On the advantages and disadvantages of choice: future research directions in choice overload and its moderators.

Researchers investigating the psychological effects of choice have provided extensive empirical evidence that having choice comes with many advantages, including better performance, more motivation, and greater life satisfaction and disadvantages, such as avoidance of decisions and regret. When the decision task difficulty exceeds the natural cognitive resources of human mind, the possibility to choose becomes more a source of unhappiness and dissatisfaction than an opportunity for a greater well-being, a phenomenon referred to as choice overload. More recently, internal and external moderators that impact when choice overload occurs have been identified. This paper reviews seminal research on the advantages and disadvantages of choice and provides a systematic qualitative review of the research examining moderators of choice overload, laying out multiple critical paths forward for needed research in this area. We organize this literature review using two categories of moderators: the choice environment or context of the decision as well as the decision-maker characteristics.

Addition of Spirulina to Craft Beer: Evaluation of the Effects on Volatile Flavor Profile and Cytoprotective Properties.

SPME-GC-MS and PTR-ToF-MS techniques were applied to describe the content of volatile flavor compounds in a craft beer before and after adding spirulina. The obtained results showed that the volatile profile of the two beer samples differed. Furthermore, to chemically characterize biomass spirulina, a derivatization reaction followed by GC-MS analysis was performed, highlighting a high content of molecules belonging to different chemical classes, such as sugars, fatty acids and carboxylic acids. A spectrophotometric analysis of total polyphenols and tannins, investigation into the scavenging activity towards DPPH and ABTS radicals and confocal microscopy of brewer's yeast cells were carried out. Moreover, the cytoprotective and antioxidant properties towards the oxidative damage induced by tert-butyl hydroperoxide (tBOOH) in human H69 cholangiocytes were investigated. Finally, the modulation of Nrf2 signaling under oxidative stress conditions was also evaluated. Both samples of beer were shown to contain similar levels of total polyphenols and tannins, with slightly increased levels in that containing spirulina 0.25% w/v. Moreover, the beers were found to be endowed with radical scavenging properties towards both DPPH and ABTS radicals, albeit with a weak contribution of spirulina; however, a higher riboflavin content was detected in spirulina-treated yeast cells. Conversely, the addition of spirulina (0.25% w/v) appeared to improve the cytoprotective properties of beer towards tBOOH-induced oxidative damage in H69 cells and reduce intracellular oxidative stress. Accordingly, the cytosolic Nrf2 expression was found to be increased.

Videoconferencing analytic psychodrama in treating young adults' psychological suffering: preliminary results.

The study aims to explore the effects that videoconferencing Analytic Psychodrama (AP) has on the psychological wellbeing and emotional competence of young adults who are suffering from mental health problems. Twenty-two undergraduate students, asking for help at the Psychological Counselling Service of the University of Bologna for anxiety-depressive problems, took part in the three online groups that met weekly from October 2020 to July 2021. The Clinical Outcomes in Routine Evaluation Outcome Measure, the Trait Emotional Intelligence Questionnaire Short Form, the Toronto Alexithymia Scale, the Interpersonal Reactivity Index, and the Group Climate Questionnaire were used as test-retest questionnaires for clinical outcomes, emotional competence, and group climate evaluations. There was a statistically significant difference between the pre-test and 10-month scores for patients in clinical outcomes. Alexithymia significantly decreased and emotional intelligence and group engagement increased post-intervention. Videoconferencing AP sounds promising for alleviating psychological problems and to improve young adults' emotional competence.

Entrepreneurship on Social Networking Sites: The Roles of Attitude and Perceived Usefulness.

BACKGROUND: Social media platforms are a significant growth opportunity for enterprises, especially for microenterprises, due to the possibility of establishing direct contact with their customers. We investigate the psychological reasons that drive entrepreneurs towards the use of social networking sites (SNSs) for their business, following two important social psychology theories: the theory of planned behaviour and the technology acceptance model. We also tested for two personality traits: openness to experience and dominance. METHODS: Data were acquired by examining 325 microentrepreneurs who decided to use either SNSs or traditional sales methods for their businesses. RESULTS AND CONCLUSIONS: Our results confirm that of all the behavioural antecedents tested, perceived usefulness and attitude towards SNSs' effect on business proved to be the best predictors of the intention to use (or continue using) SNSs for business activity. Implications and suggestions for future research are also discussed.

