On the primacy and irreducible nature of first-person versus third-person information

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The Odyssey of Dental Anxiety: From Prehistory to the Present. A Narrative Review

Dental anxiety (DA) can be considered as a universal phenomenon with a high prevalence worldwide; DA and pain are also the main causes for medical emergencies in the dental office, so their prevention is an essential part of patient safety and overall quality of care. Being DA and its consequences closely related to the fight-or-flight reaction, it seems reasonable to argue that the odyssey of DA began way back in the distant past, and has since probably evolved in parallel with the development of fight-or-flight reactions, implicit memory and knowledge, and ultimately consciousness. Basic emotions are related to survival functions in an inseparable psychosomatic unity that enable an immediate response to critical situations rather than generating knowledge, which is why many anxious patients are unaware of the cause of their anxiety. Archeological findings suggest that humans have been surprisingly skillful and knowledgeable since prehistory. Neanderthals used medicinal plants; and relics of dental tools bear witness to a kind of Neolithic proto-dentistry. In the two millennia BC, Egyptian and Greek physicians used both plants (such as papaver somniferum) and incubation (a forerunner of modern hypnosis, e.g., in the sleep temples dedicated to Asclepius) in the attempt to provide some form of therapy and painless surgery, whereas modern scientific medicine strongly understated the role of subjectivity and mind-body approaches until recently. DA has a wide range of causes and its management is far from being a matter of identifying the ideal sedative drug. A patient's proper management must include assessing his/her dental anxiety, ensuring good communications, and providing information (iatrosedation), effective local anesthesia, hypnosis, and/or a wise use of sedative drugs where necessary. Any weak link in this chain can cause avoidable suffering, mistrust, and emergencies, as well as having lifelong psychological consequences. Iatrosedation and hypnosis are no less relevant than drugs and should be considered as primary tools for the management of DA. Unlike pharmacological sedation, they allow to help patients cope with the dental procedure and also overcome their anxiety: achieving the latter may enable them to face future dental care autonomously, whereas pharmacological sedation can only afford a transient respite

Gli interventi non farmacologici per la prevenzione del delirium: una revisione della letteratura

Il delirium una condizione comune nei pazienti anziani ospedalizzati, in particolare in area critica e lungodegenza. La letteratura suggerisce come l'utilizzo di farmaci psicoattivi possa costituire un fattore di rischio per il delirium e di come invece interventi non farmacologici possano rivelarsi efficaci nel prevenire questa condizione.In stata condotta una revisione in letteratura per individuare le evidenze più aggiornate riguardo gli interventi non farmacologici più efficaci.ope

ambivalent trust and ontological representations of death as latent factors of religiosity

AbstractThe studies on the relationship between religiosity and the management of trust in postmodern society are an emerging field of research. The psychological contribute of the attachment theory shows how early relationships with the parental figures determine the adult attachment styles and the related dispositions to trust and religiosity. Lack of trust is a critical aspect of the insecure attachment styles: the avoidant and the anxious. This study in focused on these two traits, considering their level of trust compared to religiosity and representations of death. The Interpersonal Trust Survey, The World Health Organization Quality Of Life-Spirituality, Religiousness and Personal Beliefs, the Testoni Death Representations Scale and the Experiences in Close Relationships-Revised were utilized. The results illustrated different expressions of trust in avoidant and anxious styles

Identification of novel STAT5B mutations and characterization of TCR beta signatures in CD4+T-cell large granular lymphocyte leukemia

CD4+ T-cell large granular lymphocyte leukemia (T-LGLL) is a rare subtype of T-LGLL with unknown etiology. In this study, we molecularly characterized a cohort of patients (n = 35) by studying their T-cell receptor (TCR) repertoire and the presence of somatic STAT5B mutations. In addition to the previously described gain-of-function mutations (N642H, Y665F, Q706L, S715F), we discovered six novel STAT5B mutations (Q220H, E433K, T628S, P658R, P702A, and V712E). Multiple STAT5B mutations were present in 22% (5/23) of STAT5B mutated CD4+ T-LGLL cases, either coexisting in one clone or in distinct clones. Patients with STAT5B mutations had increased lymphocyte and LGL counts when compared to STAT5B wild-type patients. TCR beta sequencing showed that, in addition to large LGL expansions, non-leukemic T cell repertoires were more clonal in CD4+ T-LGLL compared to healthy. Interestingly, 25% (15/59) of CD4+ T-LGLL clonotypes were found, albeit in much lower frequencies, in the non-leukemic CD4+ T cell repertoires of the CD4+ T-LGLL patients. Additionally, we further confirmed the previously reported clonal dominance of TRBV6-expressing clones in CD4+ T-LGLL. In conclusion, CD4+ T-LGLL patients have a typical TCR and mutation profile suggestive of aberrant antigen response underlying the disease.Peer reviewe

Agricultural by-products with bioactive effects: A multivariate approach to evaluate microbial and physicochemical changes in a fresh pork sausage enriched with phenolic compounds from olive vegetation water

