Orthorexia nervosa: A cross-sectional study among athletes competing in endurance sports in Northern Italy

Orthorexia Nervosa (ON) is an eating disorder marked by an excessive control over the quality of the food eaten. Some groups present a higher prevalence of ON and people practicing sports seems to be a population at risk. The aim of this study is to assess the prevalence of ON in endurance athletes and to compare their prevalence with the ones recorded in the sedentary population and in athletes playing other sports. A cross-sectional survey was carried in Piedmont and Valle d'Aosta, among 549 participants in local sports events aged between 18 and 40 years old. The questionnaire assessed socio-demographic characteristics, physical activity, nutrition and diet, the ORTO-15 questionnaire and Eating Habits Questionnaire (EHQ). The sample was stratified according to the minutes of sport practiced in a week and the type of sport played. Crosstab chi-square analyses to determine group differences on categorical variables (e.g. gender), and ANOVAs or t tests to determine group differences on continuous variables were performed. When required, post hoc analyses were performed. Linear and logistic regressions were performed in order to investigate potential predictors of orthorexia. The EHQ mean scores ware significantly higher in people who practice sports >150 minutes/week. EHQ score resulted to be positively correlated with endurance sport practice >150 minutes/week, with a coefficient of 2.407 (I.C.95% [0.27;4.54], p = 0.027). Analyses carried out suggested a correlation between endurance sport practice and ON. Further studies should be performed to identify diagnostic criteria and to compare different questionnaire used to assess them

SARS-CoV-2 seroprevalence in the Vatican city state

The results of this seroprevalence analysis showed a positivity rate among individuals assisted by the internal healthcare system of the Vatican City State lower than that found in other studies on similar samples. This may be due to the small sample size and to the low number of COVID-19 cases tracked in the Vatican City State thanks to the control and prevention measures taken by the Directorate of Health and Hygiene. These measures were applied uninterruptedly through the first and second waves and included preventive measures such as hand disinfection, social distancing, use of face masks, body temperature measurement and symptom screening, as well as clinical surveillance, isolation protocols for symptomatic individuals and careful evaluation of all potential contacts

Hemorrhage during induction chemotherapy in neuroblastoma: additional risk factors in high-risk patients

Background: Neuroblastoma is the most common solid extracranial tumor in children. Patients affected by neuroblastoma are stratified into low, intermediate, and high risk in terms of event-free and overall survival. Some high-risk patients have an additional risk of acute hemorrhagic complications during induction chemotherapy. Aim: To find easily and rapidly assessed parameters that help clinicians identify those patients affected by high-risk neuroblastoma who have an additional risk of hemorrhagic complications. Methods: The clinical notes of patients diagnosed with high-risk neuroblastoma from January 2013 until February 2021 were retrospectively reviewed. Clinical, demographic and laboratory data, biological characteristics of the tumor, and information about treatment and hospital stay were identified. Results: In the examined period, 44 patients were diagnosed with high-risk neuroblastoma. Four of these patients had hemorrhagic complications within 2–7 days after the initiation of induction chemotherapy; two patients had hemothorax, one patient had hemoperitoneum and one patient had hemothorax and hemoperitoneum. The patient with isolated hemoperitoneum was treated with blood components transfusions, clotting factors and colloids infusions; the three patients with hemothorax underwent thoracostomy tube placement and respiratory support. At initial presentation, patients who suffered from hemorrhagic complications had a higher degree of hypertension (stage 2, p = 0.0003), higher levels of LDH (median 3,745 U/L, p = 0.009) and lower levels of hemoglobin (mean 7.6 gr/dl, p = 0.0007) compared to other high-risk patients. Conclusions: A subgroup of “additional” high-risk patients can be identified within the high-risk neuroblastoma patients based on mean arterial pressure, LDH levels and hemoglobin levels at presentation. Further studies to define cut-off values and optimal management strategies for these patients are needed

Bosentan treatment for Raynauds phenomenon and skin fibrosis in patients with Systemic Sclerosis and pulmonary arterial hypertension: an open-label, observational, retrospective study.

Raynaud's phenomenon (RP) and cutaneous fibrosis are the distinctive manifestations of scleroderma, in which Endothelin-1 plays a fundamental pathogenetic role. Bosentan, an Endothelin-1 receptor antagonist used for the treatment of pulmonary arterial hypertension, retards the beginning of new sclerodermic digital ulcers (DU). This open-label, observational, retrospective study verified the effect of Bosentan on RP and skin fibrosis in sclerodermic outpatients affected by pulmonary arterial hypertension without DU. Fourteen subjects (13 women, 1 man; mean age 60 ± 7.5 years; ten with limited and four with diffuse scleroderma) were observed at baseline (T0) and after four (T1), twelve (T2), twenty-four (T3) and forty-eight (T4) weeks during treatment with Bosentan. They were evaluated for daily quantity and duration of RP attacks and skin thickness (using modified Rodnan total skin score, MRSS). Videocapillaroscopic evaluation was performed at TO and T4. Bosentan decreased significantly the number and duration of RP attacks, beginning at T2 (p<0.05). Videocapillaroscopy showed significant improvement of microcirculatory patterns at T4 (p<0.05). MRSS decreased throughout the study, reaching the statistical significance at T3 and T4 (p<0.01) in the whole cohort. The present data suggest that Bosentan is effective in stabilmng the microcirculation involvement and in improving skin fibrosis irrespective of scleroderma patterns