Preliminary Study of the Relationship between Osteopontin and Relapsed Hodgkin's Lymphoma.

The primary objective of this study was to investigate the potential role of tissue osteopontin, also known as secreted phosphoprotein 1 (SPP1), as a contributing factor to an unfavorable prognosis in classical Hodgkin's lymphoma (HL) patients who received the same treatment protocol. The study involved 44 patients aged 4-22 years, with a median follow-up period of 3 years. Patients with higher levels of SPP1 were associated with tissue necrosis and inflammation, and there was a trend toward a poorer prognosis in this group. Before therapy, we found a correlation between positron emission tomography (PET) scans and logarithmic SPP1 levels (p = 0.035). However, the addition of SPP1 levels did not significantly enhance the predictive capacity of PET scans for recurrence or progression. Elevated SPP levels were associated with tissue mRNA counts of chemotactic and inflammatory chemokines, as well as specific monocyte/dendritic cell subtypes, defined by IL-17RB, PLAUR, CXCL8, CD1A, CCL13, TREM1, and CCL24 markers. These findings contribute to a better understanding of the potential factors influencing the prognosis of HL patients and the potential role of SPP1 in the disease. While the predictive accuracy of PET scans did not substantially improve during the study, the results underscore the complexity of HL and highlight the relationships between SPP1 and other factors in the context of HL relapse.

Relapsing subcutaneous nodules of the penis in a pediatric patient.

A 14-year-old boy presented with a history of non-tender, subcutaneous coalescing nodules located on the ventral-lateral aspects of the penis shaft for one year. Laboratory investigations for blood count and autoimmunity were within normal limits. Complete excision was performed, and on histology, the dermis showed necrobiotic material composed of altered collagen bundles, surrounded by a palisade of histiocytes and scattered lymphocytes, thus allowing a diagnosis of subcutaneous granuloma annulare. Only 18 published cases reported penile granuloma annulare. Medical management was advocated in 7/18 cases, either as a first-line or adjuvant therapy where surgery was not radical. Three patients received high-potency local steroids: two cases underwent adjuvant sessions of intralesional triamcinolone, and one patient received pentoxifylline orally. Surgery should be considered a second-line option since 5/8 of treated cases eventually recurred. The pentoxifylline-treated case witnessed a relapse after drug discontinuation, while topical steroids lead to complete recovery without relapses.

Identification of Volatile Molecules and Bioactivity of Gruyt Craft Beer Enriched with Citrus aurantium var. dulcis L. Essential Oil.

In this work, for the first time, a gruyt beer and the same one after the addition of Citrus aurantium essential oil (AEO), were investigated to determine the composition of the volatile fraction. The applied analytical techniques, such as Head Space/Solid Phase Microextraction-Gas Chromatography-Mass Spectrometry (HS/SPME-GC-MS) and Proton Transfer Reaction-Time of Flight-Mass Spectrometer (PTR-ToF-MS), allowed us to identify the content of volatile organic compounds (VOCs). From the comparison between the two beer samples, it showed that the one after the addition of AEO was particularly richened in limonene and a series of minor terpene compounds. AEO was also characterized by GC/MS analysis and the results showed that limonene reached 95%. Confocal microscopy was used to look at riboflavin autofluorescence in yeast cells. It was found that beer with AEO had twice as much fluorescence intensity as the control. A spectrophotometric analysis of total polyphenols, tannins, and flavonoids, and a bioactivity screening, including 2,2-diphenyl-1-picrylhydrazyl (DPPH) and 2,2'-Azinobis-(3-Ethylbenzthiazolin-6-Sulfonic Acid) (ABTS) radical scavenger, chelating, reducing, antiglycative ones, were also carried out. Moreover, the tolerability of the tested samples in human H69 cholangiocytes and the cytoprotection towards the tert-butyl hydroperoxide (tBOOH)-induced oxidative damage were evaluated. Under our experimental conditions, the beers were found to be able to scavenge DPPH and ABTS radicals and chelate iron ions, despite weak antiglycative and reducing properties. The tested samples did not affect the viability of H69 cholangiocytes up to the highest concentrations; moreover, no signs of cytoprotection against the damage induced by tBOOH were highlighted. Adding AEO to beer resulted in a moderate enhancement of its DPPH scavenging and chelating abilities, without improvements in the other assays. Conversely, AEO and its major compound limonene were ineffective when assessed at the concentrations added to beer. This evidence suggests that the addition of AEO may enhance the organoleptic features of the beer and slightly potentiate some of its bioactivities.

