Differential diagnosis in children with autistic symptoms and subthreshold ADOS total score: An observational study

Background: Children with autism spectrum disorder (ASD) share some symptoms with children with other neurodevelopmental disorders (ie, intellectual disability or communication disorders or language disorders). These similarities can make difficult to obtain an accurate diagnosis, which is essential to give targeted treatments to the patients. We aim to verify in our study if children with autistic traits who undergo to Autism Diagnostic Observation Schedule had specific clinical diagnosis. Patients and Methods: We selected 73 children tested with ADOS-G or ADOS-2, for the presence of autistic symptoms. The whole sample did not reach the cut-off of ADOS and did not receive the ASD diagnosis, according to DSM-5. Results: Results of this study showed that in order of frequency and early diagnosis, communication disorders (CD), mild intellectual disability (mID) and the attention deficit hyperactivity disorders (ADHD) represent the most common final clinical diagnosis in children with autistic traits. Conclusion: Our results showed as the CD was the common diagnosis of these children and that often associated with younger age. Moreover, analyses of ADOS domains and the difference of individual items between groups did not show the capacity to differentiate between different neurodevelopmental disorders in terms of differential diagnosis, and this confirms the need for integrating multiple sources of information during the diagnostic process

Impact of sleep disorders on behavioral issues in preschoolers with autism spectrum disorder

BackgroundSleep disorders are one of the most common problems in children with Autism Spectrum Disorder (ASD). However, they often tend to be underdiagnosed and incorrectly treated in clinical practice. This study aims to identify sleep disorders in preschool children with ASD and to explore their relationship with the core symptoms of autism, the child's developmental and cognitive level as well as the psychiatric comorbidities. MethodsWe recruited 163 preschool children with a diagnosis of ASD. The Children's Sleep Habits Questionnaire (CSHQ) assessed sleep conditions. Multiple standardized tests were used to evaluate intellectual abilities, the presence of repetitive behaviors (through the Repetitive Behavior Scale-Revised), as well as the emotional-behavioral problems and the psychiatric comorbidities (through the Child Behavior Checklist -CBCL 1(1/2)-5). ResultsThe results showed that poor disorders had consistently higher scores in all areas assessed by the CSHQ and on the CBCL across all domains. The correlational analysis showed that severe sleep disorders were associated with higher scores in internalizing, externalizing, and total problems at the CBCL syndromic scales, and in all DSM-oriented CBCL subscales. Moreover, we found that the association between sleep disorders and restricted and repetitive behaviors (RRBs) is explained by the anxiety-related symptoms. ConclusionBased on these findings, the study recommends that screening for sleep problems followed by early intervention should constitute a routine part of clinical practice for children with ASD

Body Representations in Children with Cerebral Palsy

We constantly process top-down and bottom-up inputs concerning our own body that interact to form body representations (BR). Even if some evidence showed BR deficits in children with cerebral palsy, a systematic study that evaluates different kinds of BR in these children, taking into account the possible presence of a general deficit affecting non-body mental representations, is currently lacking. Here we aimed at investigating BR (i.e., Body Semantics, Body Structural Representation and Body Schema) in children with cerebral palsy (CP) taking into account performance in tasks involving body stimuli and performance in tasks involving non-body stimuli. Thirty-three CP (age range: 5–12 years) were compared with a group of 103 typically-developing children (TDC), matched for age and sex. 63.64% of children with CP showed a very poor performance in body representation processing. Present data also show alterations in different body representations in CP in specific developmental stages. In particular, CP and TDC performances did not differ between 5 to 7 years old, whereas CP between 8 and 12 years old showed deficits in the Body Structural Representation and Body Schema but not in Body Semantics. These findings revealed the importance of taking into account the overall development of cognitive domains when investigating specific stimuli processing in children who do not present a typical development and were discussed in terms of their clinical implications

Wastewater-based epidemiology for early warning of SARS-COV-2 circulation: A pilot study conducted in Sicily, Italy

