Lifetime Bipolar Disorder comorbidity and related clinical characteristics in patients with primary Obsessive Compulsive Disorder: a report from the International College of Obsessive-Compulsive Spectrum Disorders (ICOCS)

IntroductionBipolar disorder (BD) and obsessive compulsive disorder (OCD) are prevalent, comorbid, and disabling conditions, often characterized by early onset and chronic course. When comorbid, OCD and BD can determine a more pernicious course of illness, posing therapeutic challenges for clinicians. Available reports on prevalence and clinical characteristics of comorbidity between BD and OCD showed mixed results, likely depending on the primary diagnosis of analyzed samples.MethodsWe assessed prevalence and clinical characteristics of BD comorbidity in a large international sample of patients with primary OCD (n = 401), through the International College of Obsessive-Compulsive Spectrum Disorders (ICOCS) snapshot database, by comparing OCD subjects with vs without BD comorbidity.ResultsAmong primary OCD patients, 6.2% showed comorbidity with BD. OCD patients with vs without BD comorbidity more frequently had a previous hospitalization (p < 0.001) and current augmentation therapies (p < 0.001). They also showed greater severity of OCD (p < 0.001), as measured by the Yale-Brown Obsessive Compulsive Scale (Y-BOCS).ConclusionThese findings from a large international sample indicate that approximately 1 out of 16 patients with primary OCD may additionally have BD comorbidity along with other specific clinical characteristics, including more frequent previous hospitalizations, more complex therapeutic regimens, and a greater severity of OCD. Prospective international studies are needed to confirm our findings.Peer reviewe

Experimental apparatus for solar energy storage via methane production

Paper presented to the 3rd Southern African Solar Energy Conference, South Africa, 11-13 May, 2015.Renewable energy production from intermittent sources has seen a large expansion the last decade and has introduced new challenges in the energy system. Problems are related to the non-programmable electric power generated and the production peaks that especially characterize photovoltaic energy. In addition to these issues, the extensive and long-term task of reducing CO2 emissions should be considered. The utilization of CO2 as a feedstock for producing fuels not only contributes to alleviating global climate changes but also provides a new research field for energy development. An innovative process for solar energy storage via methane production seems to be a viable technology to tackle the above-mentioned issues. In this paper an experimental apparatus, formed by PV panels, a pressurized electrolyser and a Sabatier reactor is presented. The Sabatier reaction exothermically combines hydrogen and carbon dioxide to produce methane and water. The produced methane is a carbon neutral gas that fits in with the existing natural gas and allows to overcame issues related to the intermittence and non-programmability of solar power. The paper focuses on the description of the experimental apparatus and the results of a preliminary investigation. An economic evaluation was also carried out on the integration of methanation process with a traditional PV system.cf201

Particle monitoring capability of the Solar Orbiter Metis coronagraph through the increasing phase of solar cycle 25

Context. Galactic cosmic rays (GCRs) and solar particles with energies greater than tens of MeV penetrate spacecraft and instruments hosted aboard space missions. The Solar Orbiter Metis coronagraph is aimed at observing the solar corona in both visible (VL) and ultraviolet (UV) light. Particle tracks are observed in the Metis images of the corona. An algorithm has been implemented in the Metis processing electronics to detect the VL image pixels crossed by cosmic rays. This algorithm was initially enabled for the VL instrument only, since the process of separating the particle tracks in the UV images has proven to be very challenging. Aims. We study the impact of the overall bulk of particles of galactic and solar origin on the Metis coronagraph images. We discuss the effects of the increasing solar activity after the Solar Orbiter mission launch on the secondary particle production in the spacecraft. Methods. We compared Monte Carlo simulations of GCRs crossing or interacting in the Metis VL CMOS sensor to observations gathered in 2020 and 2022. We also evaluated the impact of solar energetic particle events of different intensities on the Metis images. Results. The study of the role of abundant and rare cosmic rays in firing pixels in the Metis VL images of the corona allows us to estimate the efficiency of the algorithm applied for cosmic-ray track removal from the images and to demonstrate that the instrument performance had remained unchanged during the first two years of the Solar Orbiter operations. The outcome of this work can be used to estimate the Solar Orbiter instrument's deep charging and the order of magnitude for energetic particles crossing the images of Metis and other instruments such as STIX and EUI.Comment: 8 pages, 6 figure