Retrospective analysis of outcomes and complications after Korus hemiarthroplasty in elderly patients with neck femur fractures.

BACKGROUND: Femoral neck fractures (FNF) is one of the most common traumatic events in elderly patients: the choice of an appropriate treatment is necessary to decrease the related mortality and to achieve the best possible outcomes. Nowadays, it is still debated whether or not to cement the stem in hemiarthroplasty and above all, which stem to use to best respect the integrity of the elderly bone. METHODS: From January 2017 to December 2019, a bi-centric study utilizing prospectively collected databases of elderly patients with FNF treated with uncemented Korus stem hemiarthroplasty was performed. Patients were preoperatively classified according to ASA score. Patients' clinical and X-ray follow-up was at 1, 3, 6, 12 months. Harris Hip Score (HHS) was used for analysed clinical improvement. On the X-rays, we analysed iatrogenic fractures, osteolysis area and radiolucent lines in the stem region during follow up. RESULTS: 233 patients were identified. Median follow-up was 12 months. Over time, 51 patients died (21.88%). Mean age was 89,56 ± 6,25. 75 patients had ASA score of 2 (32.3%), 102 patients a score of 3 (43.7%), 56 an ASA score of 4 (24,0%). The main Harris hip score was 68,66 ± 8.53 at 1 month of follow-up, 71,74 ± 9.65 after 3 months, 72,50 ± 10.66 at 6 months and 75,61 ± 9.63 at 12 months control. CONCLUSIONS: Hydroxyapatite coated stem with an accurate design guarantee early fixation, good clinical and radiographic results, low rate of re-intervention and mortality rate and a satisfying return to pre-injury activities.

Tronco-conical locking plate in distal radius fractures.

INTRODUCTION: Volar locked plates represent the most popular fixation technique for distal radius fracture (DRF). However, threaded screw-hole angular stability mechanism has some issues. The purpose of our study is to evaluate clinical and radiological outcome of a tronco-conical locking mechanism for volar plating of DRF. MATERIALS AND METHODS: Eighty patients with DRF treated with tronco-conical locking volar plates between May 2013 to December 2017 in two institutions were collected. We analysed clinical and radiological outcomes and peri-operative complications, like loss of reduction, fragment displacement, deformation or implant-related problems and surgical and other general complications. RESULTS: 78 patients were available for at final follow-up. The average follow-up period was 11.4 months (range, 6-18 months). All fractures healed within three months. Five cases of final reductions were defined unsatisfying. According to Gartland and Werley's scoring system at final follow up, 36 patients had excellent results, 40 patients had good results, one patient had fair and one patient had poor results. Five complications were observed. No complications were observed during surgical plate removal. CONCLUSION: Complications found in our study are not related to tronco-conical locking mechanism and are like those found in the literature. Further studies are needed to evaluate functional results or radiographic parameters of this new type of angular stability mechanism. Tronco-conical locking plate is an attractive alternative threaded screw-hole angular stability mechanism.

Management of Airways through Rapid Tracheostomy in a Severely Burnt Patient Attended to via Helicopter.