There is increasing evidence of the use of wastewater-based epidemiology to integrate conventional monitoring assessing disease symptoms and signs of viruses in a specific territory. We present the results of SARS-CoV-2 environmental surveillance activity in wastewater samples collected between September 2020 and July 2021 in 9 wastewater treatment plants (WTPs) located in central and western Sicily, serving over 570,000 residents. The presence of SARS-CoV-2, determined in 206 wastewater samples using RT-qPCR assays, was correlated with the notified and geo-referenced cases on the areas served by the WTPs in the same study period. Overall, 51% of wastewater samples were positive. Samples were correlated with 33,807 SARS-CoV-2 cases, reported in 4 epidemic waves, with a cumulative prevalence of 5.9% among Sicilian residents. The results suggest that the daily prevalence of SARS-CoV-2 active cases was statistically significant and higher in areas with SARS-CoV-2 positive wastewater samples. According to these findings, the proposed method achieves a good sensitivity profile (78.3%) in areas with moderate or high viral circulation (≥133 cases/100,000 residents) and may represent a useful tool in the management of epidemics based on an environmental approach, although it is necessary to improve the accuracy of the process

Mediterranean diet impact on cardiovascular diseases: a narrative review

: Cardiovascular disease (CVD) accounts for more than 17 million deaths per year worldwide. It has been estimated that the influence of lifestyle on CVD mortality amounts to 13.7% for smoking, 13.2% for poor diet, and 12% for inactive lifestyle. These results deeply impact both the healthy status of individuals and their skills in working. The impact of CVD on productivity loss accounts for the 24% in total costs for CVD management.Mediterranean diet (MedD) can positively impact on natural history of CVD. It is characterized by a relatively high consumption of inexpensive and genuine food such as cereals, vegetables, legumes, nuts, fish, fresh fruits, and olive oil as the principal source of fat, low meat consumption and low-to-moderate consumption of milk, dairy products, and wine.Its effects on cardiovascular health are related to the significant improvements in arterial stiffness. Peripheral artery disease, coronary artery disease, and chronic heart failure are all positively influenced by the MedD. Furthermore, MedD lowers the risk of sudden cardiac death due to arrhythmias.The present narrative review aims to analyze the effects of MedD on CVD

The rapid spread of SARS-COV-2 Omicron variant in Italy reflected early through wastewater surveillance

The SARS-CoV-2 Omicron variant emerged in South Africa in November 2021, and has later been identified worldwide, raising serious concerns. A real-time RT-PCR assay was designed for the rapid screening of the Omicron variant, targeting characteristic mutations of the spike gene. The assay was used to test 737 sewage samples collected throughout Italy (19/21 Regions) between 11 November and 25 December 2021, with the aim of assessing the spread of the Omicron variant in the country. Positive samples were also tested with a real-time RT-PCR developed by the European Commission, Joint Research Centre (JRC), and through nested RT-PCR followed by Sanger sequencing. Overall, 115 samples tested positive for Omicron SARS-CoV-2 variant. The first occurrence was detected on 7 December, in Veneto, North Italy. Later on, the variant spread extremely fast in three weeks, with prevalence of positive wastewater samples rising from 1.0% (1/104 samples) in the week 5–11 December, to 17.5% (25/143 samples) in the week 12–18, to 65.9% (89/135 samples) in the week 19–25, in line with the increase in cases of infection with the Omicron variant observed during December in Italy. Similarly, the number of Regions/Autonomous Provinces in which the variant was detected increased fromone in the first week, to 11 in the second, and to 17 in the last one. The presence of the Omicron variant was confirmed by the JRC real-time RT-PCR in 79.1% (91/115) of the positive samples, and by Sanger sequencing in 66% (64/97) of PCR amplicons

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Gender and organisational culture: relationships between marginality and women’s career success

