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Europe is in the midst of a COVID-19 epidemic and a number of non-pharmaceutical public health and social measures have been implemented, in order to contain the transmission of severe acute respiratory syndrome coronavirus 2. These measures are fundamental elements of the public health approach to controlling transmission but have proven not to be sufficiently effective. Therefore, the European Centre for Disease Prevention and Control has conducted an assessment of research gaps that can help inform policy decisions regarding the COVID-19 response. We have identified research gaps in the area of non-pharmaceutical measures, physical distancing, contact tracing, transmission, communication, mental health, seasonality and environment/climate, surveillance and behavioural aspects of COVID-19. This prioritisation exercise is a step towards the global efforts of developing a coherent research road map in coping with the current epidemic but also developing preparedness measures for the next unexpected epidemic.
Control of the novel COronaVIrus Disease-2019 (COVID-19) in a hospital setting is a priority. A COVID-19-infected surgeon performed surgical activities before being tested. An exposure risk classification was applied to the identified exposed subjects and high- and medium-risk contacts underwent active symptom monitoring for 14 days at home. All healthcare professionals (HCPs) were tested for severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) at the end of the quarantine and serological tests were performed. Three household contacts and 20 HCPs were identified as high- or medium-risk contacts and underwent a 14-day quarantine. Fourteen HCPs and 19 patients were instead classified as low risk. All the contacts remained asymptomatic and all HCPs tested negative for SARS-CoV-2. About 25–28 days after their last exposure, HCPs underwent serological testing and two of them had positive IgM but negative confirmatory swabs. In a low COVID-19 burden area, the in-hospital transmission of SARS-CoV-2 from an infectious doctor did not occur and, despite multiple and frequent contacts, a hospital outbreak was avoided. This may be linked to the adoption of specific recommendations and to the use of standard personal protective equipment by HCPs.
Although recognized as one of the most significant cultural transformations in North America, the reintroduction of the horse to the continent after AD 1492 has been rarely addressed by archaeological science. A key contributing factor behind this limited study is the apparent absence of equine skeletal remains from early historic archaeological contexts. Here, we present a multidisciplinary analysis of a horse skeleton recovered in Lehi, Utah, originally attributed to the Pleistocene. Reanalysis of stratigraphic context and radiocarbon dating indicates a historic age for this horse (cal AD 1681–1939), linking it with Ute or other Indigenous groups, whereas osteological features demonstrate its use for mounted horseback riding—perhaps with a nonframe saddle. DNA analysis indicates that the animal was a female domestic horse, which was likely cared for as part of a breeding herd despite outliving its usefulness in transport. Finally, sequentially sampled stable carbon, oxygen, and strontium isotope values from tooth enamel (δ13C, δ18O, and 87Sr/86Sr) suggest that the horse was raised locally. These results show the utility of archaeological science as applied to horse remains in understanding Indigenous horse pastoralism, whereas consideration of the broader archaeological record suggests a pattern of misidentification of horse bones from early historic contexts.
The EVOSHEEP project combines archaeozoology, geometric morphometrics and genetics to study archaeological sheep assemblages dating from the sixth to the first millennia BC in eastern Africa, the Levant, the Anatolian South Caucasus, the Iranian Plateau and Mesopotamia. The project aims to understand changes in the physical appearance and phenotypic characteristics of sheep and how these related to the appearance of new breeds and the demand for secondary products to supply the textile industry.
Dengue virus can affect the heart, with complications as bradycardia, arrhythmias, and death. We present a case of a 15-year-old patient, diagnosed 4 years before with severe idiopathic pulmonary hypertension, confirmed by catheterism, with continuous follow up. At that time, she was living in Bogotá (2640 m above sea level). Sildenafil and Macitentan were started. She was recommended to live at low altitude and she moved. The patient was transferred back to Bogota, from that place, due to flu-like symptoms and fever. Immunoglobulin M for dengue was confirmed and second-degree atrioventricular block Mobitz I with bradycardia (40 beats/minute) was documented throughout the clinical course. She recovered.
Essence of fundamental rights – Article 52(1) of the Charter – Court of Justice of the EU – Methodology for determination of interference with essence – EU values – Proportionality – Balancing – Absolute and relative theory – Absolute rights – Interest theory of rights – Choice theory of rights – Hohfeld’s theory of rights – ‘Newtonian’ conception of rights – Case law on Article 52(1) of the Charter.