In Catanzaro, Italy, an adult male with severe burns all over his body and in a state of coma was promptly rescued by the medical team at the air ambulance service (HEMS), who provided airway safety through laryngeal mask placement (LMA). The patient was subsequently transferred to the nearest Hub center, where an emergency tracheostomy was performed to ensure better airway management during the flight to the nearest available major burn center. This is the first documented case at regional level of a patient undergoing rapid tracheostomy through an imminent transfer with air ambulance.

ST-Segment Elevation Acute Myocardial Infarction Complicated by Cardiogenic Shock: Early Predictors of Very Long-Term Mortality.

BACKGROUND: Cardiogenic shock (CS) is the leading cause of in-hospital mortality in ST-segment elevation myocardial infarction (STEMI). Only limited data are available on the long-term outcome of STEMI patients with CS undergoing contemporary treatment. We aimed to investigate long-term mortality and its predictors in STEMI patients with CS and to develop a risk score for long-term mortality prediction. METHODS AND RESULTS: We retrospectively included 465 patients with STEMI complicated by CS and treated with primary angioplasty and intra-aortic balloon pump between 2005 and 2018. Long-term mortality, including both in-hospital mortality and all-cause mortality following discharge from the index hospitalization, was the primary endpoint. The long-term mortality (median follow-up 4 (2.0-5.2) years) was 60%, including in-hospital mortality (34%). At multivariate analysis, independent predictors of long-term mortality were age (HR 1.41, each 10-year increase), admission left ventricular ejection fraction (HR 1.51, each 10%-unit decrease) and creatinine (HR 1.28, each mg/dl increase), and acute kidney injury (HR 1.81). When these predictors were pooled together, the area under the curve (AUC) for long-term mortality was 0.80 (95% CI 0.75-0.84). Using the four variables, we developed a risk score with a mean (cross-validation analysis) AUC of 0.79. When the score was applied to in-hospital mortality, its AUC was 0.79, and 0.76 when the score was applied to all-cause mortality following discharge. CONCLUSIONS: In STEMI patients with CS, the risk of death is still substantial in the years following the index event. A simple clinical score at the time of the index event accurately predicts long-term mortality risk.

Biotechnological Approaches for Genetic Improvement of Lemon (Citrus limon (L.) Burm. f.) against Mal Secco Disease.

Among Citrus species, lemon is one of the most susceptible to mal secco disease, a tracheomycosis caused by the mitosporic fungus Plenodomus tracheiphilus, which induces chlorosis followed by leaf drop and progressive desiccation of twigs and branches. Severe infection can cause the death of the plant. Since no effective control strategies are available to efficiently control the pathogen spread, host tolerance is the most desirable goal in the struggle against mal secco disease. To date, both traditional breeding programs and biotechnological techniques were not efficient in developing novel varieties coupling tolerance to mal secco with optimal fruit quality. Furthermore, the genetic basis of host resistance has not been fully deciphered yet, hampering the set-up of marker-assisted selection (MAS) schemes. This paper provides an overview of the biotechnological approaches adopted so far for the selection of mal secco tolerant lemon varieties and emphasizes the promising contribution of marker-trait association analysis techniques for both unraveling the genetic determinism of the resistance to mal secco and detecting molecular markers that can be readily used for MAS. Such an approach has already proved its efficiency in several crops and could represent a valuable tool to select novel lemon varieties coupling superior fruit quality traits and resistance to mal secco.

A Randomized, Controlled Trial Comparing the Impact of a Low-Calorie Ketogenic vs a Standard Low-Calorie Diet on Fat-Free Mass in Patients Receiving an Elipse™ Intragastric Balloon Treatment.

