A public early intervention approach to first-episode psychosis: Treated incidence over 7 years in the Emilia-Romagna region

AimTo estimate the treated incidence of individuals with first-episode psychosis (FEP) who contacted the Emilia-Romagna public mental healthcare system (Italy); to examine the variability of incidence and user characteristics across centres and years. MethodsWe computed the raw treated incidence in 2013-2019, based on FEP users aged 18-35, seen within or outside the regional program for FEP. We modelled FEP incidence across 10 catchment areas and 7 years using Bayesian Poisson and Negative Binomial Generalized Linear Models of varying complexity. We explored associations between user characteristics, study centre and year comparing variables and socioclinical clusters of subjects. ResultsThousand three hundred and eighteen individuals were treated for FEP (raw incidence: 25.3 / 100.000 inhabitant year, IQR: 15.3). A Negative Binomial location-scale model with area, population density and year as predictors found that incidence and its variability changed across centres (Bologna: 36.55; 95% CrI: 30.39-43.86; Imola: 3.07; 95% CrI: 1.61-4.99) but did not follow linear temporal trends or density. Centers were associated with different user age, gender, migrant status, occupation, living conditions and cluster distribution. Year was associated negatively with HoNOS score (R = -0.09, p < .001), duration of untreated psychosis (R = -0.12, p < .001) and referral type. ConclusionsThe Emilia-Romagna region presents a relatively high but variable incidence of FEP across areas, but not in time. More granular information on social, ethnic and cultural factors may increase the level of explanation and prediction of FEP incidence and characteristics, shedding light on social and healthcare factors influencing FEP

Cognitive functioning throughout adulthood and illness stages in individuals with psychotic disorders and their unaffected siblings.

Important questions remain about the profile of cognitive impairment in psychotic disorders across adulthood and illness stages. The age-associated profile of familial impairments also remains unclear, as well as the effect of factors, such as symptoms, functioning, and medication. Using cross-sectional data from the EU-GEI and GROUP studies, comprising 8455 participants aged 18 to 65, we examined cognitive functioning across adulthood in patients with psychotic disorders (n = 2883), and their unaffected siblings (n = 2271), compared to controls (n = 3301). An abbreviated WAIS-III measured verbal knowledge, working memory, visuospatial processing, processing speed, and IQ. Patients showed medium to large deficits across all functions (ES range = -0.45 to -0.73, p < 0.001), while siblings showed small deficits on IQ, verbal knowledge, and working memory (ES = -0.14 to -0.33, p < 0.001). Magnitude of impairment was not associated with participant age, such that the size of impairment in older and younger patients did not significantly differ. However, first-episode patients performed worse than prodromal patients (ES range = -0.88 to -0.60, p < 0.001). Adjusting for cannabis use, symptom severity, and global functioning attenuated impairments in siblings, while deficits in patients remained statistically significant, albeit reduced by half (ES range = -0.13 to -0.38, p < 0.01). Antipsychotic medication also accounted for around half of the impairment in patients (ES range = -0.21 to -0.43, p < 0.01). Deficits in verbal knowledge, and working memory may specifically index familial, i.e., shared genetic and/or shared environmental, liability for psychotic disorders. Nevertheless, potentially modifiable illness-related factors account for a significant portion of the cognitive impairment in psychotic disorders.The European Community’s Seventh Framework Programme under grant agreement No. HEALTH-F2-2010-241909 (EU-GEI)

Planning and control of medical device investments by Italian public health authorities: A means to improve the decision-making process

Within the context of increased health care spending in Italy and governmental cost-containment efforts, attention has focused on the medical device sector also in light of the newly introduced centralized procurement policy, of Health Technology Assessment, and of the Government’s call for a more managerial-type approach by public health authorities. In this scenario, it became necessary to analyse investments in medical devices and to assess their contribution not only to the health of patients, but also to – if any – the whole economy and to the nation’s economic growth. Public health authorities must now also assess the effect of investments on profitability by evaluating investment regenerations based on the diagnosis-related group revenue for inpatients and on the Regional tariffs established by the Italian National Health Service for outpatients. Knowledge of the medical device sector, and planning and control systems, will enable public health authorities to improve their internal decision-making processes, which in turn will enable them to reach their objectives of long-term economic balance and of quality of health care services to citizens

