Transmission dynamics of the ongoing chikungunya outbreak in Central Italy. From coastal areas to the metropolitan city of Rome, summer 2017

A large chikungunya outbreak is ongoing in Italy, with a main cluster in the Anzio coastal municipality. With preliminary epidemiological data, and a transmission model using mosquito abundance and biting rates, we estimated the basic reproduction number R0 at 2.07 (95% credible interval: 1.47–2.59) and the first case importation between 21 May and 18 June 2017. Outbreak risk was higher in coastal/rural sites than urban ones. Novel transmission foci could occur up to mid-November

Mindfulness-based stress reduction in patients with interstitial lung diseases: a pilot, single-centre observational study on safety and efficacy

open11siBackground Chronic, progressive respiratory symptoms are associated with great psychological and emotional impact in patients suffering from interstitial lung disease (ILD). This single-centre pilot study evaluated for the first time the safety, feasibility and efficacy of a Mindfulness Based Stress Reduction Program (MBSR) in a group of patients with ILD. Methods Prospective observational study set in a university hospital ILD outpatient clinic. Nineteen patients with different ILDs were recruited 2 months prior to the start of the 8-week MBSR program and followed up for 12 months. Primary outcomes were program safety and feasibility, while secondary outcomes were changes in moods and stress (assessed by Profile Of Mood State (POMS) and Perceived Stress Scale (PSS) questionnaires), symptoms (Shortness Of Breath (SOB) and Cough And Sputum Assessment (CASA-Q) questionnaires), lung function and exercise tolerance at 12 months. Results Two patients (10.5%) dropped out in the observational period before the start of the MBSR intervention because of non-respiratory causes. All 17 patients who entered the 8-week MBSR program managed to complete it with an adherence average of eight sessions of nine. No adverse events related to the mindfulness training were reported. Statistically significant improvements in the POMS total score and in several individual items of POMS and PSS were observed throughout the study. However, respiratory questionnaire scores, lung function and exercise tolerance did not show a significant difference over time. Conclusions An MBSR program appears to be safe and feasible in patients with ILD, and might affect perceived moods and stress producing a positive and lasting improvement in several stress-related negative domains. These findings pave the way to larger (possibly multicentre), randomised, controlled confirmatory trials.openSgalla, Giacomo; Cerri, Stefania; Ferrari, Roberto; Ricchieri, Maria Pia; Poletti, Stefano; Ori, Margherita; Garuti, Martina; Montanari, Gloria; Luppi, Fabrizio; Petropulacos, Kyriakoula; Richeldi, LucaSgalla, Giacomo; Cerri, Stefania; Ferrari, Roberto; Ricchieri, Maria Pia; Poletti, Stefano; Ori, Margherita; Garuti, Martina; Montanari, Gloria; Luppi, Fabrizio; Petropulacos, Kyriakoula; Richeldi, Luc

A experiência do estigma dos consumidores de baixa renda no encontro de serviços

This article focuses on low-income consumers facing social stigma in service encounters with contact employees. Research have regarded the income-consumers from the disadvantaged perspective but few from the stigmatized perspective. The literature tends to propose direct functional relationships between emotions and coping processes. Further studies suggested that emotional and cognitive appraisals interact to influence consumers' choice of coping strategies. Our study was designed using Critical Incident Technique and Content Analysis in 210 low income individuals. The results state the existence of that stigmatized behavior beyond the legitimate expected interaction between the parties involved. The construction of the stigma model evolution illustrated this research. Ações automáticas de preconceito ou de uma imagem previamente categorizada sugerem que os indivíduos pobres carregam consigo um estigma pela sua condição social, manifestado por sinais físicos ou psicológicos e, muitas vezes, materializado nas suas respostas. Assim, este trabalho visa estudar a experiência do consumidor de baixa renda ao ser estigmatizado no encontro de serviços. Para isso, foram entrevistados 210 indivíduos com renda familiar de até R$ 2400,00. Suas narrativas foram coletadas utilizando a Técnica do Incidente Critico e examinadas e categorizadas por meio da análise de conteúdo. Os resultados confirmaram a estigmatização do consumidor pobre, bem como o impacto das emoções primárias e das emoções secundárias e terciárias delas derivadas sobre suas estratégias de resposta. Também possibilitaram a construção de um modelo explicativo da evolução do estigma em consumidores pobres