BACKGROUND: The Elipse™ intragastric balloon (EIGB) is a new swallowable balloon for weight loss (WL). Preserving metabolically active fat-free mass (FFM) and resting metabolic rate (RMR) during WL are crucial to maximize fat mass (FM) loss. After EIGB placement, a standard low-calorie diet (LCD) is generally prescribed. A low-calorie ketogenic diet (LCKD) has proven to be safe and effective in reducing FM while preserving FFM and RMR. OBJECTIVE: To prospectively compare the effects on WL, FM, FFM, and RMR in two groups of patients who were randomized to two different diets: LCKD and a standard LCD after EIGB placement. METHODS: WL, FM, FFM, and RMR were measured before EIGB and at 4 months in 48 patients who received either a LCKD (n = 24) or a standard LCD (n = 24). Compliance in following the prescribed diet was determined with food frequency questionnaires in all patients. The impact of LCKD and LCD on renal function was also evaluated. RESULTS: The LCKD group showed a significantly lower decrease in FFM and RMR when compared with the LCD group (3.55 vs 14.3%, p < 0.001; 9.79 vs 11.4%, p < 0.001, respectively). FM decreased more significantly with LCKD compared to LCD (41.6 vs 33.1%, p = 0.0606). Compliance in following the prescribed diets, without negative impact on renal function, was found. CONCLUSION: Based on our findings, despite the small sample size, we were able to support the hypothesis that LCKD is associated with an increased FM loss while reducing the FFM loss and the RMR, without interfering with renal function after EIGB.

Stress Hyperglycemia and Mortality in Subjects With Diabetes and Sepsis.

OBJECTIVES: Poor glycemic control is associated with mortality in critical patients with diabetes. The aim of the study was to assess the predicting value of stress hyperglycemia in patients with diabetes following hospital admission for sepsis. DESIGN: Retrospective observational study. SETTING: Adult, emergency department, and critical care in a district hospital. PATIENTS: In a 10-year retrospective analysis of sepsis-related hospitalizations in the emergency department, we carried out a secondary analysis of 915 patients with diabetes (males, 54.0%) in whom both fasting glucose at entry and glycosylated hemoglobin were available. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Patients' mean age was 79.0 (sd 11.0), glucose at admission was 174.0 mg/dL (74.3 mg/dL), and glycosylated hemoglobin was 7.7% (1.7%). Stress hyperglycemia was defined by the stress hyperglycemia ratio, that is, fasting glucose concentration at admission divided by the estimated average glucose derived from glycosylated hemoglobin. A total of 305 patients died (33.3%) in hospital. Factors associated with in-hospital case fatality rate were tested by multivariable logistic model. Ten variables predicting outcomes in the general population were confirmed in the presence of diabetes (male sex, older age, number of organ dysfunction diagnoses, in particular cardiovascular dysfunction, infection/parasitic, circulatory, respiratory, digestive diseases diagnosis, and Charlson Comorbidity Index). In addition, also glycemic control (glycosylated hemoglobin: odds ratio, 1.17; 95% CI, 1.15-1.40) and stress hyperglycemia (stress hyperglycemia ratio: 5.25; 3.62-7.63) were significant case fatality rate predictors. High stress hyperglycemia ratio (≥ 1.14) significantly increased the discriminant capacity (area under the receiver operating characteristic curve, 0.864; se, 0.013; p < 0.001). CONCLUSIONS: Stress hyperglycemia, even in the presence of diabetes, is predictive of mortality following admission for sepsis. Stress hyperglycemia ratio may be used to refine prediction of an unfavorable outcome.

Associations of Job Insecurity With Perceived Work-Related Symptoms, Job Satisfaction, and Turnover Intentions: The Mediating Role of Leader-Member Exchange and the Moderating Role of Organizational Support.

This study wants to examine effects of job insecurity on several work-related outcomes (perceived work-related symptoms, job satisfaction, and turnover intentions) by developing a moderated mediation model. The model emphasizes the role played by the quality of leader-member exchange (LMX) in mediating the relation between perceived job insecurity and outcomes related to work, and the moderating role of perceived organizational support (POS) in influencing the mediation. Survey data from 510 workers at Italian organizations were collected, and regression was used to evaluate the hypotheses. After age, gender, education, and organizational tenure were controlled, results showed that perceived quality of LMX carried the effect of job insecurity on all outcomes, and that this relationship was stronger for employees who reported higher levels of POS. This study makes important theoretical and practical contributions to job insecurity, LMX, and POS research, underlining the importance of promoting the leader-member relationship's quality in an ethical and supportive work environment.