Feminist and management literature (Kanter, 1977; Burton, 1991; Hede 2000) has chronicled the deep stirrings felt by women excluded from choices and marginalised from power in many organisations. This thesis aimed to investigate the experiences of marginality for women who work in organisations and to explore the associations between marginality and career success, and between marginality and quality of work variables such as stress and role conflict. The research used a model that encompasses a version of fit, whereby stress is viewed as a mis-fit between an individual’s personal values and the ‘environmental’ supplies available to fulfil those values (Edwards, 1996; Code & Langan-Fox, 2001). This is a shift away from models that focus on appraisals of demand versus capacity (such as Lazarus & Folkman, 1984). Tenets of marginality theory (Park, 1928) and gender schema theory (Bem, 1981) were key points of reference. These theories support the proposition that individuals who experience greater congruence between their own gender identity and that of the organisational culture will experience less occupational stress and higher quality work outcomes (including career success). Marginality was operationalised as the degree of incongruence between individuals’ self ratings of gender related characteristics and values, and ratings of gender related characteristics and values of the organisational culture. Marginality was conceptualised as both shaped and constructed by the individual–cultural relationship, positioned within a wider social, political and ideological context. The thesis used two studies to explore first the nature of marginality, and then its hypothesised antecedents, effects and their mediators. Three Australian private sector organisations participated in a qualitative study in Study 1 (EducOrg, MetalOrg, and ComputerOrg) and two private sector organisations participated in a quantitative study in Study 2 (ComputerOrg and InsurOrg). Study 1 involved conducting interviews with senior managers across organisations (metal, computing, and education service industries) and Study 2 involved a survey completed by a total 150 participants drawn from both the computing organisation, and from a newly recruited organisation from the insurance sector. Interviews were semi-structured around topics related to gender and career development. The survey in Study 2, the design of which was informed by findings from Study 1, comprised gender and values scales, as well as quality of work indices such as stress and job satisfaction measures. The results in Study 1 appeared to confirm the existence of gendered phenomena in the three organisations studied. Gender polarisation processes appeared to perpetuate exemplars of the ‘good’ manager as masculine, positioning women as deviant within the organisational culture. For women to deviate from the dominant management style involves risk, and many women found themselves with less freedom than expected to move at the ‘contact zone’ between masculine and feminine behavioural modalities. Study 2 provided an opportunity to test the hypothesis that psychological resources and marginality, would significantly mediate stress. As hypothesised, women experienced greater degrees of marginality than men. However, marginality was experienced differently in each of the organisations studied. Findings in both organisations participating in Study 2 suggested the factor that distinguished the organisations on levels of marginality appeared to be perceptions of the existence or non-existence of nurturing values and practices in the organisation. It was hypothesised that perceptions of psychological resources (self-efficacy, locus of control, self esteem) and social support resources (network position, and availability of mentors) would be predictors of marginality and occupational stress. Findings supported this in part. Four of the psychological resource variables significantly mediated the effects of marginality. They were positive and negative affect, self-esteem and mentoring experiences. As expected, psychological and social support variables were also significant predictors of occupational stress factors, though their impact differed according to the particular stress factor. Overall the findings provided some evidence to support the framework of gender marginality developed in this thesis: that marginality, mediated by psychosocial resources, will have adverse effects on perceptions of career success and occupational stress. It was concluded that further research to address the limitations and implications of this thesis, in order to consolidate understandings of the gender differences on career success for women, is worthy of consideration

Determination of aflatoxins in cereal flours by solid-phase microextraction coupled with liquid chromatography and post-column photochemical derivatization-fluorescence detection

A new method for the determination of aflatoxins B1, B2, G1, and G2 (AFB1, AFB2, AFG1, AFG2) in cereal flours based on solid-phase microextraction (SPME) coupled with high performance liquid chromatography with post-column photochemical derivatization and fluorescence detection (SPME–HPLC–PD–FD) has been developed. Aflatoxins were extracted from cereal flour samples by a methanol:phosphate buffer (pH 5.8, I = 0.1) (80:20, v/v) solution, followed by a SPME step. Different SPME and HPLC–PD–FD parameters (fiber polarity, temperature, pH, ionic strength, adsorption and desorption time, mobile phase) have been investigated and optimized. This method, which was assessed for the analysis of different cereal flours, showed interesting results in terms of LOD (from 0.035 to 0.2 ng g−1), LOQ (from 0.1 to 0.63 ng g−1, respectively), within and inter-day repeatability (2.27% and 5.38%, respectively) linear ranges (up to 20 ng g−1 for AFB1 and AFG1 and 6ngg−1 for AFB2 and AFG2), and total raw extraction efficiency (in the range 55–59% at concentrations in the range 0.3–1 ng g−1 and 49–52% at concentrations in the range 1–10 ng g−1). The results were also compared with the purification step carried out by conventional immunoaffinity columns