The serine protease inhibitor neuroserpin is required for normal synaptic plasticity and regulates learning and social behavior

The serine protease inhibitor neuroserpin regulates the activity of tissue-type plasminogen activator (tPA) in the nervous system. Neuroserpin expression is particularly prominent at late stages of neuronal development in most regions of the central nervous system (CNS), whereas it is restricted to regions related to learning and memory in the adult brain. The physiological expression pattern of neuroserpin, its high degree of colocalization with tPA within the CNS, together with its dysregulation in neuropsychiatric disorders, suggest a role in formation and refinement of synapses. In fact, studies in cell culture and mice point to a role for neuroserpin in dendritic branching, spine morphology, and modulation of behavior. In this study, we investigated the physiological role of neuroserpin in the regulation of synaptic density, synaptic plasticity, and behavior in neuroserpin-deficient mice. In the absence of neuroserpin, mice show a significant decrease in spine-synapse density in the CA1 region of the hippocampus, while expression of the key postsynaptic scaffold protein PSD-95 is increased in this region. Neuroserpin-deficient mice show decreased synaptic potentiation, as indicated by reduced long-term potentiation (LTP), whereas presynaptic paired-pulse facilitation (PPF) is unaffected. Consistent with altered synaptic plasticity, neuroserpin-deficient mice exhibit cognitive and sociability deficits in behavioral assays. However, although synaptic dysfunction is implicated in neuropsychiatric disorders, we do not detect alterations in expression of neuroserpin in fusiform gyrus of autism patients or in dorsolateral prefrontal cortex of schizophrenia patients. Our results identify neuroserpin as a modulator of synaptic plasticity, and point to a role for neuroserpin in learning and memory

Prescription appropriateness of anti-diabetes drugs in elderly patients hospitalized in a clinical setting: evidence from the REPOSI Register

Diabetes is an increasing global health burden with the highest prevalence (24.0%) observed in elderly people. Older diabetic adults have a greater risk of hospitalization and several geriatric syndromes than older nondiabetic adults. For these conditions, special care is required in prescribing therapies including anti- diabetes drugs. Aim of this study was to evaluate the appropriateness and the adherence to safety recommendations in the prescriptions of glucose-lowering drugs in hospitalized elderly patients with diabetes. Data for this cross-sectional study were obtained from the REgistro POliterapie-Società Italiana Medicina Interna (REPOSI) that collected clinical information on patients aged ≥ 65 years acutely admitted to Italian internal medicine and geriatric non-intensive care units (ICU) from 2010 up to 2019. Prescription appropriateness was assessed according to the 2019 AGS Beers Criteria and anti-diabetes drug data sheets.Among 5349 patients, 1624 (30.3%) had diagnosis of type 2 diabetes. At admission, 37.7% of diabetic patients received treatment with metformin, 37.3% insulin therapy, 16.4% sulfonylureas, and 11.4% glinides. Surprisingly, only 3.1% of diabetic patients were treated with new classes of anti- diabetes drugs. According to prescription criteria, at admission 15.4% of patients treated with metformin and 2.6% with sulfonylureas received inappropriately these treatments. At discharge, the inappropriateness of metformin therapy decreased (10.2%, P &lt; 0.0001). According to Beers criteria, the inappropriate prescriptions of sulfonylureas raised to 29% both at admission and at discharge. This study shows a poor adherence to current guidelines on diabetes management in hospitalized elderly people with a high prevalence of inappropriate use of sulfonylureas according to the Beers criteria

Clinical features and outcomes of elderly hospitalised patients with chronic obstructive pulmonary disease, heart failure or both

