Effectiveness of the passive lingual arch for E space maintenance in subjects with anterior or posterior rotation of the mandible: a retrospective study.

Objective: The aim of this study was to determine whether or not lingual arches in subjects with anterior or posterior mandible rotation can produce different effects in the prevention of first permanent molar mesial migration. Subjects and Methods: Forty-two patients with a mean age of 9 ± 0.8 years were selected from the Department of Orthodontics, University of Catania, Italy. These subjects were treated with a passive mandibular fixed lingual arch. The sample was divided into 3 groups according to the gonial angle in order to establish the pattern of mandible growth: mandibular posterior rotation (MPR), mandibular growth in straight-downward direction (MSD) and mandibular anterior rotation (MAR). Lateral cephalograms and study models of the patients before and after treatment were examined to determine any positional changes of the mandibular first molars and incisors. Results: Statistically significant differences between the MPR group and the other 2 (MSD and MAR) were found as regards mandibular first molar and incisor positional changes. No significant differences were found between the MSD and MAR groups. Conclusion: The results indicate that the effect of lingual arch is influenced by mandibular growth patterns. In patients with MPR, the lingual arch preserves arch length but the mesial migration of first permanent molars is not completely blocked

From Sarcopenia to Frailty: The Pathophysiological Basis and Potential Target Molecules of Intervention

Skeletal muscle is not only an endocrine organ but also one of core components of muscloskeletal system. Sarcopenia refers to a decline in the skeletal muscle mass and function. The former involves the size and number of changes in two types of myofibers, lower satellite cell density, and regeneration ability. The latter shows a loss of muscle strength. Frailty is a geriatric syndrome with multisystem impairment associated with increased vulnerability to stressors. Sarcopenia increases the risk of frailty and may be one of the major causes of physical frailty phenotype. Sarcopenia is also potentially associated with cognitive frailty phenotype. Aging might be the common underlying pathophysiology of sarcopenia and frailty. Therefore, there are some potential target molecules in aging-related signaling pathways that might be associated with sarcopenia and frailty. Nevertheless, sarcopenia can mediate metabolism and promote accelerate systemic aging, frailty, and age-related diseases by myokines in an endocrine manner. Lifestyle interventions (resistance exercise and dietary restriction) of gerontoscience are effective in the prevention of sarcopenia. Some pharmacological agents are registered in different phases of clinical trials for sarcopenia intervention. Phytochemicals, mTOR inhibitors, metformin and acarbose, NAD precursors, and sirtuin activators demonstrated that multiple target antiaging effects might also have preventive and therapeutic perspectives on sarcopenia and frailty

Old Age and Women’s Identity

Female identity is a dynamic concept, and it has been a very discussed issue by contemporary cultural critic. How does old age affect identity construction and perception in elderly woman? Has feminine gender an impact in subjective well-being? Psychological changes of midlife women have been as conflicting as the idea that society has about them. Personality changes after young adulthood in women is a controversial matter. Erikson proposed that women might not develop identities in early adulthood as men do. In fact, he argued that women develop them later, in the context of an intimate relationship. Moreover, identity development appears to have important consequences for midlife well-being. For example, Vandewater et al. found that women’s midlife well-being was facilitated by earlier attainment of a well-articulated identity. In these situations accomplishment of developmentally earlier tasks (identity formation) sets the stage for later psychological health. Our work sheds additional light on how women live this period of life in terms of happiness and purpose of life

The Complexity of Frailty: Psychological Mechanism and Therapeutic Interventions in Old People - A Narrative Review

Aging is a complex and dynamic process. Senses become less sophisticated and negative life events increase. These factors combined with medical conditions contribute to develop a degenerative functional autonomy of the elderly. This clinical condition is known as frailty. However, there is a difference in the way people live their silver years in terms of happiness and their sense of autonomy. Both being and feeling frail represent two different drives of cognitive representations concerning how the elderly live their lives. In addition, other factors such as cognitive stimulation, assistive technology and physical activity can support frail people to achieve independence. This chapter aims to provide an overview on how the psychological environment may affect frailty, suggesting a possible role of new technology’s solutions and physical activity as therapeutic interventions

