Blood cell gene expression profiles: A narrative review of biomarkers and effects of low-dose ionizing radiation exposure

Ionizing radiation (IR) is a ubiquitous environmental agent whose effects on organisms are well known. This review provides a summary about definitions and man-made low-dose ionizing radiation (LDIR) sources and dosimeters used in radiation protection. Moreover, the main purpose of this article was to overview the pro-oncogenic effects of LDIR, and to provide experimental evidence that reinforce the use of gene expression data as biomarkers of LDIR effects. Our review showed that basic studies on biological response to LDIR are considered priority. Further, understanding occupational exposure to LDIR may provide valuable information to organize the prevention and prevent from the onset of long-term health effects in radiation workers. Currently, the biodosimetry-based assessment in certain high risk occupational groups may be performed by using peripheral blood cells as samples for testing and validation of biomarkers specificity and sensitivity. Most of the studies on this topic are aimed at establishing new biomarkers and approaches to biological dosimetry, for allowing non-invasive monitoring of long-term health effects of LDIR. Analysis on changes in gene-expression, which is an early specific biological response to LDIR, could provide rapid estimates of individual dose in occupational cohorts, improving the management of periodical medical examination in subjects exposed to LDIR sources

Off-label long acting injectable antipsychotics in real-world clinical practice: a cross-sectional analysis of prescriptive patterns from the STAR Network DEPOT study

Introduction Information on the off-label use of Long-Acting Injectable (LAI) antipsychotics in the real world is lacking. In this study, we aimed to identify the sociodemographic and clinical features of patients treated with on- vs off-label LAIs and predictors of off-label First- or Second-Generation Antipsychotic (FGA vs. SGA) LAI choice in everyday clinical practice. Method In a naturalistic national cohort of 449 patients who initiated LAI treatment in the STAR Network Depot Study, two groups were identified based on off- or on-label prescriptions. A multivariate logistic regression analysis was used to test several clinically relevant variables and identify those associated with the choice of FGA vs SGA prescription in the off-label group. Results SGA LAIs were more commonly prescribed in everyday practice, without significant differences in their on- and off-label use. Approximately 1 in 4 patients received an off-label prescription. In the off-label group, the most frequent diagnoses were bipolar disorder (67.5%) or any personality disorder (23.7%). FGA vs SGA LAI choice was significantly associated with BPRS thought disorder (OR = 1.22, CI95% 1.04 to 1.43, p = 0.015) and hostility/suspiciousness (OR = 0.83, CI95% 0.71 to 0.97, p = 0.017) dimensions. The likelihood of receiving an SGA LAI grew steadily with the increase of the BPRS thought disturbance score. Conversely, a preference towards prescribing an FGA was observed with higher scores at the BPRS hostility/suspiciousness subscale. Conclusion Our study is the first to identify predictors of FGA vs SGA choice in patients treated with off-label LAI antipsychotics. Demographic characteristics, i.e. age, sex, and substance/alcohol use co-morbidities did not appear to influence the choice towards FGAs or SGAs. Despite a lack of evidence, clinicians tend to favour FGA over SGA LAIs in bipolar or personality disorder patients with relevant hostility. Further research is needed to evaluate treatment adherence and clinical effectiveness of these prescriptive patterns

The Role of Attitudes Toward Medication and Treatment Adherence in the Clinical Response to LAIs: Findings From the STAR Network Depot Study

Background: Long-acting injectable (LAI) antipsychotics are efficacious in managing psychotic symptoms in people affected by severe mental disorders, such as schizophrenia and bipolar disorder. The present study aimed to investigate whether attitude toward treatment and treatment adherence represent predictors of symptoms changes over time. Methods: The STAR Network \u201cDepot Study\u201d was a naturalistic, multicenter, observational, prospective study that enrolled people initiating a LAI without restrictions on diagnosis, clinical severity or setting. Participants from 32 Italian centers were assessed at three time points: baseline, 6-month, and 12-month follow-up. Psychopathological symptoms, attitude toward medication and treatment adherence were measured using the Brief Psychiatric Rating Scale (BPRS), the Drug Attitude Inventory (DAI-10) and the Kemp's 7-point scale, respectively. Linear mixed-effects models were used to evaluate whether attitude toward medication and treatment adherence independently predicted symptoms changes over time. Analyses were conducted on the overall sample and then stratified according to the baseline severity (BPRS < 41 or BPRS 65 41). Results: We included 461 participants of which 276 were males. The majority of participants had received a primary diagnosis of a schizophrenia spectrum disorder (71.80%) and initiated a treatment with a second-generation LAI (69.63%). BPRS, DAI-10, and Kemp's scale scores improved over time. Six linear regressions\u2014conducted considering the outcome and predictors at baseline, 6-month, and 12-month follow-up independently\u2014showed that both DAI-10 and Kemp's scale negatively associated with BPRS scores at the three considered time points. Linear mixed-effects models conducted on the overall sample did not show any significant association between attitude toward medication or treatment adherence and changes in psychiatric symptoms over time. However, after stratification according to baseline severity, we found that both DAI-10 and Kemp's scale negatively predicted changes in BPRS scores at 12-month follow-up regardless of baseline severity. The association at 6-month follow-up was confirmed only in the group with moderate or severe symptoms at baseline. Conclusion: Our findings corroborate the importance of improving the quality of relationship between clinicians and patients. Shared decision making and thorough discussions about benefits and side effects may improve the outcome in patients with severe mental disorders

Which of the Physiological vs. Critical Speed Is a Determinant of Modern Pentathlon 200 m Front Crawl Swimming Performance: The Influence of Protocol and Ergometer vs. Swimming Pool Conditions

