34 research outputs found

    Psychometric Properties and Validation of the Italian Version of Ages & Stages Questionnaires Third Edition

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    : Objectives: The Ages & Stages Questionnaires Third Version (ASQ-3) identifies the risk of developmental delay in children aged 1 to 66 months. The aim of this study was to determine a reliable and valid instrument for the Italian population to enable the screening of children's development. Methods: Data from 2278 Italian children (age range: 1-66 months) were used to evaluate item discrimination power using the corrected item-total correlation. Internal consistency was analyzed by Cronbach's alpha scores and a Confirmative Factor Analysis was conducted to test the factor structure of the test. Data were also collected to examine the ASQ-3 test-retest reliability and concurrent validity, which was investigated using the Griffiths Scales of Child Development, Third Edition, the Peabody Developmental Motor Scale, Second Edition, and the Developmental Profile, Third Edition tools. In order to evaluate discriminant validity, differences between typical development children and several clinical groups have been performed. Finally, two different cut-off scores have been proposed. Results: The results showed that the questionnaires are composed of high-quality items; the original factor structure has been confirmed and strong Pearson product-moment correlation coefficients between the overall and the total for each domain (ranging from 0.73 to 0.88). The Italian version of the ASQ-3 had adequate internal consistency and a strong agreement between observations with two weeks' intervals. Moreover, the test showed a high discriminant validity due to the possibility of fully discriminating between typical development children and several clinical groups. Finally, two different cut-off scores have been identified using ROC curves in order to have a screening and a diagnostic cut-off value. Conclusion: This study evaluated the psychometric properties of the Italian adaptation of ASQ-3 questionnaires. We demonstrated the validity of the ASQ-3 and determined new cut-off scores for Italian children. Early identification and accurate assessment are important starting points to better understand and anticipate the needs of children and their link to services

    Understanding Factors Associated With Psychomotor Subtypes of Delirium in Older Inpatients With Dementia

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    Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

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    Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

    Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

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    IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

    Perfusion-based brain connectivity:PASL vs PCASL

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    Arterial Spin Labelling (ASL) is a magnetic resonance imaging technique which provides a more direct measure of neural activity as compared to blood-oxygenation-level-dependent (BOLD) contrast. While it has been used for years for perfusion quantification, ASL has recently been adopted for functional connectivity (FC) analyses. However, the impact of the different ASL schemes on connectivity estimates remains to be fully investigated. In this work, pulsed and pseudo continuous ASL (PASL/pCASL) were compared in terms of cerebral blood flow (CBF) and FC measures. In line with literature, higher CBF and increased spatial signal-to-noise ratio were reported for pCASL, as compared to PASL. In terms of FC, pCASL was able to more reliably recover the main networks and showed higher correlations between brain areas. These preliminary results suggest pCASL to provide reliable and stable results, not only for CBF estimation but also for FC analyses

    Morphing Task: The Emotion Recognition Process in Children with Attention Deficit Hyperactivity Disorder and Autism Spectrum Disorder

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    Recognizing a person’s identity is a fundamental social ability; facial expressions, in particular, are extremely important in social cognition. Individuals affected by autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) display impairment in the recognition of emotions and, consequently, in recognizing expressions related to emotions, and even their identity. The aim of our study was to compare the performance of participants with ADHD, ASD, and typical development (TD) with regard to both accuracy and speed in the morphing task and to determine whether the use of pictures of digitized cartoon faces could significantly facilitate the process of emotion recognition in ASD patients (particularly for disgust). This study investigated the emotion recognition process through the use of dynamic pictures (human faces vs. cartoon faces) created with the morphing technique in three pediatric populations (7–12 years old): ADHD patients, ASD patients, and an age-matched control sample (TD). The Chi-square test was used to compare response latency and accuracy between the three groups in order to determine if there were statistically significant differences (p < 0.05) in the recognition of basic emotions. The results demonstrated a faster response time in neurotypical children compared to ASD and ADHD children, with ADHD participants performing better than ASD participants on the same task. The overall accuracy parameter between the ADHD and ASD groups did not significantly differ

    Probing functional connectivity and network modelling from perfusion neuroimaging with Arterial Spin Labeling

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    Nowadays, the assessment of brain functional connectivity (FC) patterns, ranging from resting-state networks to network modelling, can rely on Arterial Spin Labeling (ASL) MRI as an alternative to the gold-standard sequence represented by the blood-oxygenation-level-dependent contrast. We have evaluated these aspects from different point of view (experimental protocols, populations and analysis methods), trying to overcome some of the present challenges related to the ASL applicability in this context. The results demonstrate how FC patterns and changes can be reliably detected using ASL, with the added value of allowing the simultaneous quantification of brain perfusion, i.e. a marker of neuronal activity

    Citogenética y filogenia en especies silvestres y cultivadas de ajíes (Capsicum - Solanaceae)

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    En Capsicum se han realizado análisis citogenéticos mediante diversas técnicas que han contribuido a caracterizar un número importante de especies y a establecer relaciones entre las mismas. No obstante los progresos realizados a la fecha en este aspecto, todavía quedan grupos con límites aún discutidos y otros poco conocidos. A través de este proyecto se propone ampliar los estudios de citogenética y biología molecular en el género con diversos objetivos. En forma general, acrecentar el conocimiento de la organización genómica, las relaciones filogenéticas y la evolución cromosómica en Capsicum. Respecto a los taxones cultivados, se intentará esclarecer si los tres miembros del complejo C. annuum (C. annuum, C. chinense, C. frutescens) constituyen especies diferentes o se trata de taxones co-específicos. En cuanto a las especies silvestres, se obtendrá información citogenética de C. geminifolium, C. lanceolatum y C. lycianthoides, a fin de caracterizarlas y determinar su validez taxonómica. Así mismo, considerando estas especies y otras menos conocidas como C. coccineum, C. cornutum, C. dimorphum y C. mirabile, se intentará definir relaciones interespecíficas y clados infragenéricos. Este estudio comprenderá aspectos tales como análisis cromosómico con métodos de bandeos (de fluorescencia y AgNOR), mapeo de secuencias del DNA (genes ribosómicos) mediante hibridación in situ fluorescente (FISH), análisis estructural de la heterocromatina, evaluación de la variabilidad intra - e interespecífica usando marcadores moleculares “microsatélites”, análisis filogenético utilizando marcadores nucleares y cloroplastidiales. La información obtenida puede, además, ser una herramienta básica aplicable al mejoramiento genético de las especies cultivadas (variedades de ajíes y pimientos comerciales) y a la conservación de los recursos genéticos silvestres
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