Virtual Round care model in a Covid-19 Geriatric sub intensive unit

Introduction. Telepresence provides clinicians the ability to monitor patients as well to communicate with all the members of the healthcare staff.  Covid-19 Units cope with high complexity in providing care and an integration amount the care team and the patients’ relatives should be carried out to obtained successful outcomes and preventing complication. Virtual rounding (VR) has been successfully applied to cope with this task in the last 2000 years in medical units.  Covid-19 patients due to safety rules may be prone to isolation and lack of communication with their family. Purpose. The aim of our study was to evaluate the effect of structured virtual round protocol in a geriatric Covid-19 unit on anxiety and depression for the patients and their relatives. Methodology. All the patients admitted to the geriatric Covid-19 unit from 1 February 2021 to 30 April were studied. Inclusion criteria to the study were the followings: no severe cognitive impairment (MMSE =>24) or neuro sensorial deficits; informed consent to participate to the study. Forty-nine 49 (75% of patients) met the inclusion criteria. All the subject who were found to be eligible to the study underwent a VR standard protocol of care. VR was consisted with: 1) a video call with a tablet device conducted by a psychologist that established a cooperative communication between the health care staff (nurses and MD, their relatives) at the bed sides; 2) a video call with the patient’s relatives in which it was clearly explained the standard care and the role of each healthcare member was also included. Anxiety and depression levels were assessed for the patients at baseline after the end of the protocol by the Hospital Anxiety and Depression Scale (HADS). Patients’ relatives were investigated for depression at baseline and after the end of the protocol by the Beck Depression Inventory- Primary Care (BDI-PC). The Beck Depression Inventory for primary care has seven items with each item rated on a 4-point scale (0–3). It is scored by summing ratings for each item (range 0–21). Items are symptoms of sadness, pessimism, past failure, loss of pleasure, self-dislike, self-criticalness, and suicidal thoughts and wishes. The Hospital Anxiety and Depression Scale (HADS) is a self- assessment scale found to be a reliable instrument for detecting states of depression and anxiety. The anxiety and depressive sub-scales are also valid measures of severity of the emotional disorder. The questionnaire comprises seven questions for anxiety and seven questions for depression, and takes 2–5min to complete. For both scales, scores less than 7 indicate non- cases, 8-10 mild, 11-14 moderate, 15-21 severe. JMP software by SAS (v.16) was used for the statistical analysis. Results. The present study included forty-nine 49 patients (67% male), mean age of 69.9 ±14.7 years with one relative for each patient. The average mean of the hospitalization for each patients was 17.6 ± 5.7 days The mean VR duration time was 60±5.5 minutes. VR showed a significant decrease in both Anxiety and depression for patients: (HADS Depression baseline 10.6 ±3.1 vs 6.9 ±2.7 end p<0.01) (HADS Anxiety baseline 10.2 ±3.4 vs 6.8 ±3.0 end p<0.01). VR has also reduced depression in the relatives of patients (BDI-PC 3.6 ±2.4 vs 1.9 ±1.9 p<0.01). Discussion. VR has reduced anxiety and depression in patients hospitalized in a sub-intensive COVID 19 unit and it also has been found to be effective in decreasing depression in the relatives of these patients Limitation. However, the study has some possible limitations considering its small size and that it was mono centric Conclusions. Our data confirm the efficacy of VR in the sub-intensive care setting. This evidence supports the key role of a multidisciplinary team, focusing on the importance of social and psychological support during the hospital stay.   More studies will be consequently necessary to better validate the importance of VR as a standard care tool in intensive/sub- intensive care units for the elderly patient

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Planning urban pavement maintenance by a new interactive multiobjective optimization approach

Pavement maintenance is essential to prevent the deterioration of asset value and to satisfy the expectations of all stakeholders (objectives). However, the budgets are often insufficient to keep the road pavement at optimum levels. Therefore, a decision making process ought to be used for prioritizing different maintenance activities in order to achieve pre-defined goals by optimizing the use of the available budget. One of the biggest difficulties in multiobjective optimization method is the large number of the feasible solutions (Pareto optimal set or its approximation), which makes it hard for the Decision Maker to select the best solution.To support interaction with the decision maker for identifying the best combination of maintenance actions, this paper proposes a new methodology named Interactive Multiobjective Optimization-Dominance Rough Set Approach (IMO-DRSA), using a decision-rule preference model.The preference information, obtained by the Decision Maker (DM) during the course of the interaction, is processed using the Dominance-based Rough Set Approach in order to achieve a decision model expressed in terms of easily understandable if ....then ... decision rules. This approach makes possible an interaction between the analyst and the decision maker and helps the decision maker to classify maintenance options and allocate limited funds according to predefined objectives (quantitative or qualitative). An application of the proposed methodology to road pavements of an Italian urban sub-network is presented

Feline Coronavirus and Alpha-Herpesvirus Infections: Innate Immune Response and Immune Escape Mechanisms

Over time, feline viruses have acquired elaborateopportunistic properties, making their infections particularly difficult to prevent and treat. Feline coronavirus (FCoV) and feline herpesvirus-1 (FeHV-1), due to the involvement of host genetic factors and immune mechanisms in the development of the disease and more severe forms, are important examples of immune evasion of the host’s innate immune response by feline viruses.It is widely accepted that the innate immune system, which providesan initial universal form of the mammalian host protection from infectious diseases without pre-exposure, plays an essential role in determining the outcome of viral infection.The main components of this immune systembranchare represented by the internal sensors of the host cells that are able to perceive the presence of viral component, including nucleic acids, to start and trigger the production of first type interferon and to activate the cytotoxicity by Natural Killercells, often exploited by viruses for immune evasion.In this brief review, we providea general overview of the principal tools of innate immunity, focusing on the immunologic escape implemented by FCoVand FeHV-1 during infection