Don't judge a book by its cover. factitious disorder imposed on children-report on 2 cases

Factitious Disorder Imposed on Another (FDIA), also known as Munchausen Syndrome by Proxy (MSbP) is a very serious form of child abuse. The perpetrator, usually the mother, invents symptoms or causes real ones in order to make her child appear sick. Usually this is due to a maladaptive disorder or to an excessive of attention-seeking on her part. We report here two new cases of FDIA. The first one is a 9-year-old boy with a history of convulsive episodes, reduced verbal production, mild psychomotor disorder and urological problems who underwent several invasive procedures and hospitalizations before a diagnosis of FDIA was made. The second is a 12 year-old girl with headache, abdominal pain, lipothymic episodes, seizures and a gait impairment, who was hospitalized in several hospitals before an FDIA was diagnosed

Adverse Mental Health Impact of the COVID-19 Lockdown in Individuals With Tourette Syndrome in Italy: An Online Survey

During the early stages of the coronavirus disease 2019 (COVID-19) pandemic in Italy, an online survey was launched via a local patient advocacy website to investigate mental health issues in children and adolescents with Tourette syndrome (TS). Respondents were parents, who were asked to report on their child's general health, tics, comorbidities/problems, pharmacological treatment/psychotherapy, symptom variations, and daily routine, as well as on their family's health and work experiences during the pandemic. Two hundred thirty-eight people participated in the survey, 203 females and 35 males. Our findings indicate that, in the time window of 4–6 weeks after the beginning of the COVID-19-related lockdown, 67% of individuals with TS developed a relevant worsening of the overall clinical condition as rated by their parents. An improvement or no variation of the clinical picture was reported in 20.5 and 6.7% of cases, respectively. Most worsened symptoms included tics, hyperactivity, rage attacks, obsessions/compulsions, and anxiety. Of the subjects experiencing a clinical worsening, the majority (51.76%) showed variations across two to five symptom domains. No association was found between symptom variation and family demographics or health and economic issues specifically related to the lockdown. The current COVID-19 pandemic is exerting a considerable impact on the mental health of young individuals with TS by worsening both tics and emotional and behavioral symptoms

Insomnia in the Italian Population During Covid-19 Outbreak: A Snapshot on One Major Risk Factor for Depression and Anxiety

Objectives: One of the largest clusters of Covid-19 infections was observed in Italy. The population was forced to home confinement, exposing individuals to increased risk for insomnia, which is, in turn, associated with depression and anxiety. Through a cross-sectional online survey targeting all Italian adult population (≥18 yrs), insomnia prevalence and its interactions with relevant factors were investigated. Methods: The survey was distributed from 1st April to 4th May 2020. We collected information on insomnia severity, depression, anxiety, sleep hygiene behaviors, dysfunctional beliefs about sleep, circadian preference, emotion regulation, cognitive flexibility, perceived stress, health habits, self-report of mental disorders, and variables related to individual difference in life changes due to the pandemic's outbreak. Results: The final sample comprised 1,989 persons (38.4 ± 12.8 yrs). Prevalence of clinical insomnia was 18.6%. Results from multivariable linear regression showed that insomnia severity was associated with poor sleep hygiene behaviors [β = 0.11, 95% CI (0.07–0.14)]; dysfunctional beliefs about sleep [β = 0.09, 95% CI (0.08–0.11)]; self-reported mental disorder [β = 2.51, 95% CI (1.8–3.1)]; anxiety [β = 0.33, 95% CI (0.25–0.42)]; and depression [β = 0.24, 95% CI (0.16–0.32)] symptoms. Conclusion: An alarming high prevalence of clinical insomnia was observed. Results suggest that clinical attention should be devoted to problems of insomnia in the Italian population with respect to both prevention and treatment