Genetic variants associated with increased risk of malignant pleural mesothelioma: a genome-wide association study

Asbestos exposure is the main risk factor for malignant pleural mesothelioma (MPM), a rare aggressive tumor. Nevertheless, only 5–17% of those exposed to asbestos develop MPM, suggesting the involvement of other environmental and genetic risk factors. To identify the genetic risk factors that may contribute to the development of MPM, we conducted a genome-wide association study (GWAS; 370,000 genotyped SNPs, 5 million imputed SNPs) in Italy, among 407 MPM cases and 389 controls with a complete history of asbestos exposure. A replication study was also undertaken and included 428 MPM cases and 1269 controls from Australia. Although no single marker reached the genome-wide significance threshold, several associations were supported by haplotype-, chromosomal region-, gene- and gene-ontology process-based analyses. Most of these SNPs were located in regions reported to harbor aberrant alterations in mesothelioma (SLC7A14, THRB, CEBP350, ADAMTS2, ETV1, PVT1 and MMP14 genes), causing at most a 2–3-fold increase in MPM risk. The Australian replication study showed significant associations in five of these chromosomal regions (3q26.2, 4q32.1, 7p22.2, 14q11.2, 15q14). Multivariate analysis suggested an independent contribution of 10 genetic variants, with an Area Under the ROC Curve (AUC) of 0.76 when only exposure and covariates were included in the model, and of 0.86 when the genetic component was also included, with a substantial increase of asbestos exposure risk estimation (odds ratio, OR: 45.28, 95% confidence interval, CI: 21.52–95.28). These results showed that genetic risk factors may play an additional role in the development of MPM, and that these should be taken into account to better estimate individual MPM risk in individuals who have been exposed to asbestos.Giuseppe Matullo ... Lyle J. Palmer ... et al

Telomerase activity as an adjunct to high-risk human papillomavirus types 16 and 18 and cytology screening in cervical cancer

Telomerase is a ribonucleoprotein comprising an RNA template, the telomerase-associated protein and its catalytic subunit, human telomerase reverse transcriptase (hTERT). Telomerase activation is a critical step in cellular immortalisation and development of cancer. Enhanced telomerase activity has been demonstrated in cervical cancer. In the present study telomerase activity and hTERT mRNA expression were evaluated and correlated with the presence of human papillomavirus (HPV) infection and cytological changes in the cervical lesions. Telomerase activity was assayed by telomeric repeat amplification protocol, hTERT mRNA expression by reverse transcriptase polymerase chain reaction and presence of high risk HPV (HR-HPV) infection by polymerase chain reaction. Out of 154 cervical samples of different cytology, 90 (58.44%) were positive for HR-HPV types 16/18, while among 55 normal cervical scrapes, 10 (18.18%) were HPV DNA positive. All 59 invasive cancer samples showed a very high telomerase activity. Among dysplasia, seven (63.6%) mild dysplasia, 18 (100%) of moderate, 20 (100%) of severe dysplasia and 6 (100%) carcinoma in situ (CIS) samples were positive with mild to moderate to high to very high telomerase activity respectively. Seven (12.7%) samples of apparently normal cervical scrapes were weakly positive for telomerase activity. We observed a good correlation (P<0.001) between telomerase activity and HR-HPV 16/18 positivity with a sensitivity of 88.1% for HPV and 100% for telomerase activity. It is suggested that telomerase activity may be used as an adjunct to cytology and HPV DNA testing in triaging women with cervical lesions

Attitudes towards compulsory vaccination in Italy: Results from the NAVIDAD multicentre study

ABSTRACT: Background: Vaccine hesitancy is a considerable issue in European countries and leads to low coverage rates. After a long debate, Italy has made vaccination mandatory for admission to its schools. Methods: In the NAVIDAD study (a cross-sectional multicentre study), a 63-item questionnaire was administered to 1820 pregnant women from 15 Italian cities. The questionnaire assessed the interviewee's opinion on mandatory vaccines, as well as their socioeconomic status, sources of information about vaccines, confidence in the Italian National Healthcare Service (NHS), and intention to vaccinate their newborn. Results: Information sources play a key role in determining the opinion on restoration of mandatory vaccines; in particular, women who obtained information from anti-vaccination movements are less likely to accept the vaccines (OR: 0.35, 95% CI: 0.21\u20130.58, p < 0.001). Women who had confidence in healthcare professional information agreed more on mandatory vaccination than did the other women (OR: 2.66, 95% CI: 1.62\u20134.36, p < 0.001); those who perceived that healthcare professionals have economic interest in child immunization and who declared that healthcare providers inform only on vaccinations benefits not on risks were less likely to agree on compulsory vaccination (OR: 0.66, CI 95%: 0.46\u20130.96, p = 0.03; OR: 0.66, CI 95%: 0.46\u20130.95, p = 0.03, respectively). Conclusion: Information sources and confidence towards health professionals are the main determinants of acceptance of mandatory vaccine restoration. To increase the acceptability of the restoration and reduce vaccine hesitancy, these aspects need to be strengthened