Remdesivir treatment in hospitalized patients affected by COVID-19 pneumonia: a case-control study

Background: to date the optimal antiviral treatment against severe coronavirus disease 2019 (COVID-19) has not been proven; remdesivir is a promising drug with in vitro activity against several virus, but in COVID-19 the clinical results are currently not definitive. Methods: in this retrospective observational study we analyzed the clinical outcomes (survival analysis, efficacy and safety) in a group of hospitalized patients with COVID-19 treated with remdesivir in comparison with a control group of patients treated with other antiviral or supportive therapies. Results: we included 163 patients treated with remdesivir and 403 subjects in the control group; the baseline characteristics were similar in the two groups; mortality rate was higher in control group (24.8% vs 2.4%, p<0.001), the risk of intensive-care-unit (ICU) admission was higher in control group (17.8% vs 9.8%, p=0.008); hospitalization time was significantly lower in patients treated with remdesivir (9.5 vs 12.5 days, p<0.001). The safety of remdesivir was good and no significant adverse events were reported. In multivariate analysis the remdesivir treatment was independently associated with a 34% lower mortality rate (OR=0.669; p=0.014). Conclusions: in this analysis the treatment with remdesivir was associated with lower mortality, lower rate of ICU admission, shorter time of hospitalization. No adverse events were observed. This promising antiviral treatment should also be confirmed by other studies. This article is protected by copyright. All rights reserved

FAST, a method based on split-GFP for the detection in solution of proteins synthesized in cell-free expression systems

ackground: Depression and anxiety are two of the most prevalent and disabling mental disorders worldwide, both in the general population and in outpatient clinical settings. Objective: This study aimed to analyze the psychometric properties of the Patient Health Questionnaire-4 (PHQ-4) based on network analysis metrics. Methods: A total of 911 Paraguayans (23.71% women and 76.29% men; mean age 31.25 years, SD = 10.63), selected by non-probabilistic convenience sampling, participated in the study. Network analysis was used to evaluate the internal structure, reliability, and measurement invariance between men and women. Results: The results revealed that the PHQ-4 is a unidimensional measure through Exploratory Graph Analysis (EGA). Reliability, through structural consistency, identified that 100% of the time, only a single dimension was obtained, and all items remained stable, as they were always replicated within the empirical dimension. The unidimensional structure has shown evidence of configural invariance; therefore, the network structure functioned equally among the different sex groups. Conclusion: The PHQ-4 presented optimal preliminary evidence of validity based on its internal structure, reliability, and invariance between sexes. Therefore, it may be useful as an accurate and brief measure of anxiety and depressive symptoms in the Paraguayan context.Horizon 2020 Framework Programm

Alexithymia may modulate decision making in patients with de novo Parkinson’s disease

The aim of this study was to investigate whether and how alexithymia may influence decision making under conditions of uncertainty, assessed using the Iowa Gambling Task, in patients with newly diagnosed, untreated (de novo) Parkinson’s disease, as previously reported for healthy subjects. Twenty-four patients with de novo Parkinson’s disease underwent a neuropsychological and neuropsychiatric assessment, including the Toronto Alexithymia Scale, the Geriatric Depression Scale Short Form, and the Iowa Gambling Task (IGT). The assessment showed that 12 patients were alexithymic and 12 were non-alexithymic; seven patients were found to be mildly depressed and 17 non-depressed. Alexithymic and non-alexithymic patients did not differ in the IGT total score; however, significant differences emerged across the third block of the IGT, in which the alexithymic patients outperformed the nonalexithymic patients. Depression did not influence IGT performance. Alexithymia may modulate decision making, as assessed with the IGT; alexithymia could be associated with faster learning to avoid risky choices and negative feedback, as previously reported in some studies conducted in anxious or depressed patients

Sexual regional dimorphism of post-adolescent and middle age brain maturation. A multi-center 3T MRI study