Since the beginning of 2020, the COVID-19 pandemic has dramatically influenced almost every aspect of human life. Activities requiring human gatherings have either been postponed, cancelled, or held completely virtually. To supplement lack of in-person contact, people have increasingly turned to virtual settings on-line, advantages of which include increased inclusivity and accessibility and reduction of carbon footprint. However, emerging online technologies cannot fully replace, in-person scientific events. In-person meetings are not susceptible to poor internet connectivity problems, and they provide novel opportunities for socialization, creating new collaborations, and sharing ideas. To continue such activities, a hybrid model for scientific events could be a solution offering both in-person and virtual components. While participants can freely choose the mode of their participation, virtual meetings would most benefit those who cannot attend in-person due to the limitations. In-person portions of meetings should be organized with full consideration of prevention and safety strategies including risk assessment and mitigation, venue and environmental sanitation, participant protection and disease prevention, and promoting the hybrid model. This new way of interaction between scholars can be considered as a part of a resilience system which was neglected previously and should become a part of routine practice in scientific community.
Pharmacological intervention is an important component of patient care. However, drugs are often inappropriately used. It is necessary for countries to implement strategies to improve the rational use of drugs, including independent information for healthcare professionals and the public, which must be supported by well-trained staff. The primary objectives of the EDU.RE.DRUG (Effectiveness of informative and/or educational interventions aimed at improving the appropriate use of drugs designed for general practitioners and their patients) study are the retrospective evaluation of rates of appropriate prescribing indicators (APIs) and the assessment of the effectiveness of informative and/or educational interventions addressed to general practitioners (GPs) and their patients, aimed at improving prescribing quality and promoting proper drug use.
Methods and analysis:
This is a prospective, multicentre, open-label, parallel-arm, controlled, pragmatic trial directed to GPs and their patients in two Italian regions (Campania and Lombardy). The study data are retrieved from administrative databases (Demographic, Pharmacy-refill, and Hospitalization databases) containing healthcare information of all beneficiaries of the National Health Service in the Local Health Units (LHUs) involved. According to LHU, the GPs/patients will be assigned to one of the following four intervention arms: (1) intervention on GPs and patients; (2) intervention on GPs; (3) intervention on patients; and (4) no intervention (control). The intervention designed for GPs consists of reports regarding the status of their patients according to the APIs determined at baseline and in two on-line Continuous Medical Education (CME) courses. The intervention designed for patients consists in flyers and posters distributed in GPs ambulatories and community pharmacies, focusing on correct drug use.
A set of indicators (such as potential drug–drug interactions, unnecessary duplicate prescriptions, and inappropriate prescriptions in the elderly), adapted to the Italian setting, has been defined to determine inappropriate prescription at baseline and after the intervention phase. The primary outcome was a composite API.
Ethics and dissemination:
The study was approved by the Ethics Committee of the University of Milan on 7th June 2017 (code 15/17). The investigators will communicate trial results to stakeholders, collaborators, and participants via appropriate presentations and publications.
Registration details: NCT04030468. EudraCT number 2017-002622-21
Prenatal glucocorticoid overexposure has been shown to programme adult cardiovascular function in a range of species, but much less is known about the long-term effects of neonatal glucocorticoid overexposure. In horses, prenatal maturation of the hypothalamus–pituitary–adrenal axis and the normal prepartum surge in fetal cortisol occur late in gestation compared to other precocious species. Cortisol levels continue to rise in the hours after birth of full-term foals and increase further in the subsequent days in premature, dysmature and maladapted foals. Thus, this study examined the adult cardiovascular consequences of neonatal cortisol overexposure induced by adrenocorticotropic hormone administration to full-term male and female pony foals. After catheterisation at 2–3 years of age, basal arterial blood pressures (BP) and heart rate were measured together with the responses to phenylephrine (PE) and sodium nitroprusside (SNP). These data were used to assess cardiac baroreflex sensitivity. Neonatal cortisol overexposure reduced both the pressor and bradycardic responses to PE in the young adult males, but not females. It also enhanced the initial hypotensive response to SNP, slowed recovery of BP after infusion and reduced the gain of the cardiac baroreflex in the females, but not males. Basal diastolic pressure and cardiac baroreflex sensitivity also differed with sex, irrespective of neonatal treatment. The results show that there is a window of susceptibility for glucocorticoid programming during the immediate neonatal period that alters cardiovascular function in young adult horses in a sex-linked manner.
To construct and test the validity of a new psychometric questionnaire to assess psychological impact of facial lipoatrophy (ABCD-F), that is the most stigmatizing feature of HIV-related lipodystrophy.
Construction: The development went through Focus groups and Content Validity, Item reduction and Exploratory Factor Analysis.
Validation: ABCD-F questionnaire was administered together with ABCD and MOS HIV questionnaires. The Cronbach's Alfa was used to test internal consistency, while convergent validity and divergent validity were analyzed by the correlations with MOS, ABCD items and BMI and CD4 counts respectively.
42 HIV+ people participated to focus groups. In the EFA the 17 Items were aggregated around psychological distress and role functioning domains.
