The Neonatal Environment and Health Outcomes (NEHO) Birth Cohort Study: Behavioral and Socioeconomic Characteristics and Drop-Out Rate from a Longitudinal Birth Cohort in Three Industrially Contaminated Sites in Southern Italy

Pregnant women living in industrially contaminated sites (ICSs) are exposed to environmental contaminants through different pathways, and thus children’s health may be affected by pollutants. We created the Neonatal Environment and Health Outcomes (NEHO) longitudinal birth cohort in three ICSs in the Mediterranean area of southern Italy, collecting comprehensive information on personal data and lifestyles by questionnaire. Through multiple correspondence analysis, we identified possible clusters of enrolled women, and a neural network classifier analysis (NNCA) was performed to identify variables capable of predicting the attrition rate of the study. NEHO recruited 845 mother–child pairs over two years. The mothers’ mean age was 31.1 ± 5.2 SD years. We found significant differences in socioeconomic status (SES) among the three evaluated ICS, and an overall 11.1% prevalence of mothers who actively smoked during pregnancy. Active smoking during pregnancy was strongly associated with the lowest socioeconomic level (p < 0.0001). By means of the NNCA, we found that smoking during pregnancy and the lowest education level characterized the cluster with the highest attrition rate (p < 0.001). Our results demonstrate that reason for public health concern still exists regarding smoking during pregnancy and that SES influences both lifestyles, producing negative pregnancy outcomes and a higher survey attrition rate

Pioglitazone and bariatric surgery are the most effective treatments for non-alcoholic steatohepatitis: A hierarchical network meta-analysis

AIMS To compare different treatments for non-alcoholic steatohepatitis (NASH) and to determine an effectiveness hierarchy. MATERIALS AND METHODS We conducted a systematic review and Bayesian network meta-analysis including randomized controlled trials or prospective trials with at least 6 months' follow-up and histologically proven NASH in adult participants. Monte Carlo simulations were performed, each generating 10 000 data points, and results are reported as medians and 95% credibility intervals (CrIs). A meta-regression was conducted to find the effects of body mass index (BMI) decrement or reduction of homeostatic model assessment of insulin resistance (HOMA-IR) index on non-alcoholic fatty liver disease activity score (NAS) change. RESULTS The review identified 48 eligible trials comprising 2356 adults (55.6% men). Data were pooled using a random-effects model. The most effective treatments in terms of NAS reduction per semester were pioglitazone and Roux-en-Y gastric bypass (RYGB; -1.50 [95% CrI -2.08, -1.00] for pioglitazione and -1.00 [95% CrI -1.70, -0.32] for RYGB). Pioglitazone was also the best therapy for steatosis and lobular inflammation reduction. RYGB was the best treatment for hepatocellular ballooning reduction, whereas antioxidants appeared to be best for fibrosis improvement. For each 1% decrement in BMI, NAS was reduced by 1.3% (β = 1.28%, P = 0.01). Conversely, a 1% reduction of HOMA-IR index reduced NAS by 0.3% (β = 0.31%, P < 0.001). Treatments that were regarded as promising, such as elafibranor, simtuzumab, selonsertib, cenicriviroc, obeticholic acid and liraglutide, did not reduce either NAS or liver fibrosis significantly. CONCLUSIONS Pioglitazione and RYGB are the most effective therapies for NASH. Antioxidants may be effective in reducing liver fibrosis. Weight loss and improvement of hepatic insulin resistance are promising approaches in the treatment of NASH

Comparative efficacy of different weight loss treatments on knee osteoarthritis: A network meta-analysis