Planning and control of medical device investments by Italian public health authorities: A means to improve the decision-making process

Within the context of increased health care spending in Italy and governmental cost-containment efforts, attention has focused on the medical device sector also in light of the newly introduced centralized procurement policy, of Health Technology Assessment (HTA), and of the Government’s call for a more managerial-type approach by public health authorities (PHAs). In this scenario, it became necessary to analyse investments in medical devices and to assess their contribution not only to patients’ health, but also to – if any – to the whole economy and to the nation’s economic growth. Public health authorities must now also assess the effect of investments on profitability by evaluating investment regenerations based on the diagnosis-related group revenue for inpatients and on the Regional tariffs established by the Italian national health service for outpatients. Knowledge of the medical device sector, and planning and control systems, will enable PHAs to improve their internal decision-making processes, which in turn, will enable them to reach their objectives of long-term economic balance and of quality of health care services to citizens

Air Quality in the Italian Northwestern Alps during Year 2020: Assessment of the COVID-19 «Lockdown Effect» from Multi-Technique Observations and Models

The effect of COVID-19 confinement regulations on air quality in the northwestern Alps is assessed here based on measurements at five valley sites in different environmental contexts. Surface concentrations of nitrogen oxides (NO and NO2), ozone (O3), particulate matter (PM2.5 and PM10), together with a thorough microphysical (size), chemical, and optical (light absorption) aerosol characterisation, complemented by observations along the vertical column are considered. Even in the relatively pristine environment of the Alps, the «lockdown effect» is well discernible, both in the early confinement phase and in late 2020. The variations observed during the first confinement period in the city of Aosta (−61% NO, −43% NO2, +5% O3, +9% PM2.5, −12% PM10, relative to average 2015–2019 conditions) are attributed to the competing effects of air pollution lockdown-induced changes (−74%, −52%, +18%, −13%, −27%, relative to the counterfactual scenario for 2020 provided by a predictive statistical model trained on past measurements) and meteorology (+52%, +18%, −11%, +25%, +20%, relative to average conditions). These changes agree well with the ones obtained from a chemical transport model with modified emissions according to the restrictions. With regard to column-integrated quantities and vertical profiles, the NO2 column density decreases by &gt;20% due to the lockdown, whereas tropospheric aerosols are mainly influenced by large-scale dynamics (transport of secondary particles from the Po basin and mineral dust from the Sahara desert and the Caspian Sea), except a shallow layer about 500 m thick close to the surface, possibly sensitive to curtailed emissions (especially exhaust and non-exhaust particles from road traffic and fugitive emissions from the industry)

Partial Replacement of Fishmeal with Seafood Discards for Juvenile Penaeus japonicus: Effects on Growth, Flesh Quality, Chemical and Fatty Acid Composition

The present study was designed to assess the influence of fishmeal replacement with increasing percentages of fresh seafood discards (0, 25, 50 and 75%) in diets for Penaeus japonicus on growth performance, physical characteristics and the chemical and fatty acid composition of shrimp flesh. Each diet was administered for 108 days, and the trial was assayed in triplicate. The final body weight and the specific growth rate were significantly higher (p &lt; 0.05) in shrimps fed with 75% fishmeal replacement as compared to 25%, while the abdomen weight and the total length were the highest (p &lt; 0.01). Moreover, 75% replacement showed a significantly (p &lt; 0.05) lower value of hardness and a greater crude protein and lipid content as compared to the 0% replacement. The shrimps fed with high levels of seafood discards (50 and 75%) showed a lower saturated fatty acid concentration and, in turn, a greater amount of polyunsaturated fatty acids in shrimp meat significantly (p &lt; 0.05) affected the lower atherogenic and thrombogenic indices. In conclusion, replacing 75% of fishmeal with seafood discards provided satisfactory results. An economic analysis based on ESG indicators and PESTLE methodology is provided in order to show the socio-economic and governance impacts affecting the replacement of shrimps’ diet with fish discard