ABCD-F showed high internal consistency (Chronbach's alpha = 0.95). Both convergent and divergent validity were confirmed. ABCD-F scores were highly correlated to Physical Health Summary (B 0.59; 95% [CI] 0.35; 0.84; p< 0.0001), Mental Health Summary (B-1.54; 95% [CI] 1.15; 1.93; p< 0.0001), and weakly correlated to CD4 count (B-0.02; 95% [CI] -0.01; 0.06; p=0.54) and HIV viral load (B-0.004; 95% [CI] -2.69; 2.69; p=1.00).
ABCD-F is a valid and reliable questionnaire to assess psychological impact of facial lipoatrophy (FLA).
ABCD-F may result as a useful tool both in clinical and research settings: it's able to identify people experiencing greater psychological impact due to FLA. It may become an objective instrument to evaluate priority and efficacy of plastic surgery to treat lipodystrophy. In research setting may be used to compare different populations or different treatments of FLA.
Empathy is the human ability to understand and share other people's feelings through knowledge, observation and memory. Lower levels of empathy lead to poor social functioning, like in Major Depressive Disorder (MDD), Schizophrenia and Autism. Until today, very few studies have focused on empathic deficits in depressed patients.
Our aim was to evaluate whether MDD causes variations in empathy levels.
We wanted to assess cognitive and affective components of Empathy in a sample of women with MDD, and relate them to clinical issues. We compared these results to a control sample.
Our sample included 20 female patients with MDD and a control group, homogeneous for age and gender. We used the Hamilton scale for depression (HAM- D) to evaluate depression severity, the Interpersonal Reactivity Index (IRI) to evaluate cognitive and affective empathy, the Faux pas test to assess cognitive empathy; Pearson and Mann tests for statistic analysis.
In general, patients showed mild depression levels (HAM- D: 14, 41± 6, 07). Severity of symptoms and empathy levels were inversely related with Faux Pas and IRI results (R: −0, 5805; R: −0, 5145), with patients being worse than the control group. Patients showed deficits in personal distress and perspective taking IRI subscales.
Our study shows that in depressed patients both components of Empathy are modified; in particular, personal distress increases, while perspective taking decreases. Additional studies and higher numbers of patients will be necessary to further investigate whether empathic deficits are trait- or state-depending MDD characteristics.
Obesity has been associated with cognitive impairment. However, it is not clear whether cognitive impairment may depend on concomitant psychopathology, since several psychiatric conditions, e.g. schizophrenia, include cognitive deficits among their manifestations.
To assess cognitive performances and psychopathology in obese patients, and to compare cognitive alterations in obese patients with those in schizophrenics and controls.
To compare cognitive performances in obese patients to normal percentiles. To provide an analysis of correlation with specific psychopathological domains. To evaluate whether cognitive performances in very obese patients were different from those in schizophrenia patients and non-affected controls.
88 obese patients were included. Exclusion criteria were: axis I and II diagnosis; severe medical, neurological, or endocrinology conditions. Patients underwent an extensive battery of cognitive tests and completed the Toronto Alexithymia Scale (TAS-20), the Barratt Impulsiveness Scale (BIS-11), the Beck Depression Inventory (BDI), the State-Trait Anxiety Inventory (STAI). In the second part of the study, very obese patients (BMI>40; n=16) were compared for cognitive performances to schizophrenia patients (n=16) and non-affected controls (n=17).
Obese patients performed at low percentiles (<15) on the Problem Solving and the Social Cognition tasks. Mean scores on psychopathology rating scales did not reach abnormal values. No correlation was found with psychopathology. When compared to schizophrenics, no significant differences were found in performances on spatial working memory.
Obese patients show cognitive alterations even in the absence of abnormal psychopathology. Very obese patients share cognitive alterations with schizophrenia patients, which may imply common neurobiological basis.
The internalized stigma of mental illness leads to negative outcomes (low self-esteem, demoralization, lower compliance to the treatment, unemployment). Previous studies have shown that the prevalence in psychotic patients is about 64%; furthermore, patients with non-psychotic disorders exhibit high prevalence, as well.
Our aim is to study internalized stigma, insight and social functioning in psychotic patients.
Through the investigation of low insight patients, we sought to verify the insight paradox theory and the impact stigma has on social functioning. We also investigated ISMI subscales (alienation, discrimination, stigma resistance, stereotype endorsement, social withdrawal) and the correlation between those elements.
Our sample included 19 psychotic patients: 11 with bipolar disorder; 3 with schizoaffective disorder; 5 with NOS psychosis. Patients were assessed with the following tests: SAI to evaluate insight; PANSS for clinical and psychopathological evaluation; GAF for social functioning; ISMI for the assessment of internalized stigma.
