The role of epistemic trust in the relationship between attachment and mentalization: a systematic review

Epistemic trust can be defined as the ability to rely on social and cultural information from others. It allows to integrate the new knowledge in the vision of self and world, promoting the learning from experience. Recently, the issue of epistemic trust is gaining growing interest in literature thanks to the recognition of the significant implications that it may have for treatment effectiveness but not only, as evidenced by the extension of it field of research and application to different contexts and psychopathological conditions. However, this makes it increasingly difficult to identify a unique relational dynamic between epistemic trust, attachment and mentalization. In addition, this issue is still predominantly addressed on the theoretical level, while empirical studies are still scarce, and this allows each researcher to make a different hypothesis. Therefore, this systematic review aims at exploring the role of epistemic trust in the relationship between attachment and mentalization, looking also at factors able to affect this bond. The keywords were the following: “mentalization”, “attachment” and “epistemic trust” and its dimensions and dysfunction. Articles were included if they explicitly focused on the relationship between attachment, mentalization and epistemic trust, and if they were research articles. Studies were excluded if they addressed only one or two of the three constructs, and if they were theoretical articles, opinion articles, commentary, book chapters and interviews. Results predominantly showed a relation of interdependence between these variables, although from studies that empirically investigated this topic an interesting, contrasting datum emerges: there seems to be a relationship of interdependence only between mentalization and epistemic mistrust or credulity, but not between mentalization and epistemic trust. These findings highlight the need to empirically deepen the link between these three variables and suggest therapists to pay attention not only to the creation of a secure therapeutic relationship and the improvement of mentalizing abilities, but also to clients’ epistemic trust, especially to its disrupted forms

Time related variations in stem cell harvesting of umbilical cord blood

Umbilical cord blood (UCB) contains hematopoietic stem cells and multipotent mesenchymal cells useful for treatment in malignant/nonmalignant hematologic-immunologic diseases and regenerative medicine. Transplantation outcome is correlated with cord blood volume (CBV), number of total nucleated cells (TNC), CD34+ progenitor cells and colony forming units in UCB donations. Several studies have addressed the role of maternal/neonatal factors associated with the hematopoietic reconstruction potential of UCB, including: gestational age, maternal parity, newborn sex and birth weight, placental weight, labor duration and mode of delivery. Few data exist regarding as to how time influences UCB collection and banking patterns. We retrospectively analyzed 17.936 cord blood donations collected from 1999 to 2011 from Tuscany and Apulia Cord Blood Banks. Results from generalized multivariable linear mixed models showed that CBV, TNC and CD34+ cell were associated with known obstetric and neonatal parameters and showed rhythmic patterns in different time domains and frequency ranges. The present findings confirm that volume, total nucleated cells and stem cells of the UCB donations are hallmarked by rhythmic patterns in different time domains and frequency ranges and suggest that temporal rhythms in addition to known obstetric and neonatal parameters influence CBV, TNC and CD34+ cell content in UBC units

Diagnosis, treatment, and follow-up of a case of Wolman disease with hemophagocytic lymphohistiocytosis

: Wolman Disease (WD) is a severe multi-system metabolic disease due to lysosomal acid lipase (LAL) deficiency. We report on a WD infant who developed an unusual hemophagocytic lymphohistiocytosis (HLH) phenotype related to WD treated with sebelipase alfa. A male baby came to our attention at six months of life for respiratory insufficiency and sepsis, abdominal distension, severe hepatosplenomegaly, diarrhea, and severe growth retardation. HLH was diagnosed and treated with intravenous immunoglobulin, steroids, cyclosporine, broad-spectrum antimicrobial therapy, and finally with the anti-IL-6 drug tocilizumab. WD was suspected for the presence of adrenal calcifications and it was confirmed by LAL enzyme activity and by molecular analysis of LIPA. Plasma oxysterols cholestan-3β,5α,6β-triol (C-triol), and 7-ketocholesterol (7-KC) were markedly increased. Sebelipase alfa was started with progressive amelioration of biochemical and clinical features. The child died from sepsis, 2 months after sebelipase discontinuation requested by parents. Our case shows the importance of an early diagnosis of WD and confirms the difficulty to reach a diagnosis in the HLH phenotype. Sebelipase alpha is an effective treatment for LAL deficiency, also in children affected by WD. Further data are necessary to confirm the utility of measuring plasma c-triol as a biochemical marker of the disease

Goodbye Hartmann trial: a prospective, international, multicenter, observational study on the current use of a surgical procedure developed a century ago