Role and clinical implications of atypical antipsychotics in anxiety disorders, obsessive-compulsive disorder, trauma-related, and somatic symptom disorders: A systematized review

Atypical antipsychotics (AAs) may play a role in the treatment of anxiety disorders, obsessive-compulsive disorder (OCD), and trauma-related disorders. No reviews on their differential use in these different disorders have been performed recently. The aim of this systematized review was to obtain data on efficacy and comparative effectiveness of AAs as a treatment of anxiety disorders, OCD, and trauma-related disorders to provide guidance for clinicians on when and which AA to use. We searched on PubMed, Psychnet, and Cochrane Libraries from inception to July 2015. Search results were limited to randomized, placebo-controlled trials of adult patients. Evidence of efficacy was considered the presence of positive results in two or more double-blind placebo-controlled studies. Our systematized search identified 1298 papers, of which 191 were subjected to a full-Text review and 56 were included. Quetiapine extended-release showed a role in both acute and maintenance treatment of uncomplicated generalized anxiety disorder, whereas more studies are needed before drawing practical recommendations on the use of olanzapine and risperidone; aripiprazole and risperidone are effective in resistant OCD as augmentation treatments. Risperidone and olanzapine add-on may have a role in resistant or chronic post-Traumatic stress disorder patients, although only risperidone addition can be recommended on the basis of the criterion of two or more positive placebocontrolled trials. This systematized review supports the evidence that only a few AAs are effective in only a minority of the off-label conditions in which they are currently used and confirms that AAs are not all the same. Their use should be on the basis of a balance between efficacy and side effects, and the characteristics as well as the preference of the patient

Dietary Supplementation with Oregano and Linseed in Autochthonous “Facciuta Lucana” Goats: Effects on Meat Quality Traits in Suckling Kids

Extruded linseed (Linum usitatissimum) in ruminant diets has been investigated as a strategy to improve the nutritional value and healthiness of meat fat; however, increased polyunsaturated fatty acids may limit the shelf-life of meat. Oregano (Origanum vulgare) has a documented antioxidant activity. The aim of the study was to investigate the effects of dietary supplementation with extruded linseed and oregano on goat milk quality and whether the characteristics of goat milk affect the physical and chemical features, fatty acid profile, meat lipid oxidation, and sensory properties of meat from suckling kids. Thirty-six male kids were weaned and divided into three homogeneous groups (n = 12); each group was either fed a control diet (C), or a diet containing 3% extruded linseed with or without the addition of 0.6% oregano (“L + O” and “L”, respectively). The diets containing linseed lowered (p &lt; 0.05) the saturated fatty acid content in meat, and increased (p &lt; 0.05) monounsaturated and polyunsaturated fatty acids and conjugated linoleic acid. Oregano addition to the linseed diet proved to be effective in preserving meat shelf-life, as shown by a significant (p &lt; 0.01) reduction in the malondialdehyde concentration after 10 days of storage, and improved meat succulence, tenderness, juiciness, and overall acceptance

GSK-3-Selective Inhibitors Derived from Tyrian Purple Indirubins

AbstractGastropod mollusks have been used for over 2500 years to produce the “Tyrian purple” dye made famous by the Phoenicians. This dye is constituted of mixed bromine-substituted indigo and indirubin isomers. Among these, the new natural product 6-bromoindirubin and its synthetic, cell-permeable derivative, 6-bromoindirubin-3′-oxime (BIO), display remarkable selective inhibition of glycogen synthase kinase-3 (GSK-3). Cocrystal structure of GSK-3β/BIO and CDK5/p25/indirubin-3′-oxime were resolved, providing a detailed view of indirubins' interactions within the ATP binding pocket of these kinases. BIO but not 1-methyl-BIO, its kinase inactive analog, also inhibited the phosphorylation on Tyr276/216, a GSK-3α/β activation site. BIO but not 1-methyl-BIO reduced β-catenin phosphorylation on a GSK-3-specific site in cellular models. BIO but not 1-methyl-BIO closely mimicked Wnt signaling in Xenopus embryos. 6-bromoindirubins thus provide a new scaffold for the development of selective and potent pharmacological inhibitors of GSK-3