Vitamin D: Mechanism of action and biological effects in uterine fibroids

Uterine fibroids (UFs) are the most common benign gynecological tumors. It was esti-mated that fifty percent of women presenting with UFs has symptomatology that negatively in-fluences their quality of life. Pharmacological and/or surgical treatments are frequently required, depending on the woman’s desire to preserve fertility, with a high impact on healthcare costs. Generally, the use of currently available pharmacological treatments may lead to side effects. Therefore, there is a growing interest in a natural and safe approach for UFs. In recent years, epi-demiological studies reported a vitamin D deficiency in patients with UFs raised interest in the potential biological effects of vitamin D supplementation. In vitro studies proved vitamin D efficacy in inhibiting UFs growth by targeting pathways involved in the regulation of various biological processes, including proliferation, extracellular matrix (ECM) remodeling, DNA repair, signaling and apoptosis. However, clinical studies supported only in part the beneficial effects of vitamin D supplementation in reducing UFs growth and tumor volume. Randomized controlled trials and large population studies are mandatory as the potential clinical benefits are likely to be substantial

Ethical issues in assistive ambient living technologies for ageing well

Assistive Ambient Living (AAL) in ageing refers to any device used to support ageing related psychological and physical changes aimed at improving seniors’ quality of life and reducing caregivers’ burdens. The diffusion of these devices opens the ethical issues related to their use in the human personal space. This is particularly relevant when AAL technologies are devoted to the ageing population that exhibits special bio-psycho-social aspects and needs. In spite of this, relatively little research has focused on ethical issues that emerge from AAL technologies. The present article addresses ethical issues emerging when AAL technologies are implemented for assisting the elderly population and is aimed at raising awareness of these aspects among healthcare providers. The overall conclusion encourages a person-oriented approach when designing healthcare facilities. This process must be fulfilled in compliance with the general principles of ethics and individual nature of the person devoted to. This perspective will develop new research paradigms, paving the way for fulfilling essential ethical principles in the development of future generations of personalized AAL devices to support ageing people living independently at their home

Comparison of alternate and original forms of the Montreal Cognitive Assessment (MoCA): an Italian normative study

Objective: The Montreal Cognitive Assessment (MoCA) is a screening test widely used in clinical practice and suited for detection of Mild Cognitive Impairment. Alternate forms of the MoCA were developed to avoid \u201clearning effect\u201d in serial assessments, and the present study aimed at investigating inter-form parallelism and at providing normative values for the Italian versions of MoCAs 2 and 3. Method: Three separate convenience samples were recruited: the first (n = 78) completed three alternate MoCA versions for ascertaining inter-form parallelism; the second (n = 302) and the third (n = 413) samples were administered MoCA 2 or 3 to compute normative data. Results: A three-step procedure complemented by confirmatory factor analysis and a mixed factorial ANOVA suggested that the three MoCA versions are not strictly parallel. Multiple linear regression analysis revealed that age and education significantly influenced MoCA 2 and 3 total scores. No significant effect of sex was found. From the derived linear equation, correction grids for MoCA 2 and 3 raw scores were built and equivalent scores computed. Inferential cutoff for adjusted scores, estimated using a non-parametric technique, were 17.49 for MoCA 2 and 18.34 for MoCA 3. Correlation analysis showed strong correlations of MoCA 2 (r = 0.69, p <.001) and MoCA 3 (r = 0.61, p <.001) adjusted total scores with MMSE adjusted scores. Conclusion: The three MoCA forms are not strictly parallel. Specifically developed normative data must be adopted for using MoCA in serial cognitive assessments for clinical and research studies

Frontal left alpha activity as an indicator of willingness to interact with virtual agents: A pilot study

Over the last decade, much effort has been made to develop virtual agents acting as assistants of elderly people in their daily activities. With the emergence of such technologies, several questionnaires have been developed to investigate the factors increasing user's acceptance of virtual agents. While questionnaires provide detailed information about users' preferences, they may not be sufficient for investigating user's internal affective states and impressions during the interaction with virtual agents. Therefore, improving assessment techniques for elders' acceptance of virtual agents is necessary for understanding the impressions they arouse and determining their design accordingly. This paper is a report of a pilot study that benefits from the predictive ability of left frontal alpha activity in the brain on positive affect and approach related motivation, and investigates relationships between user's willingness to interact with virtual agents and left frontal alpha activity in order to gain insights on user's affective and motivational states during the interaction with an agent

Relationships between constructional and visuospatial abilities in normal subjects and in focal brain-damaged patients.