Background: Literature suggests colonic resection and primary anastomosis (RPA) instead of Hartmann's procedure (HP) for the treatment of left-sided colonic emergencies. We aim to evaluate the surgical options globally used to treat patients with acute left-sided colonic emergencies and the factors that leading to the choice of treatment, comparing HP and RPA. Methods: This is a prospective, international, multicenter, observational study registered on ClinicalTrials.gov. A total 1215 patients with left-sided colonic emergencies who required surgery were included from 204 centers during the period of March 1, 2020, to May 31, 2020. with a 1-year follow-up. Results: 564 patients (43.1%) were females. The mean age was 65.9 ± 15.6 years. HP was performed in 697 (57.3%) patients and RPA in 384 (31.6%) cases. Complicated acute diverticulitis was the most common cause of left-sided colonic emergencies (40.2%), followed by colorectal malignancy (36.6%). Severe complications (Clavien-Dindo ≥ 3b) were higher in the HP group (P < 0.001). 30-day mortality was higher in HP patients (13.7%), especially in case of bowel perforation and diffused peritonitis. 1-year follow-up showed no differences on ostomy reversal rate between HP and RPA. (P = 0.127). A backward likelihood logistic regression model showed that RPA was preferred in younger patients, having low ASA score (≤ 3), in case of large bowel obstruction, absence of colonic ischemia, longer time from admission to surgery, operating early at the day working hours, by a surgeon who performed more than 50 colorectal resections. Conclusions: After 100 years since the first Hartmann's procedure, HP remains the most common treatment for left-sided colorectal emergencies. Treatment's choice depends on patient characteristics, the time of surgery and the experience of the surgeon. RPA should be considered as the gold standard for surgery, with HP being an exception

Enzymatic Degradation of the Most Common Aliphatic Bio-Polyesters and Evaluation of the Mechanisms Involved: An Extended Study

Commercial hydrolytic enzymes belonging to different subclasses (several lipases, proteinase k, cutinase) were investigated for their ability to degrade different aliphatic polyesters, i.e., poly(butylene succinate) (PBS), poly(butylene succinate-co-adipate) (PBSA), two poly(caprolactone), having two different molecular weights, poly(lactic acid) (PLA) and poly(propylene carbonate) (PPC). The enzyme screening was first carried out by investigating the capacity of fully degrading the target polymers in 24 h, then weight loss measurements of selected polyesters and target enzymes were performed. Solid residues after enzyme degradation were characterized by proton nuclear magnetic resonance (1H NMR), gel permeation chromatography (GPC), infrared spectroscopy (FT-IR), differential scanning calorimetry (DSC) and thermogravimetry (TGA). Liquid fractions were studied via GPC, 1H NMR and high-performance liquid chromatography (HPLC). PCL and PBSA were found to be the most biodegradable polyesters, under the conditions used in this study. PBS was fully degraded only by cutinase, whereas none of the tested enzymes were able to completely degrade PLA and PPC, in the conditions assessed here. Cutinase exhibited the highest hydrolytic activity on PBSA, while lipase from Candida sp. (CALB) on low molecular weight PCL. Chemical analyses on residual solids showed that the enzymatic degradation occurred homogeneously from the surface through an erosion mechanism and did not significantly affect the macromolecular structure and thermal stability. Cleaving action mode for each enzyme (endo- and/or exo-type) on the different polyesters were also proposed based on the evaluation of the degradation products in the liquid fraction

Enzymatic degradation of the most common aliphatic biopolyesters

The constant increase of the plastic production over the world has become a serious problem, since most conventional plastic materials come from fossil resources and are not biodegradable. This causes significant plastics accumulation in the environment, whose end-life must be managed. An effective and eco-friendly approach to solve such problem is the use of biodegradable materials. Biopolymers such as poly(butylene succinate) (PBS), poly(butylene succinate-co-adipate) (PBSA), poly(caprolactone) (PCL), poly(lactic acid) (PLA) and poly(propylene carbonate) (PPC) are among the most promising biodegradable commercial polyesters thanks to their high susceptibility to hydrolytic enzymes and to many microorganisms naturally occurring in the environment. The current study is an investigation of the degradation ability of several hydrolytic enzymes belonging to different subclasses (i.e. lipase, esterase, proteinase, etc.) against some common aliphatic commercial polyesters. A deeper elucidation on the degradative ability and the mechanism of hydrolytic biodegradation can be useful for the management of biodegradable plastic wastes, the bioremediation of plastic-polluted environments, as well as the design of innovative biodegradable plastic materials. The end-of-life of biopolymers indeed, should also be addressed in view of a circular economy concept. The enzyme screening was first carried out by investigating the capacity of fully degrading the target polymers in 24 h, then weight loss measurements of selected polyesters and target enzymes were performed. Solid residues after enzyme degradation were characterized by proton nuclear magnetic resonance (1H NMR), gel permeation chromatography (GPC), infrared spectroscopy (FT-IR), differential scanning calorimetry (DSC) and thermogravimetry (TGA). Liquid fractions were studied via GPC, 1H NMR and high-performance liquid chromatography (HPLC). This, in order to understand molecular and chemical modifications induced at the surface and/or in the bulk of polymer materials over time. The results showed that the enzymatic degradation occurred homogenously from the surface through an erosion mechanism and involved both the amorphous and the crystalline regions. Cleaving action mode for each enzyme (endo- and/or exo-type) is also proposed

