% identity). The two modification mechanisms and their functions, however, are highly distinct and the two Ubls are not interchangeable. A complex network of interactions between modifying enzymes and adaptors, most of which are specific while others are promiscuous, ensures selectivity. Many domains that bind the ubiquitin hydrophobic patch also bind NEDD8 while no domain that specifically binds NEDD8 has yet been described. Here we report an unbiased selection of domains that bind ubiquitin and/or NEDD8 and we characterize their specificity/promiscuity. Many ubiquitin binding domains bind ubiquitin preferentially and, to a lesser extent, NEDD8. In a few cases, the affinity of these domains for NEDD8 can be increased by substituting the alanine at position 72 with arginine, as in ubiquitin. We have also identified a unique domain, mapping to the carboxyl‐end of the protein KHNYN, which has a starkly preference for NEDD8. Given its ability to bind neddylated cullins we have named this domain CUBAN (Cullin Binding domain Associating with NEDD8). We present here the solution structure of the CUBAN domain both in the isolated form and in complex with NEDD8. The results contribute to the understanding of the discrimination mechanism between ubiquitin and the Ubl. They also provide new insights on the biological role of a ill‐defined protein, whose function is hitherto only predicted

ANTEPARTUM DISTRESS DURING COVID-19 PANDEMIC: AN OBSERVATIONAL STUDY

Background: The present study investigates the impact of the Coronavirus diseases 2019 (Covid-19) pandemic on the subjective experience of pregnant women, as well as the impact of the pandemic on this population in terms of psychopathological correlates. Subjects and methods: Pregnant women referring to the Section of Obstetrics and Gynecology of the General Hospital of Perugia, Italy, were recruited from 1st May, 2021 to 15th June, 2021. Socio-demographic and clinical data was collected, as well as information regarding the Covid-19 pandemic impact on the subjective experience of pregnancy. Psychopathology was evaluated by means of the State-Trait Anxiety Inventory Form Y (STAI-Y), the Symptom Checklist-90 (SCL-90) and the Prenatal Distress Measure (Pre-DM). Descriptive analyses were performed. Significant associations between distress symptoms and the collected sociodemographic and clinical variables were assessed by using the Pearson correlation (p<0.05). Results: 25 women were included in the study. Among these, 18 (72%) reported that the Covid-19 pandemic negatively impacted their experience of pregnancy. Were detected an average Pre-DM total score of 7.28±4.33 and an average state anxiety scale value of 35.56+-9.21 and an average trait anxiety scale value of 34.04+-7.44 at the STAI-Y. A global severity index > 1 at SCL-90 was detected in 8.3% of the sample. Conclusions: The identification of antepartum distress and the early treatment of perinatal psychopathology represent a priority during the Covid-19 pandemic era