Nanomaterials for the cleaning and pH adjustment of vegetable tanned leather

Leather artifacts in historical collections and archives are often contaminated by physical changes such as soiling, which alter their appearance and readability, and by chemical changes which occur on ageing and give rise to excessive proportion of acids that promote hydrolysis of collagen, eventually leading to gelatinization and loss of mechanical properties. However, both cleaning and pH adjustment of vegetable tanned leather pose a great challenge for conservators, owing to the sensitivity of these materials to the action of solvents, especially water-based formulations and alkaline chemicals. In this study the cleaning of historical leather samples was optimized by confining an oil-in-water (o/w) nanostructured fluid in a highly retentive chemical hydrogel, which allows the controlled release of the cleaning fluid on sensitive surfaces. The chemical gel exhibits optimal viscoelasticity, which facilitates its removal after the application without leaving residues on the object. Nanoparticles of calcium hydroxide and lactate, dispersed in 2-propanol, were used to adjust the pH up to the natural value of leather, preventing too high alkalinity which causes swelling of fibers and denaturation of the collagen. The treated samples were characterized using Scanning Electron Microscopy (FE SEM), controlled environment dynamic mechanical analysis (DMA-RH), and infrared spectroscopy (ATR-FTIR). The analytical assessment validated the use of tools derived from colloid and materials science for the preservation of collagen-based artifacts

Facilitating the conservation treatment of Eva Hesse's Addendum through practice-based research, including a comparative evaluation of novel cleaning systems

Abstract This paper describes the methodology and practice-based research underpinning the development of a successful cleaning strategy for Eva Hesse's sculpture Addendum (1967, Tate Collection T02394). Research strands included: technical and art historical investigations to determine the materials and construction of the work of art and to define the aims of the conservation treatment; the production, soiling and accelerated ageing of mock-up samples using contemporary equivalent materials; and the systematic, iterative evaluation of soiling removal systems, which were further refined for appropriate use on the work of art. The comparative cleaning system evaluation was employed to determine options which offered optimal soiling removal efficacy and posed minimal risk to the work of art. Newly developed Nanorestore Gel® Peggy series (i.e. polyvinyl alcohol (PVA) and polyvinyl alcohol/polyvinylpyrrolidone (PVA/PVP)-based hydrogels), designed for the cleaning of modern and contemporary art, were evaluated with a range of other gels, emulsifiers and cosmetic sponges and assessed through a combination of empirical observation, microscopy and spectroscopic techniques. Promising options, combined with tailored aqueous phases derived from trials on mock-up samples, were then evaluated on discreet areas of the sculpture. After extensive testing, the top papier mâché section of Addendum was surface cleaned using an aqueous solution applied with cosmetic sponges, and the ropes were surface cleaned using a modified version of Nanorestore Gel® Peggy 5 (PVA/PVP) loaded with a tailored aqueous solution. The optimisation of this hydrogel, combined with the extensive supporting research, enabled the successful, low-risk, conservation treatment of Addendum for the first time since acquisition

Mode-coupling theory predictions for a limited valency attractive square-well model

Recently we have studied, using numerical simulations, a limited valency model, i.e. an attractive square well model with a constraint on the maximum number of bonded neighbors. Studying a large region of temperatures $T$ and packing fractions $\phi$, we have estimated the location of the liquid-gas phase separation spinodal and the loci of dynamic arrest, where the system is trapped in a disordered non-ergodic state. Two distinct arrest lines for the system are present in the system: a {\it (repulsive) glass} line at high packing fraction, and a {\it gel} line at low $\phi$ and $T$. The former is essentially vertical ($\phi$-controlled), while the latter is rather horizontal ($T$-controlled) in the $(\phi-T)$ plane. We here complement the molecular dynamics results with mode coupling theory calculations, using the numerical structure factors as input. We find that the theory predicts a repulsive glass line -- in satisfactory agreement with the simulation results -- and an attractive glass line which appears to be unrelated to the gel line.Comment: 12 pages, 6 figures. To appear in J. Phys. Condens. Matter, special issue: "Topics in Application of Scattering Methods for Investigation of Structure and Dynamics of Soft Condensed Matter", Fiesole, November 200

Reviving WHAAM! a comparative evaluation of cleaning systems for the conservation treatment of Roy Lichtenstein's iconic painting

Abstract Roy Lichtenstein's Whaam! (1963) is an iconic artwork in Tate's collection (T00897). Over the past 50 years, the painting has been on almost continuous display and had accrued a layer of deposited soiling, which resulted in the dampening of Lichtenstein's vibrant colours and the masking of numerous subtleties across the painting surface. This paper outlines the design and execution of an optimal soiling removal strategy for this challenging work; utilising collaborative, practice-based research. The conservation treatment employed was derived through an iterative process that reflected and supported the conservation decision-making process. The research strands included: technical and art historical investigations to determine the materials and construction of Whaam! and to define the aims of the conservation treatment; preparation of accelerated aged and artificially soiled test (mock-up) paint samples based on contemporary equivalent materials and a comparative evaluation of a range of established and novel soil-removal systems, followed by further tailoring for use on the work of art. The range of cleaning systems evaluated included free-solvents, gels and emulsifiers; which were documented using star diagrams, digital microscopy and infrared spectroscopy. After a rigorous process of assessment and refinement, the strategy taken forward to Whaam! included the use of a polyvinyl alcohol-based polymeric hydrogel (Nanorestore Gel® Peggy 6), uploaded with tailored aqueous solutions. This process facilitated a low risk, controlled and even-removal of the soiling layer, enabling the successful treatment of this sensitive painting for the first time in the painting's history