Background: Modern pentathlon includes horse riding, fencing, swimming, shooting and cross-country running. Events can last many hours during which the athletes face almost maximal energy and physiological demands, and fatigue. Early recognition and prevention of injuries and overuse syndromes can be achieved by refining the individual training loads. The purpose of the study was to determine which parameter could be the most accurate predictor of swimming working capacity determinants in pentathletes. Methods: Fourteen male pentathletes performed a continuous maximal incremental test in the swimming flume ergometer to measure peak oxygen uptake (VO2peak), and five swimming tests in a 50 m swimming pool to detect critical velocity (CV); velocity at 2 and 4 mM·L−1 of blood lactate (v2, v4) and energy cost (EC). Results: The 200 m swimming time was 2:18–2:32 m:s (340 FINA points). CV was 1.21 ± 0.04 m·s−1, v2 was 1.14 ± 0.09 and v4 1.23 ± 0.08 m·s−1. VO2peak was 3540.1 ± 306.2 mL·min−1 or 48.8 ± 4.6 mL·kg−1·min−1. EC at 1.24 m·s−1 was 45.7 ± 2.4 mL·kg−1·min−1. Our main finding was the large correlation of CV with 200 m swimming performance; Conclusions: Among all the protocols analysed, CV is the most predictive and discriminative of individual swimming performance in this group of pentathletes. It appears as the most suitable test to constantly refine their swimming training loads for both performance enhancement and health promotion

Puberal and Adolescent Horse Riders’ Fitness during the COVID-19 Pandemic: The Effects of Training Restrictions on Health-Related and Functional Motor Abilities

The aim of the study was to analyse the fitness level of young horse riders before and after 12 weeks of training restrictions instituted due to the COVID-19 emergency. Anthropometrical measure assessment and an eight-items fitness test battery were administered to 61 puberal and adolescent female amateur horse riders. Subjects were evaluated within 3 weeks before (pre-tests) the period of training restrictions and on the first day of normal training after it (post-tests). Post-test results showed significant increases in body weight (Z: −1.732; p value: 0.001; ES: −0.157) and BMI (F: 9.918; p value: 0.003; ES: 0.146), whilst the performance in hand grip and abdominal strength, hip mobility, and 10 × 5 m Shuttle and Cooper 12 min tests’ outcomes significantly decreased (F: 29.779; p value: 0.001 F: 29.779; p value: 0.001 F: 29.779; p value: 0.001 F: 29.779; p value: 0.001 F: 29.779; p value: 0.001, respectively). Correlation analysis revealed that riders’ experience was significantly correlated with hand grip (p < 0.01), leg strength (p < 0.01), hip mobility (p < 0.05), and 5 × 10 m Shuttle (p < 0.01) and the Cooper 12 min (p < 0.01) test results. It could be suggested that equestrian activities could produce a higher fitness level in puberal and adolescent riders, whilst home-based, unsupervised, and unattentively planned training during the twelve weeks of training restrictions might be insufficient to maintain it

Energy Consumption of Water Running and Cycling at Four Exercise Intensities

Water exercise provides a workload in every direction of motion for training in a reduced impact environment. The selection of an appropriate physical activity and an individual exercise prescription are essential to obtain training effects. The aim of the present study was to determine individualised relative exercise intensities at four speeds of motion for water cycling and water running. Running was tested both in buoyancy and with the feet in contact with the bottom of the pool. To this purpose, gas exchanges, heart rate, and blood lactate were measured in each test session. Fourteen active, healthy females (23.2 ± 1.6 years) underwent a dry land maximal incremental protocol to exhaustion on a treadmill and hydrobike (HB); they engaged in water running with ground contact (RC) and water running suspended (RS) tests in a swimming pool at 30, 40, 50, and 60 cycles per minute (cpm), submerged at the individual xiphoid level. The four motion speeds of the three water exercise modalities ranged from 50% to 95% of the maximal heart rate and the maximal oxygen uptake, representing a moderate-to-vigorous training stimulus. RS elicited the lowest oxygen consumption, whereas HB demanded the significantly highest oxygen consumption and presented the highest blood lactate accumulation, with vigorous intensity being reached at 50 cpm and near maximal intensity at 60 cpm. It appears that water cycling could be more suitable for athletic training, whereas water running could be more appropriate for health and fitness purposes

Creative Learning in Digital and Virtual Environments During COVID-19 and Beyond

In this final chapter, authors engage in a conversation specifically about digital and virtual environments and use some of the findings reported in this book, results from their previous research, as well as their general expertise, to shed a new light on this complex topic. The conversation format, we believe, adds a dialogical and emerging element to what is nowadays a highly debated topic. In this way, we offer in what follows an overview of the main topics covered in this book and add to them, conceptually and practically. The focus is twofold: on the one hand, on theoretical notions that help us understand the current situation created by the pandemic and, on the other, on practical advice that can guide those interested in technology-enhanced learning and creativity, now and in the future

Creative Learning in Digital and Virtual Environments During COVID-19 and Beyond

In this final chapter, authors engage in a conversation specifically about digital and virtual environments and use some of the findings reported in this book, results from their previous research, as well as their general expertise, to shed a new light on this complex topic. The conversation format, we believe, adds a dialogical and emerging element to what is nowadays a highly debated topic. In this way, we offer in what follows an overview of the main topics covered in this book and add to them, conceptually and practically. The focus is twofold: on the one hand, on theoretical notions that help us understand the current situation created by the pandemic and, on the other, on practical advice that can guide those interested in technology-enhanced learning and creativity, now and in the future