The lifetime risk of developing symptomatic knee osteoarthritis is 60% in subjects with obesity. It is unclear which is the best weight loss interventions leading to a meaningful improvement of osteoarthritis symptoms and clinical conditions in subjects with obesity. Our network meta-analysis compares different weight loss interventions on the improvement of osteoarthritis symptoms and clinical conditions in subjects affected by obesity. PubMed, Embase, and Cochrane databases were systematically searched for eligible studies until November 2020. Thirty eligible studies comprising 4651 adults (74.6% women) were included. The most effective interventions reducing pain were bariatric surgery, low-calorie diet and exercise, and intensive weight loss and exercise (-62.7 [95% CrI: -74.6, -50.6]; -34.4 [95% CrI: -48.1, -19.5]; -27.1 [95% CrI: -40.4, -13.6] respectively). For every 1% weight loss Western Ontario and McMaster Universities Osteoarthritis (WOMAC) pain, function, and stiffness scores decreased by about 2% points. In conclusion, our meta-analysis shows that a substantial weight loss is necessary to reduce significantly knee pain and joint stiffness and to improve physical function: 25% weight reduction from baseline is necessary to obtain a 50% reduction of each subscale of the WOMAC score. However, performing physical exercise is essential to preserve the lean body mass and to avoid sarcopenia. Our results apply to a large spectrum of body mass index (BMI), from overweight to severe obesity

The Influence of Sociodemographic Factors, Lifestyle, and Risk Perception on Dietary Patterns in Pregnant Women Living in Highly Contaminated Areas: Data from the NEHO Birth Cohort

During pregnancy, maternal nutrition and lifestyle play a critical role in influencing fetal development and newborn health outcomes. The aim of this study is to investigate the factors influencing the adherence to dietary patterns in pregnant women living in highly contaminated areas, and whether women with higher environmental risk perception manifest different nutritional behaviors during pregnancy. Food consumption data on 816 pregnant women from the Neonatal Environment and Health Outcomes (NEHO) residential birth cohort were analyzed. Dietary patterns were computed by principal component analysis. A multinomial logistic regression was also applied to identify sociodemographic, lifestyle, and pregnancy-related determinants of adherence to dietary patterns during pregnancy. Three patterns of food consumption&mdash;explaining 24.9% of the total variance&mdash;were identified as &ldquo;prudent&rdquo;, &ldquo;high energy&rdquo;, and &ldquo;vegetarian&rdquo; patterns. Results suggest that food choices during pregnancy follow a social gradient and align with other health behaviors during pregnancy: older, better educated, and physically active women with higher risk perception are more likely to follow healthier dietary patterns. Knowledge about what is eaten can contribute to dietary choices. Interventions to improve the prenatal nutrition knowledge of pregnant women are needed, especially concerning younger mothers and those with lower educational levels

Pioglitazone and bariatric surgery are the most effective treatments for non-alcoholic steatohepatitis:A hierarchical network meta-analysis

Aims: To compare different treatments for non-alcoholic steatohepatitis (NASH) and to. determine an effectiveness hierarchy. Materials and Methods: We conducted a systematic review and Bayesian network meta-analysis including randomized controlled trials or prospective trials with at least 6 months' follow-up and histologically proven NASH in adult participants. Monte Carlo simulations were performed, each generating 10 000 data points, and results are reported as medians and 95% credibility intervals (CrIs). A meta-regression was conducted to find the effects of body mass index (BMI) decrement or reduction of homeostatic model assessment of insulin resistance (HOMA-IR) index on non-alcoholic fatty liver disease activity score (NAS) change. Results: The review identified 48 eligible trials comprising 2356 adults (55.6% men). Data were pooled using a random-effects model. The most effective treatments in terms of NAS reduction per semester were pioglitazone and Roux-en-Y gastric bypass (RYGB; 121.50 [95% CrI 122.08, 121.00] for pioglitazione and 121.00 [95% CrI 121.70, 120.32] for RYGB). Pioglitazone was also the best therapy for steatosis and lobular inflammation reduction. RYGB was the best treatment for hepatocellular ballooning reduction, whereas antioxidants appeared to be best for fibrosis improvement. For each 1% decrement in BMI, NAS was reduced by 1.3% (\u3b2 = 1.28%, P = 0.01). Conversely, a 1% reduction of HOMA-IR index reduced NAS by 0.3% (\u3b2 = 0.31%, P &lt; 0.001). Treatments that were regarded as promising, such as elafibranor, simtuzumab, selonsertib, cenicriviroc, obeticholic acid and liraglutide, did not reduce either NAS or liver fibrosis significantly. Conclusions: Pioglitazione and RYGB are the most effective therapies for NASH. Antioxidants may be effective in reducing liver fibrosis. Weight loss and improvement of hepatic insulin resistance are promising approaches in the treatment of NASH