We tested 125 normal subjects and 24 right and 22 left focal brain-damaged patients (RBD and LBD) on the Rey figure copying test and on a battery of perceptual and representational visuospatial tasks, in search of relationships between constructional and visuospatial abilities. Selected RBD and LBD were not affected by severe aphasia, unilateral spatial neglect or general intellectual defects. Both RBD and LBD showed defective performances on the constructional task with respect to normal subjects. As regards visuospatial tasks, both patient groups scored lower than normal subjects in judging angle width and mentally assembling geometrical figures; moreover, RBD, but not LBD, achieved scores significantly lower than healthy controls in judging line orientation and analyzing geometrical figures. Post-hoc comparisons did not reveal any significant differences between RBD and LBD. Multiple regression analysis showed that visuospatial abilities correlate with accuracy in copying geometrical drawings in normal subjects and in RBD, but not in LBD. From a theoretical perspective, these findings support the idea that visual perceptual and representational abilities do play a role in constructional skills

The frequency of endometriosis in the general and selected populations: A systematic review

Background: In this article, we have reviewed available data on the frequency of endometriosis considering separately the incidence and the prevalence of the disease using data from papers published from 2000 to June 2019. Study design: Systematic review and meta-analysis. PubMed and EMBASE were searched for observational studies reporting data on the incidence or prevalence rates or ratios for the following pre-speci\ufb01ed populations: general population, infertile women, women reporting pelvic pain, women who underwent pelvic surgical procedures unrelated with endometriosis. Results: A total of 42 papers were included in this review. Considering the 11 studies that have analysed the prevalence of endometriosis in the general population, the reported prevalence ranged from 0.8% to 28.6% with an overall estimated of 4.4% (95% CI 3.6\u20135.2). When we considered separately the estimates reported in each study according to geographic area, the pooled estimate was lower in the European studies (1.4%), increased to 5.7% in the US studies and was 15.4% in the Asian ones. The pooled estimated prevalence of endometriosis was 33.5% (95% CI 24.3\u201342.8, Figure 2(c)) in women who underwent surgery for benign gynaecological conditions, 23.8% (95% CI 16.1\u201331.5, Figure 2(d)) in infertile women, and 49.7 % (95% CI 14.4\u201385.0) in women with chronic pelvic pain. Conclusion: This review offers an overview of the available data on the frequency of endometriosis in the general population and in selected population, in particular among infertile women and women with chronic pelvic pain

Empathy through the Pandemic: Changes of Different Emphatic Dimensions during the COVID-19 Outbreak

Growing evidence suggests that empathy is a relevant psychological trait to face the challenges imposed by the COVID-19 pandemic, but at the present very little is known on whether this multi-dimensional construct has been affected by the pandemic outbreak differently in its separate components. Here, we aimed at filling this gap by capitalizing on the opportunity of having collected data from different self-report measures and cognitive tasks assessing the main dimensions of empathy immediately before the beginning of the global pandemic and about one year later. The results showed a detrimental impact of the pandemic outbreak on empathic social skills but not on both cognitive (perspective-taking) and emotional empathy that instead significantly improved. Thus, reduced empathic social skills could be a weakness to be targeted in psychological interventions to help people cope with the mental health challenges related to COVID-19 pandemic, whereas the ability of understanding another’s mental states and emotions could represent a strength in dealing with the current long-lasting crisis

Neuromyelitis optica spectrum disorders associated with systemic sclerosis: a case report and literature review

Neuromyelitis optica (NMO) is an autoimmune demyelinating disease of the central nervous system (CNS) afecting predominantly the spinal cord, brainstem, and optic nerves [1]. NMOSD may be associated with a variety of immunemediated disorders, such as systemic lupus erythematosus, Sjögren syndrome, and other organ-specifc autoimmune diseases [2], though accurate information about their prevalence is not available [3]. Systemic sclerosis (SSc) is characterized by vascular alterations, activation of the immune system, and tissue fbrosis [4]. Only a few cases of coexisting systemic sclerosis (SSc) and NMOSD are described [1, 5–9]. We report a case of an NMOSD AQP4-IgG antibodypositive patient associated with SSc and a review of the available evidence of the relationship between these autoimmune disease

Can the endometrioma be an obstacle to complete oocyte retrieval in IVF cycles? A retrospective study

Objective: The study aimed to evaluate the utility and safety of ancillary maneuvers during oocyte retrieval for patients with endometrioma that makes ovum pick-up hard due to poor ovarian surgical accessibility. Patients and methods: Cases of 251 women with ovarian endometriomas undergoing in vitro fertilization (IVF) in our infertility unit were retrospectively analyzed to evaluate the clinical IVF cycle outcomes after oocyte retrieval. Controls (n = 251) were age-matched women without endometriomas who underwent an uncomplicated oocyte retrieval. Results: No statistically significant differences were observed between groups except for the number of oocytes retrieved, which was higher in the control group than in the group of women with endometrioma. On the contrary, there were no differences between the experimental groups in the fertilization rate and number of embryos, and neither were there in the pregnancy and live birth rate. Moreover, the surgical complications were infrequent and similar between the two analyzed groups. Accidental or voluntary endometrioma punctures were not accompanied by increases in the risk of a pelvic infection. Conclusions: In conclusion, patients with endometrioma can undergo high-performance oocyte recovery procedures thanks to safe accessory maneuvers during the ovum pick-up