Pediatric trauma and emergency surgery: an international cross-sectional survey among WSES members

Background: In contrast to adults, the situation for pediatric trauma care from an international point of view and the global management of severely injured children remain rather unclear. The current study investigates structural management of pediatric trauma in centers of different trauma levels as well as experiences with pediatric trauma management around the world. Methods: A web-survey had been distributed to the global mailing list of the World Society of Emergency Surgery from 10/2021-03/2022, investigating characteristics of respondents and affiliated hospitals, case-load of pediatric trauma patients, capacities and infrastructure for critical care in children, trauma team composition, clinical work-up and individual experiences with pediatric trauma management in response to patients´ age. The collaboration group was subdivided regarding sizes of affiliated hospitals to allow comparisons concerning hospital volumes. Comparable results were conducted to statistical analysis. Results: A total of 133 participants from 34 countries, i.e. 5 continents responded to the survey. They were most commonly affiliated with larger hospitals (&gt; 500 beds in 72.9%) and with level I or II trauma centers (82.0%), respectively. 74.4% of hospitals offer unrestricted pediatric medical care, but only 63.2% and 42.9% of the participants had sufficient experiences with trauma care in children ≤ 10 and ≤ 5&nbsp;years of age (p = 0.0014). This situation is aggravated in participants from smaller hospitals (p &lt; 0.01). With regard to hospital size (≤ 500 versus &gt; 500 in-hospital beds), larger hospitals were more likely affiliated with advanced trauma centers, more elaborated pediatric intensive care infrastructure (p &lt; 0.0001), treated children at all ages more frequently (p = 0.0938) and have higher case-loads of severely injured children &lt; 12&nbsp;years of age (p = 0.0009). Therefore, the majority of larger hospitals reserve either pediatric surgery departments or board-certified pediatric surgeons (p &lt; 0.0001) and in-hospital trauma management is conducted more multi-disciplinarily. However, the majority of respondents does not feel prepared for treatment of severe pediatric trauma and call for special educational and practical training courses (overall: 80.2% and 64.3%, respectively). Conclusions: Multi-professional management of pediatric trauma and individual experiences with severely injured children depend on volumes, level of trauma centers and infrastructure of the hospital. However, respondents from hospitals at all levels of trauma care complain about an alarming lack of knowledge on pediatric trauma management

Comparison of heterogeneous space projects through complexity indexes, for technical and managerial evaluations

Learn as much as possible from the past is the main purpose of modern knowledge-management approaches which allows continuous improvement of new products design and verification applied methods. In the space domain, data acquired from successful and unsuccessful missions should be aggregated to highlight effective and poor practices, basing on the comparison between actual results of several projects. The first step to reach this objective is to collect relevant data and gather them in a structured information system, as the ESA Model and Test Effectiveness Database (MAT€D) experience learns. The second step is to analyze and compare the historical information to understand better trends and effectiveness of design and verification philosophies, but space systems may be extremely different one from another, and the comparison requires a normalization method able to compare "apples and oranges", assigning to each system its complexity level, according to the objective of the single analysis that can be devoted to risk, cost and schedule evaluations. Rough methods have been used since now, using the spacecraft mass or the number of electronic parts as normalization factors, but they are not able to describe with good approximation the real complexity of the system and specialize it for the specific purpose. This problem has been driving the joint Thales Alenia Space Italia- Politecnico di Torino Research Group for the last years. The objective is the transition in the ESA Model and Test Effectiveness Database (MAT€D) analysis from the number of Electronic Parts (EP) to complexity indexes, as variable to normalize the data from different spacecraft programs, including technical, industrial and operational dimensions of the complexity. The objective of this paper is to present the latest definition of the methodology for the calculation of complexity indexes for space, based on the functional analysis of a generic space project, validated preliminarily with scientific satellites and pressurized modules data, but conceived to be used also for exploration systems. The methodology is then applied to eleven heterogeneous spacecrafts whose data are contained in MAT€D (including earth observation satellites, planetary probes and manned pressurized modules) for the comparison of ground (AIT) and flight anomalies and of cost evaluation. Copyright ©2010 by Thales Alenia Space Italia S.p.A