MODELLISTICA MATEMATICA E PIATTAFORME INFORMATICHE A SUPPORTO DELLA RICERCA AMBIENTALE

La modellizzazione matematica è diventata ormai uno strumento essenziale nell’avanzamento delle conoscenze in qualsiasi campo della scienza, dall’econometria alla psicologia, dalla chimica all’epidemiologia, come vissuto di recente nella pandemia da SARS-coV-2. Anche quelle che erano una volta discipline “soft” come la biomedicina o l’ecologia possono ora usufruire di tecniche di rappresentazione ed esplicazione dei processi estremamente utili alla comprensione delle dinamiche in gioco. Questa evoluzione, dovuta in non piccola parte all’attuale disponibilità di abbondante potenza di calcolo elettronico a costi ridotti, non è però opera ed appannaggio soltanto della nostra generazione. Lo stesso Consiglio nazionale delle ricerche (CNR) fondato nel 1923 ha avuto come primo presidente il Prof. Vito Volterra, uno dei fondatori della biomatematica, il cui nome è storicamente legato alle equazioni di dinamica di popolazione da lui introdotte insieme a Lotka. Nel solco di tale tradizione oggi la biomatematica ha un ruolo primario nello studio delle dinamiche di inquinamento, diffusione di sostanze tossiche, bioaccumulo nelle specie di rilevanza alimentare, tossicocinetica, tossicodinamica ed epidemiologia delle malattie legate all’inquinamento. In tutte queste discipline viene affidato alla biomatematica il ruolo di svolgere o supportare interpretazioni quantitative dei dati e facilitare l’inquadramento delle esperienze specifiche degli specialisti di campo (esperti ambientali, biologi, epidemiologi e clinici), in una cornice protesa a collegare dati disparati in una logica di insieme coerente. Si tratta di un compito non facile, che richiede non solo lo sforzo di molti ricercatori con competenze complementari (biologi, medici, epidemiologi, analisti numerici, sistemisti, statistici), ma che deve anche fare i conti con le limitazioni dovute alla mancata disponibilità di dati talvolta cruciali, un fenomeno purtroppo frequente nelle indagini su sistemi complessi. Le pagine che seguono si propongono di illustrare, in modo comprensibile anche per non specialisti, alcuni di questi temi. Il capitolo comprende una panoramica su cosa sono i modelli statici e dinamici, ed in particolare quelli sviluppati in ambito “ambiente e salute”. Inoltre viene offerta al lettore una scheda riassuntiva del sistema formalizzato BioMatLab (MoSpec) dedicato all’implementazione dei modelli matematici in diversi linguaggi di programmazione, corredato da un link alla piattaforma online nella quale sono rese disponibili alla comunità scientifica alcuni modelli prodotti/implementati per lo studio delle dinamiche di interazione ambiente e salute sviluppate durante le attività del progetto CISAS (capitolo 14)

Emotional Competence in Primary School Children: Examining the Effect of a Psycho-Educational Group Intervention: A Pilot Prospective Study

Emotional competence (EC) is a key component of children’s psychological, cognitive, and social development, and it is a central element of learning. The primary goal of this study was to evaluate the effectiveness of implementing a psycho-educational group intervention aimed at improving children’s emotional competence (EC), quality of integration and scholastic skills. A total of 229 children (123 females; M Age = 7.22 years; SD = 0.97 years) completed the Pictures of Facial Affect (POFA), the Drawn Stories Technique, the Classroom Drawing, and the Colored Progressive Matrices. The total sample was randomly divided into an intervention group (N = 116) who took part in psycho-educational activities and a control (no-intervention) group (N = 84). Both groups were tested at baseline, before the intervention started, and at the end of the intervention (4 months from baseline). Results from mixed-model ANOVA revealed a significant main effect for POFA score over time (F = 6.24, p = 0.01) and an interaction effect between POFA and group (F = 4.82, p = 0.03). No significant main effect was found for classroom drawing over time (F = 0.81, p &gt; 0.05) or for quality of integration and group intervention. These findings support the importance of developing psycho-educational programmes in school for promotion of emotional health for preventing not only the onset of problematic behaviours at school such as bullying but also the development of clinical conditions linked to difficulties in emotional recognition, expression, and regulation such as alexithymia