The role of Attachment Insecurity in the emergency of anxiety symptoms in children and adolescent with migraine: an empirical study

Background: It is widely recognised that there are associations between headache, psychiatric comorbidity and attachment insecurity in both adults and children. The aims of this study were: 1) to compare perceived attachment security and anxiety in children and adolescents with migraine without aura and a healthy control group; 2) to test whether the child’s perceived security of attachment to the mother and the father mediated the association between migraine and anxiety. Methods: One hundred children and adolescents with Migraine without Aura were compared with a control group of 100 children without headache. The Security Scale (measures perceived security of attachments) and the Self-Administered Psychiatric Scales for Children and Adolescents, a measure of anxiety symptoms, were administered to all participants. Results: The clinical group had lower attachment security than the control group and higher scores on all anxiety scales. Anxiety was negatively correlated with attachment. Children’s attachment to their mother mediated the increase in global anxiety in the clinical group. Insecure paternal attachment was associated with greater insecurity in maternal attachment, suggesting that there is a complex pathway from migraine to anxiety symptoms mediated by perceived insecurity of paternal attachment and hence also by perceived insecurity of maternal attachment. Conclusion: These results suggest that insecure parental attachment may exacerbate anxiety in children and adolescents with migraine and point to the importance of multimodal interventions, perhaps taking account of family relationships, for children and adolescents with migraine

Challenges and opportunities beyond structured data in analysis of electronic health records

Electronic health records (EHR) contain a lot of valuable information about individual patients and the whole population. Besides structured data, unstructured data in EHRs can provide extra, valuable information but the analytics processes are complex, time-consuming, and often require excessive manual effort. Among unstructured data, clinical text and images are the two most popular and important sources of information. Advanced statistical algorithms in natural language processing, machine learning, deep learning, and radiomics have increasingly been used for analyzing clinical text and images. Although there exist many challenges that have not been fully addressed, which can hinder the use of unstructured data, there are clear opportunities for well-designed diagnosis and decision support tools that efficiently incorporate both structured and unstructured data for extracting useful information and provide better outcomes. However, access to clinical data is still very restricted due to data sensitivity and ethical issues. Data quality is also an important challenge in which methods for improving data completeness, conformity and plausibility are needed. Further, generalizing and explaining the result of machine learning models are important problems for healthcare, and these are open challenges. A possible solution to improve data quality and accessibility of unstructured data is developing machine learning methods that can generate clinically relevant synthetic data, and accelerating further research on privacy preserving techniques such as deidentification and pseudonymization of clinical text

Teledermoscopy in the Diagnosis of Melanocytic and Non-Melanocytic Skin Lesions: NurugoTM Derma Smartphone Microscope as a Possible New Tool in Daily Clinical Practice

Background: Due to the COVID-19 pandemic, teledermoscopy has been increasingly used in the remote diagnosis of skin cancers. In a study conducted in 2020, we demonstrated a potential role of an inexpensive device (NurugoTM Derma) as a first triage to select the skin lesions that require a face-to-face consultation with dermatologists. Herein, we report the results of a novel study that aimed to better investigate the performance of NurugoTM. Objectives: (i) verify whether the NurugoTM can be a communication tool between the general practitioner (GP) and dermatologist in the first assessment of skin lesions, (ii) analyze the degree of diagnostic–therapeutic agreement between dermatologists, (iii) estimate the number of potentially serious diagnostic errors. Methods: One hundred and forty-four images of skin lesions were collected at the Dermatology Outpatient Clinic in Novara using a conventional dermatoscope (instrument F), the NurugoTM (instrument N), and the latter with the interposition of a laboratory slide (instrument V). The images were evaluated in-blind by four dermatologists, and each was asked to make a diagnosis and to specify a possible treatment. Results: Our data show that F gave higher agreement values for all dermatologists, concerning the real clinical diagnosis. Nevertheless, a medium/moderate agreement value was obtained also for N and V instruments and that can be considered encouraging and indicate that all examined tools can potentially be used for the first screening of skin lesions. The total amount of misclassified lesions was limited (especially with the V tool), with up to nine malignant lesions wrongly classified as benign. Conclusions: NurugoTM, with adequate training, can be used to build a specific support network between GP and dermatologist or between dermatologists. Furthermore, its use could be extended to the diagnosis and follow-up of other skin diseases, especially for frail patients in emergencies, such as the current pandemic context

Contribution of the EVER-EST project to the community of the Geohazard Supersites initiative

The EVER-EST project (European Virtual Environment for Research - Earth Science Themes: a solution) is a H2020 project (2015-2018) aimed at the creation of a Virtual Research Environment (VRE) focused on the requirements of the Earth Science community. The VRE is intended to enhance the ability to collaborate, interoperate and share knowledge and experience between all relevant stakeholders, including researchers, monitoring teams and civil protection agencies. Among the innovations of the project is the exploitation of the “Research Object” concept.PublishedVIenna,Austria1VV. Altr

SARS-CoV-2-Associated ssRNAs Activate Human Neutrophils in a TLR8-Dependent Fashion