The use of phenolic compounds derived from agricultural by-products could be considered as an eco-friendly strategy for food preservation. In this study a purified phenol extract from olive vegetation water (PEOVW) was explored as a potential bioactive ingredient for meat products using Italian fresh sausage as food model. The research was developed in two steps: first, an in vitro delineation of the extract antimicrobial activities was performed, then, the PEOVW was tested in the food model to investigate the possible application in food manufacturing. The in vitro tests showed that PEOVW clearly inhibits the growth of food-borne pathogens such as Listeria monocytogenes and Staphylococcus aureus. The major part of Gram-positive strains was inhibited at the low concentrations (0.375–3 mg/mL). In the production of raw sausages, two concentrates of PEOVW (L1:0.075% and L2: 0.15%) were used taking into account both organoleptic traits and the bactericidal effects. A multivariate statistical approach allowed the definition of the microbial and physicochemical changes of sausages during the shelf life (14 days). In general, the inclusion of the L2 concentration reduced the growth of several microbial targets, especially Staphylococcus spp. and LABs (2 log10 CFU/g reduction),while the increasing the growth of yeasts was observed. The reduction of microbial growth could be involved in the reduced lipolysis of raw sausages supplemented with PEOVWas highlighted by the lower amount of diacylglycerols. Moisture and aw had a significant effect on the variability of microbiological features,while food matrix (the sausages' environment) can mask the effects of PEOVW on other targets (e.g. Pseudomonas). Moreover, the molecular identification of the main representative taxa collected during the experimentation allowed the evaluation of the effects of phenols on the selection of bacteria. Genetic data suggested a possible strain selection based on storage time and the addition of phenol compounds especially on LABs and Staphylococcus spp. The modulation effects on lipolysis and the reduction of several microbial targets in a naturally contaminated product indicates that PEOVW may be useful as an ingredient in fresh sausages for improving food safety and quality

Near-death experiences and hypnosis: two different phenomena with something in common

Near-death experiences (NDEs) are an intriguing and somewhat awkward topic in the scientific medicine. They can be defined as the memory of impressions occurring during life-threatening conditions, including a number of special elements such as out-of-body experiences, pleasant feelings, seeing a tunnel, a light, deceased relatives, or a life review. Their transcendent tonality leads one to consider them a priori as doubtful or non-existent, not relevant, or a matter of psychiatric or organic disturbances at most. The available interpretations of NDEs, despite being scientifically sound, so far remain only speculations or, at best, clues without any demonstration, while others are not even plausible or neglect facts incompatible with the ruling mechanistic and reductionistic view, showing the deep epistemological implications of their explanation. In the past few decades NDEs, hypnosis, relaxation, and meditation have been included among the so-called altered states of consciousness (ASC), together with other physiological and pathological conditions, such as dreaming, sensory deprivation, hypnagogic states, epilepsy, effects of hallucinogens, and psychotic symptoms. However, the very term ASC, semantically suggesting abnormality, looks to be questionable for physiological mind activities like hypnosis and meditation. NDEs and hypnosis appear as two entirely distinct phenomena, but some common processes probably tinge them. Hypnosis has seldom been used to evoke previous NDEs in an attempt to relive them; conversely, NDE-like experiences have been induced in hypnosis in the context of psychotherapy with the aim of approximating their transformational therapeutic aspects and facilitating both first- and second-order patient changes. Fortunately, an increasing dissatisfaction has emerged in recent years with our merely organic medicine, which has been paralleled by a growing interest in consciousness, subjectivity, and spirituality. There is an increasing need to reappraise our paradigm and the still mysterious mind–brain–world relationship; the so-called ASC also call for a broader approach, to reappraise them in a perspective, including their still misunderstood physiology, merging mechanisms, contents, and meanings in a whole without prejudices, not even scientific ones

Esperienze di premorte: una realt\ue0 tra scienza e pregiudizio.

The near-death experiences (NDEs) are an intriguing and somewhat awkward topic in the scientific medicine. They can be defined as the memory of impressions occurred during life-threatening conditions, including a number of special elements such as out-of-body experience, pleasant feelings, seeing a tunnel, a light, deceased relatives, and a life review. Their transcendent tonality leads one to consider them a priori as doubtful or non-existent, not relevant or a matter of psychiatric disturbances at most. The apparent incompatibility between NDEs and the prevailing opinions on physical reality and physiology of consciousness, has deep epistemological implications. In fact, knowledge is closely dependent on the adopted paradigm and errors leading to false conclusions may spring from both an a priori acceptance and refusal of apparently strange and not explicable facts: the latter causes the same alienation from reality as the former making the very history of science a wonderful story of new, at times looking paradoxical, facts able to disprove previous beliefs. Our current paradigm springs form Cartesianism, Enlightment and Positivism, which have focused on the external, physical reality only, skipping Psyche in the attempt of saving natural science from Church\u2019s oversight; thus, the freedom of Galilean sciences was achieved at the cost of leaving consciousness, essential component of human kind and interface between mind and world, to the competence of religion and philosophy only. Fortunately, an increasing dissatisfaction has emerged in recent years with a merely organic medicine and a parallel interest has arisen on consciousness and subjectivity: perhaps it is now time to reappraise our paradigm and the still mysterious mind-brain-world relationship, while the physics of XX century has already overthrown the classic view of the world