13 patients with mild or complete lack of insight reported low stigma, confirming the Insight Paradox theory. There is a positive correlation, measured with the Pearson correlation analysis, between insight and social functioning (R=0,752*) and between stigma and insight (R=0,024) while stigma and social functioning correlate negatively (R= -0,491*).
Results showed that lower levels of insight are related to higher stigma resistance and higher stigma leads to poorer functioning in social contexts. Higher sample numbers are necessary for further investigations on the subject.
During weaning-to-estrus interval (WEI), the sows are usually fed with high feed level to improve the reproductive performance. However, the WEI has been reduced over the years which may reduce the impact of feed level on performance in the modern genetic lines. The aim of this study was to evaluate the effect of two feeding levels (moderate feeding level (MFL): 2.7 kg/day and high feeding level (HFL): 4.3 kg/day) and two diet types (gestation: 13.67 MJ/kg of metabolizable energy (ME) and 0.62% of standard ileal digestible lysine (SID Lys) and lactation: 14.34 MJ ME/kg and 1.20% of SID Lys) offered during the WEI on reproductive performance. In total, 19.0% of sows were excluded from the analysis due to feed intake below 75% (9.6% and 28.5% in MFL and HFL groups, respectively), remaining 254 primiparous and 806 multiparous sows. Follicular size and change in BW were measured in subsamples of 180 and 227 females, respectively. Data were analyzed considering the sow as the experimental unit. Feeding level, diet type, parity and their interactions were included as fixed effects, whereas the day of weaning was considered as a random effect. The feed intake of MFL and HFL groups averaged 2.5 ± 0.02 and 3.8 ± 0.02 kg/day, respectively. There was an interaction between feeding level and parity for daily feed intake. Within HFL, multiparous sows consumed 181 g/day more than primiparous sows (P < 0.01), but no difference was observed within MFL (P > 0.05). Both primiparous and multiparous sows lost proportionally less weight when fed HFL than MFL gestation diet during WEI. The percentage of weight loss was lower in HFL than in the MFL group in multiparous sows fed the lactation diet. The WEI was not affected by feeding level, diet type or its interaction (P > 0.05), but it was longer in primiparous than in multiparous sows (P = 0.001). There was no effect of feeding level, diet type, parity or their interactions on anestrus and farrowing rates. Multiparous sows showed greater follicular size, and greater numbers of total born and born alive piglets in the subsequent cycle than primiparous sows (P < 0.05). In conclusion, feeding weaned primiparous and multiparous sows with 4.3 kg/day of a gestation (58.78 MJ ME and 26.66 g SID Lys) or a lactation diet (61.66 MJ ME and 51.60 g SID Lys) does not improve follicular size and reproductive performance in the subsequent cycle.
Aggression and violence are common phenomena, potentially experienced by everyone.
To demonstrate that coping patterns to face aggression and violence may exhibit differential group features.
To find differences in coping styles during moments of high aggression in psychiatric patients compared to non-affected controls.
We evaluated 34 outpatients from the section of psychiatry of university Federico II of Naples by two psychometric scales: AQ to evaluate aggression levels and Brief-COPE for coping patterns. Outcomes were compared with that of 34 non-affected controls, recruited from the university student population. Pearson's correlation was used to find relationships between aggression levels and coping skills in these two groups.
We found significant differences between groups in multiple scale items and in the correlation measures, e.g. the use of expression was completely reversed in this two samples according to aggression levels.
These results show that aggression is experienced differentially and with different coping styles by psychiatric patients compared to non-affected controls.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Previous studies about young people in conflict with the law (YPCL) have a tendency to focus on the risk factors that contribute to trigger antisocial criminal behavior. Instead, this study aims to research the social determinants that encourage the criminal desistance: understood as a gradual process taking place in the periods of absence of crime and desire to abandon the criminal activity.
From a sample that is made up of 100 YPCL, the main objective is to deduce the social determinants, which encourage the criminal desistance in YPCL, it means young people who commit crimes.
To infer the social determinants (circumstances in which people are born, grow, live, including the health system) which foster the desistance in YPCL.
The results of a sample of 100 YPCL were assessed with three profiles as follows: I: DSM-IV personality disorders (PD T-Scores). II: swap personality syndromes (Q-Factor T-Scores). III. factor T-scores.
This research shows the prevalence of the following social determinants associated with the desistance: (1) integrated families. (2) Educational and cultural opportunities (3) academic progress. (4) Healthy relationships that support and help. (5) Stable living arrangements (6) social conditions preserved the use of psychoactive substances and alcohol abuse.
It is possible to identify the prevalence of social determinants which encourage the desistance in YPCL. Those allows them to transform their risk path in another that shows a positive development, associated with individual transformations that take them away from the criminal life and reintegrate into the community.