Studio del meccanismo di degradazione enzimatica di poliesteri commerciali

La produzione e il consumo di plastica sono largamente cresciuti negli ultimi decenni. La maggior parte di queste plastiche derivano da fonti fossili e non sono degradabili, per cui tendono ad accumularsi nell’ambiente. L’uso di enzimi e di plastiche biodegradabili per il trattamento di rifiuti plastici si sta sviluppando in diversi settori, quali packaging, agricoltura e medicina. Tra le plastiche biodegradabili, i poliesteri alifatici risultano essere i più suscettibili all’attacco di enzimi idrolitici e microrganismi. Questo studio indaga la degradazione enzimatica di due polimeri commerciali biodegradabili, i.e. poli(butilene succinato-co-adipato) (PBSA) e poli(ε-caprolattone) (PCL) e il meccanismo d’azione degli enzimi cutinasi da Fusarium solani e lipasi da Alcaligene sp. (QLM). Il PBSA è un poliestere alifatico che deriva da fonti rinnovabili. Si tratta di un copolimero semicristallino del poli(butilene succinato) (PBS), con l’acido adipico come co-monomero. L’alta biodegradabilità deriva dalla bassa cristallinità e dalla maggiore flessibilità delle catene polimeriche rispetto al PBS. Il PCL è un poliestere alifatico semicristallino che deriva da fonti fossili. È largamente utilizzato nel settore biomedico e nel packaging per via della sua biodegradabilità e biocompatibilità. Lo studio del meccanismo di degradazione enzimatica di questi due polimeri può essere utile nella gestione dei rifiuti plastici, e nella formulazione di nuovi materiali plastici biodegradabili

Alteration of Cholesterol Sulfate/Seminolipid Ratio in Semen Lipid Profile of Men With Oligoasthenozoospermia

The reduction of sperm motility and count, or oligoasthenozoospermia, is one of the major causes of reduced fertility or infertility in men. Lipid composition of spermatozoa is important in determining their functional characteristics, in particular on motility, acrosomal exocytosis or fusogenic properties of the sperm. Here we investigated the levels of semen lipids in 11 infertile patients with severe oligoasthenozoospermia and 9 normozoospermic subjects with normal motility values. Sperm polar and neutral lipids were analyzed by thin-layer chromatography (TLC) and matrix-assisted laser desorption and ionization time-of-flight mass spectrometry (MALDI-TOF/MS). Semen of patients with oligoasthenozoospermia showed a reduction of the degree of fatty acid unsaturation in the phospholipids chains that might affect the membrane fluidity. Furthermore, a significant higher cholesterol sulfate/seminolipid ratio was found in semen of oligoasthenozoospermic patients than in subjects with normal motility values, suggesting a critical role of sulfolipids in semen quality. The results may facilitate the understanding of the role of lipids on male fertility and offer interesting perspectives to find innovative treatments for oligoasthenozoospermia

Triggering of Polymer-Degrading Enzymes from Layered Double Hydroxides for Recycling Strategies

The use of degrading enzymes in polymer formulation is a very attractive strategy to manage the end-of-life of plastics. However, high temperatures cause the denaturation of enzymes and the loss of their catalytic activity; therefore, protection strategies are necessary. Once protected, the enzyme needs to be released in appropriate media to exert its catalytic activity. A successful protection strategy involves the use of layered double hydroxides: cutinase, selected as a highly degrading polyester hydrolytic enzyme, is thermally protected by immobilization in Mg/Al layered double hydroxide structures. Different triggering media are here evaluated in order to find the best releasing conditions of cutinase from LDH. In detail, phosphate and citrate–phosphate buffers, potassium carbonate, sodium chloride, and sodium sulfate solutions are studied. After the comparison of all media in terms of protein release and activity retained, phosphate buffer is selected as the best candidate for the release of cutinase from LDH, and the effect of pH and concentration is also evaluated. The amount of the enzyme released is determined with the Lowry method. Activity tests are performed via spectrophotometry

Enzymatic degradation of polyesters and polyurethane-based adhesives.

none7simixedGrazia Totaro, Antonella Rosato, Angela Romano, Giulio Zanaroli, Annamaria Celli, Svajus Joseph Asadauskas, Laura SistiGrazia Totaro, Antonella Rosato, Angela Romano, Giulio Zanaroli, Annamaria Celli, Svajus Joseph Asadauskas, Laura Sist