COVID-19 disease is characterized by a dysregulation of the innate arm of the immune system. However, the mechanisms whereby innate immune cells, including neutrophils, become activated in patients are not completely understood. Recently, we showed that GU-rich RNA sequences from the SARS-CoV-2 genome (i.e., SCV2-RNA1 and SCV2-RNA2) activate dendritic cells. To clarify whether human neutrophils may also represent targets of SCV2-RNAs, neutrophils were treated with either SCV2-RNAs or, as a control, R848 (a TLR7/8 ligand), and were then analyzed for several functional assays and also subjected to RNA-seq experiments. Results highlight a remarkable response of neutrophils to SCV2-RNAs in terms of TNFα, IL-1ra, CXCL8 production, apoptosis delay, modulation of CD11b and CD62L expression, and release of neutrophil extracellular traps. By RNA-seq experiments, we observed that SCV2-RNA2 promotes a transcriptional reprogramming of neutrophils, characterized by the induction of thousands of proinflammatory genes, similar to that promoted by R848. Furthermore, by using CU-CPT9a, a TLR8-specific inhibitor, we found that SCV2-RNA2 stimulates neutrophils exclusively via TLR8-dependent pathways. In sum, our study proves that single-strand RNAs from the SARS-CoV-2 genome potently activate human neutrophils via TLR8, thus uncovering a potential mechanism whereby neutrophils may contribute to the pathogenesis of severe COVID-19 disease

Pla de salut de Catalunya 1999-2001

Planificació sanitària; Sistema sanitari; Línies estratègiquesPlanificación sanitaria; Sistema sanitario; Líneas estratégicasHealth planning; Sanitary system; Strategic linesEl Pla de salut 1999-2001 conté les propostes d’actuació del Pla de salut de Catalunya per al trienni i integra els avantprojectes de plans de salut de les regions sanitàries per al mateix període. El Pla completa el darrer període d’aquesta dècada de planificació i constitueix l’instrument oportú per consolidar les accions endegades a tot el territori per assolir els objectius de salut i de disminució de risc per a l’any 2000

Pla de salut de Catalunya 1996-1998

Planificació sanitària; Sistema sanitari; Línies estratègiquesPlanificación sanitaria; Sistema sanitario; Líneas estratégicasHealth planning; Sanitary system; Strategic linesAquest document conté les propostes d’actuació per al segon trienni de vigència del Pla de salut de Catalunya i integra els avantprojectes de Pla de salut de les regions sanitàries per al mateix període. El document s’estructura en vuit grans capítols. En el primer es presenta l’orientació i el marc conceptual del model de planificació per a la salut a Catalunya, iniciat amb el Pla de salut 1993-1995. En el segon es descriu el procés seguit per a l’elaboració del present Pla de salut

Educação e Saúde no Casep

O presente projeto teve como objetivo orientar adolescentes menores infratores a identificação e proteção das doenças sexualmente transmissíveis (DST). As atividades foram desenvolvidas em duas etapas. Inicialmente, foram levantados os pontos a serem abordados pelos acadêmicos na visita ao Centro de Atendimento Sócio Educativo Provisório (Casep), do município de Xanxerê, e também realizou-se apresentações previas as professoras envolvidas no projeto. Posteriormente, os bolsistas, juntamente com a professora orientadora, realizaram a visita ao Casep. Na visita, os acadêmicos discutiram sobre as principais bactérias, vírus e protozoários capazes de causar doenças sexualmente transmissíveis. Alertaram, sobre as formas de prevenção, tratamento e a importância do diagnóstico precoce. Também explanaram, sobre os principais métodos para evitar o contágio e as formas corretas de utilização dos preservativos feminino e masculino, por meio da demonstração nos respectivos manequins. Portanto, as atividades desenvolvidas promoveram um resultado satisfatório, pois houve participação do público alvo e todos os questionamentos foram devidamente sanados. Além disso, o projeto promoveu interação dos bolsistas com o público alvo, contribuindo para o desenvolvimento acadêmico e o aproximando com a comunidade

Therapy with different dose regimens of rituximab in patients with active moderate-to-severe Graves' Orbitopathy

Background: Immunosuppressive therapy of Graves’ orbitopathy (GO) is indicated during the active phase of disease. Intravenous steroids (IVGC) are effective in about 70% of patients, although unresponsiveness or relapse are observed. In previous studies, rituximab (RTX) has been shown to be effective in inactivating moderate-to-severe GO when used early in the disease, but its optimal dosage has never been studied in randomized clinical trials. Aim of this study was to compare the efficacy and safety of different doses of RTX, based on a post-hoc analysis of two open label studies and one prospective trial randomized to IVGC. Methods: of 40 patients (35 women, 5 men), with active moderate-to-severe GO treated with RTX, 14 received a single dose of 100 mg (Group 1), 15 a single dose of 500 mg (Group 2) and 11 two 1000 mg doses, administered one week apart (Group 3). Thyroid function, TSH-receptor antibodies (TRAb) and peripheral CD19+ cells were measured. Primary endpoint was disease inactivation, measured as a decrease of the Clinical Activity Score (CAS) of at least two points. Secondary endpoints were improvement of proptosis, diplopia, quality of life and safety. Results: Baseline CAS decreased significantly in all groups (P<0.0001), independently of GO duration or whether patients had newly occurring or relapsing GO after IVGC. Proptosis did not significantly change. There was an inverse correlation between the Gorman score for diplopia and RTX dose (P<0.01). The appearance score of the GO-QoL improved in Group 1 (P=0.015), and the visual function score, in Group 2 (P=0.04). A reduction of serum TRAb was observed in Group 1 (P=0.002) and Group 2 (P<0.0002), but not in Group 3. CD19+ cell decreased in all groups (P<0.01), independently of the dose. Conclusions: We studied the optimal dosage of RTX in the treatment of active moderate-to-severe GO. In this analysis, we considered the efficacy of RTX in inactivating GO, in changing its natural course, its effect on disease severity and on the patients’ quality of life. Based on our clinical findings, and balancing the cost of therapy, a single 500 mg dose regimen is suggested in the majority of patients