Analysis of Endoplasmic Reticulum-Endosome Association Using Live-Cell Imaging in Plant Cells.

The endoplasmic reticulum (ER) is one of the most abundant endomembrane compartments and is in close association with most of the other organelles. In mammalian and yeast cells, the physiological roles and the molecular machineries underlying such association have only recently begun to emerge. In plant cells, recent live-cell confocal imaging and electron microscopy studies have established that endosomes are associated with the ER [1]. Here, we describe confocal imaging methods and software to analyze ER-endosome association in plant cells.

A preliminary experience with a new intramedullary nail for trochanteric fractures.

BACKGROUND AND AIM OF THE WORK: The worldwide incidence of fractures of the proximal end of the femur is increasing as the average age of the population rises. The current surgical gold treatment standard is intramedullary nail fixation. The Authors present their experience with the D-Nail system for intertrochanteric femur fractures. METHODS: From January 1st to February 21st 2020 (breakout of COVID-19 pandemic) 34 patients were treated with the D-Nail system: 11 with basicervical fractures, 16 with intertrochanteric stable fractures and 7 with intertrochanteric unstable fractures. In 11 cases, a single cephalic screw was used; in 23 cases, two of them were used. Distal locking was executed in 7 patients. Follow-up time ranged from 2 to 3 months. RESULTS: None of the reported intra- or post-operative complication was linked to the fixation device or the surgical technique. Patients were monitored with clinical and radiological checkups using modified Harris Hip Score to accurately evaluate the fluctuations in the rehabilitation period. CONCLUSION: The main advantages of this synthesis device are the proximal hole's peculiar shape, which allows the possibility to position one or two cephalic screws on the same nail, and the silicon coating, which provides numerous biological advantages. Distal locking was executed in selected cases only, based on fracture type. Optimum treatment involves rapid execution of surgery, minimal trauma during surgery, maximum mechanical stability, and rapid weight-bearing. Although our case number is small and follow-up time brief, our results are encouraging.

The Italian Covid-19 Phase 2 in Piacenza: results of the first semester of 2020 and future prospective of new orthopedics surgical procedures.

INTRODUCTION: During the pandemic, Piacenza's Orthopedic and Traumatology Dep. firstly dealt with the emergency with the complete closure of all the elective surgical and outpatient activities.As general population, also healthcare workers were affected by Coronavirus, increasing difficulties of epidemic management.The aim of our study is to evaluate the activity trend of the first 6months of 2020 in our hospital.Data will be compared to the two semesters of 2019, in order to have two objective samples. MATERIALS AND METHODS: We retrospectively analyzed all the orthopedics surgical procedures performed at Guglielmo da Saliceto Hospital (Piacenza, Emilia Romagna, Northern Italy)between 1/1/20 and 30/06/20. 2019 semesters (1/01/20-30/6/20 and 1/07/20-31/12/20) have been used as control group to evaluate the activity trend of the first six months of 2020, compared to the two semesters of 2019. RESULTS: We noticed a significant increase of domestic and retirement houses accidents, a consistent increase in one-month mortality rate of 2020 first semester and a decrease of mean hospitalization time.About surgical procedures, we detect a drop in the total number: in the first semester of 2020 we performed 499 (-39.9%) surgeries less than the first semester of 2019 and 337 (-30.9%) then the second one. Traumatology recorded a decrease of 27.6% than the first semester of 2019 (-204 surgeries) and of 26.3% than the second one (-191 surgeries).Concerning orthopedic procedures, in comparison to the first semester of 2019 we registered a reduction of 57.6% (-295 surgeries) and of 40.2% to the second semester (-146 surgeries). DISCUSSION AND CONCLUSION: Covid-19 forced a reorganization of the Italian Health System that led to a clear reduction of surgical procedures performed in the orthopedic and traumatology department.The "Phase 2" can't be consider the last step of the emergency.We surely will have to get used to live with this enemy, at least until we will find an effective cure or a vaccine.