Sex-related differences are tied into neurodevelopmental and lifespan processes, beginning early in the perinatal and developmental phases and continue into adulthood. The present study was designed to investigate sexual dimorphism of changes in gray matter (GM) volume in post-adolescence, with a focus on early and middle-adulthood using a structural magnetic resonance imaging (MRI) dataset of healthy controls from the European Network on Psychosis, Affective disorders and Cognitive Trajectory (ENPACT). Three hundred and seventy three subjects underwent a 3.0 T MRI session across four European Centers. Age by sex effects on GM volumes were investigated using voxel-based morphometry (VBM) and the Automated Anatomical Labeling atlas regions (ROI). Females and males showed overlapping and non-overlapping patterns of GM volume changes during aging. Overlapping age-related changes emerged in bilateral frontal and temporal cortices, insula and thalamus. Both VBM and ROI analyses revealed non-overlapping changes in multiple regions, including cerebellum and vermis, bilateral mid frontal, mid occipital cortices, left inferior temporal and precentral gyri. These findings highlight the importance of accounting for sex differences in cross-sectional analyses, not only in the study of normative changes, but particularly in the context of psychiatric and neurologic disorders, wherein sex effects may be confounded with disease-related changes

Monocyte mitochondrial dysfunction, inflammaging, and inflammatory pyroptosis in major depression

BACKGROUND: The macrophage theory of depression states that macrophages play an important role in Major Depressive Disorder (MDD). METHODS: MDD patients (N = 140) and healthy controls (N = 120) participated in a cross-sectional study investigating the expression of apoptosis/growth and lipid/cholesterol pathway genes (BAX, BCL10, EGR1, EGR2, HB-EGF, NR1H3, ABCA1, ABCG1, MVK, CD163, HMOX1) in monocytes (macrophage/microglia precursors). Gene expressions were correlated to a set of previously determined and reported inflammation-regulating genes and analyzed with respect to various clinical parameters. RESULTS: MDD monocytes showed an overexpression of the apoptosis/growth/cholesterol and the TNF genes forming an inter-correlating gene cluster (cluster 3) separate from the previously described inflammation-related gene clusters (containing IL1 and IL6). While upregulation of monocyte gene cluster 3 was a hallmark of monocytes of all MDD patients, upregulation of the inflammation-related clusters was confirmed to be found only in the monocytes of patients with childhood adversity. The latter group also showed a downregulation of the cholesterol metabolism gene MVK, which is known to play an important role in trained immunity and proneness to inflammation. CONCLUSIONS: The upregulation of cluster 3 genes in monocytes of all MDD patients suggests a premature aging of the cells, i.e. mitochondrial apoptotic dysfunction and TNF "inflammaging", as a general feature of MDD. The overexpression of the IL-1/IL-6 containing inflammation clusters and the downregulation of MVK in monocytes of patients with childhood adversity indicates a shift in this condition to a more severe inflammation form (pyroptosis) of the cells, additional to the signs of premature aging and inflammaging

Structured reporting for fibrosing lung disease: a model shared by radiologist and pulmonologist

Objectives: To apply the Delphi exercise with iterative involvement of radiologists and pulmonologists with the aim of defining a structured reporting template for high-resolution computed tomography (HRCT) of patients with fibrosing lung disease (FLD). Methods: The writing committee selected the HRCT criteria\ue2\u80\u94the Delphi items\ue2\u80\u94for rating from both radiology panelists (RP) and pulmonology panelists (PP). The Delphi items were first rated by RPs as \ue2\u80\u9cessential\ue2\u80\u9d, \ue2\u80\u9coptional\ue2\u80\u9d, or \ue2\u80\u9cnot relevant\ue2\u80\u9d. The items rated \ue2\u80\u9cessential\ue2\u80\u9d by &lt; 80% of the RP were selected for the PP rating. The format of reporting was rated by both RP and PP. Results: A total of 42 RPs and 12 PPs participated to the survey. In both Delphi round 1 and 2, 10/27 (37.7%) items were rated \ue2\u80\u9cessential\ue2\u80\u9d by more than 80% of RP. The remaining 17/27 (63.3%) items were rated by the PP in round 3, with 2/17 items (11.7%) rated \ue2\u80\u9cessential\ue2\u80\u9d by the PP. PP proposed additional items for conclusion domain, which were rated by RPs in the fourth round. Poor consensus was observed for the format of reporting. Conclusions: This study provides a template for structured report of FLD that features essential items as agreed by expert thoracic radiologists and pulmonologists