Anti‐dopamine D2 receptor antibodies in chronic tic disorders

AIM: To investigate the association between circulating anti-dopamine D2 receptor (D2R) autoantibodies and the exacerbation of tics in children with chronic tic disorders (CTDs). METHOD: One hundred and thirty-seven children with CTDs (108 males, 29 females; mean age [SD] 10y 0mo [2y 7mo], range 4-16y) were recruited over 18 months. Patients were assessed at baseline, at tic exacerbation, and at 2 months after exacerbation. Serum anti-D2R antibodies were evaluated using a cell-based assay and blinded immunofluorescence microscopy scoring was performed by two raters. The association between visit type and presence of anti-D2R antibodies was measured with McNemar's test and repeated-measure logistic regression models, adjusting for potential demographic and clinical confounders. RESULTS: At exacerbation, 11 (8%) participants became anti-D2R-positive ('early peri-exacerbation seroconverters'), and nine (6.6%) became anti-D2R-positive at post-exacerbation ('late peri-exacerbation seroconverters'). The anti-D2R antibodies were significantly associated with exacerbations when compared to baseline (McNemar's odds ratio=11, p=0.003) and conditional logistic regression confirmed this association (Z=3.49, p<0.001) after adjustment for demographic and clinical data and use of psychotropic drugs. INTERPRETATION: There is a potential association between immune mechanisms and the severity course of tics in adolescents with CTDs

The association between diurnal sleep patterns and emotions in infants and toddlers attending nursery

Background: Childcare programs often include mandatory naptime during the day. Loss of daytime sleep could lead to a moderate-to-large decrease in self-regulation, emotion processing, and learning in early childhood. Nevertheless, daytime sleep has been less accurately studied than nighttime sleep. This study aims to explore the relationship between diurnal sleep habits in nursery settings, nocturnal sleep quality, and post-nap emotional intensity in infants and toddlers. Methods: Data of 92 children (52 girls, 40 boys) aged 6 to 36 months were obtained. Sleep habits as well as positive and negative emotions were monitored by educators during nursery times through a sleep and emotion diary for two weeks. Results: Explorative analyses showed that diurnal sleep hours decreased across age groups (except for females aged 25–36 months) and that all age groups had a lower amount of nocturnal sleep than is recommended by the National Sleep Foundation. Partial correlation analysis showed significant correlation between daytime sleep onset latency and positive emotions. Mediation analyses showed that daytime napping is relevant for emotional functioning independently of nocturnal sleep quality. Conclusions: Daytime sleep in early childhood seems to be linked to the management of positive and negative emotions and could play a role in healthy development of emotional processes

A systematic review and network meta-analysis of randomized controlled trials evaluating the evidence base of melatonin, light exposure, exercise, and complementary and alternative medicine for patients with insomnia disorder

Insomnia is a prevalent disorder and it leads to relevant impairment in health-related quality of life. Recent clinical guidelines pointed out that Cognitive-Behavior Therapy for Insomnia (CBT-I) should be considered as first-line intervention. Nevertheless, many other interventions are commonly used by patients or have been proposed as effective for insomnia. These include melatonin, light exposure, exercise, and complementary and alternative medicine. Evaluation of comparable effectiveness of these interventions with first-line intervention for insomnia is however still lacking. We conducted a systematic review and network meta-analysis on the effects of these interventions. PubMed, PsycInfo, PsycArticles, MEDLINE, and CINAHL were systematically searched and 40 studies were included in the systematic review, while 36 were entered into the meta-analysis. Eight network meta-analyses were conducted. Findings support effectiveness of melatonin in improving sleep-onset difficulties and of meditative movement therapies for self-report sleep efficiency and severity of the insomnia disorder. Some support was observed for exercise, hypnotherapy, and transcranial magnetic resonance, but the number of studies for these interventions is still too small. None of the considered interventions received superior evidence to CBT-I, which should be more widely disseminated in primary care