Background and objective: Chronic obstructive pulmonary disease (COPD) and heart failure (HF) mutually increase the risk of being present in the same patient, especially if older. Whether or not this coexistence may be associated with a worse prognosis is debated. Therefore, employing data derived from the REPOSI register, we evaluated the clinical features and outcomes in a population of elderly patients admitted to internal medicine wards and having COPD, HF or COPD + HF. Methods: We measured socio-demographic and anthropometric characteristics, severity and prevalence of comorbidities, clinical and laboratory features during hospitalization, mood disorders, functional independence, drug prescriptions and discharge destination. The primary study outcome was the risk of death. Results: We considered 2,343 elderly hospitalized patients (median age 81 years), of whom 1,154 (49%) had COPD, 813 (35%) HF, and 376 (16%) COPD + HF. Patients with COPD + HF had different characteristics than those with COPD or HF, such as a higher prevalence of previous hospitalizations, comorbidities (especially chronic kidney disease), higher respiratory rate at admission and number of prescribed drugs. Patients with COPD + HF (hazard ratio HR 1.74, 95% confidence intervals CI 1.16-2.61) and patients with dementia (HR 1.75, 95% CI 1.06-2.90) had a higher risk of death at one year. The Kaplan-Meier curves showed a higher mortality risk in the group of patients with COPD + HF for all causes (p = 0.010), respiratory causes (p = 0.006), cardiovascular causes (p = 0.046) and respiratory plus cardiovascular causes (p = 0.009). Conclusion: In this real-life cohort of hospitalized elderly patients, the coexistence of COPD and HF significantly worsened prognosis at one year. This finding may help to better define the care needs of this population

Clinical features and outcomes of elderly hospitalised patients with chronic obstructive pulmonary disease, heart failure or both

Background and objective: Chronic obstructive pulmonary disease (COPD) and heart failure (HF) mutually increase the risk of being present in the same patient, especially if older. Whether or not this coexistence may be associated with a worse prognosis is debated. Therefore, employing data derived from the REPOSI register, we evaluated the clinical features and outcomes in a population of elderly patients admitted to internal medicine wards and having COPD, HF or COPD + HF. Methods: We measured socio-demographic and anthropometric characteristics, severity and prevalence of comorbidities, clinical and laboratory features during hospitalization, mood disorders, functional independence, drug prescriptions and discharge destination. The primary study outcome was the risk of death. Results: We considered 2,343 elderly hospitalized patients (median age 81&nbsp;years), of whom 1,154 (49%) had COPD, 813 (35%) HF, and 376 (16%) COPD + HF. Patients with COPD + HF had different characteristics than those with COPD or HF, such as a higher prevalence of previous hospitalizations, comorbidities (especially chronic kidney disease), higher respiratory rate at admission and number of prescribed drugs. Patients with COPD + HF (hazard ratio HR 1.74, 95% confidence intervals CI 1.16-2.61) and patients with dementia (HR 1.75, 95% CI 1.06-2.90) had a higher risk of death at one year. The Kaplan-Meier curves showed a higher mortality risk in the group of patients with COPD + HF for all causes (p = 0.010), respiratory causes (p = 0.006), cardiovascular causes (p = 0.046) and respiratory plus cardiovascular causes (p = 0.009). Conclusion: In this real-life cohort of hospitalized elderly patients, the coexistence of COPD and HF significantly worsened prognosis at one year. This finding may help to better define the care needs of this population

Una classe di stimatori basati sulla detectability: applicazioni alla misura dell'immigrazione clandestina

For many aspects knowing the number of clandestine immigrants in the same country is very important. For this purpose literature has proposed a lot of methods, among these the latest and the most interesting, because it is a direct method, is called "center sampling", as the centers are any aggregation places where the immigrants necessarily go. In this paper center sampling is modified under particular hypotheses, so two different detectabilities of immigrants are defined. The first one is equal for all the immigrants; the second one is different and related to the number of centers they go to. So these two detectabilities are used for estimating the number of clandestine immigrants. The expected value and the MSE of the two estimators have been defined, but their performance are necessarily been valued by simulation

Combinazione non parametrica di statistiche basate sulle mediane per il problema di Behrens-Fisher multivariato

James (1954), Ying Yao (1965), Ballin-Pesarin (1990) have proposed approximate solutions of the Behrens-Fisher p-variate problem. The last-mentioned is regarded as the best in approximating both the nominal significance level and the power. This solution is based on the nonparametric combination of p permutation tests, each referring to p marginal hypotheses. In Ballin-Pesarin solution, the marginal tests used are Welch's statistical tests, which, as is well known, do not strictly respect the principle of permutation inasmuch as they are quasi-invariant with respect to unknown variance ratios. In this paper, I propose a marginal permutation test of sample medians. I believe that, in order to comply more fully with the invariant properties of permutational distribution of the median as opposed to the mean, such medians improve the approximation of the nominal significance level and the exact power. It is proved, moreover, that the proposed marginal test is unbiased and consistent