Central sensitivity in fibromyalgia: testing a model to explain the role of psychological factors on functioning and quality of life.

OBJECTIVES: Central sensitivity (CS) is defined as an increased responsiveness of nociceptive neurons in the central nervous system to normal or subthreshold inputs. CS has recently been linked to the psychological burden associated with chronic pain, such as fibromyalgia (FM). The primary objective of this study is to investigate the impact of specific psychological constructs on CS in patients with FM. In Study 1, we explore the influence of temperament, personality, childhood trauma, defence mechanisms, and mental pain on CS. In Study 2, our goal is to test the role of the best predictors of CS in influencing quality of life (QoL) and FM functioning through a path analysis model. METHODS: A total of 510 women with FM participated online, completing a self-administered protocol. Data collection took place between April and June of 2023. RESULTS: In Study 1, higher levels of low sensory threshold (ß=0.210), traumatic experiences of physical threat (ß=0.141), neurotic defences (ß=0.124), and mental pain (ß=0.241) emerged as the strongest predictors of increased CS. In Study 2, the presented model demonstrated a satisfactory fit (chi2=27.200; df=10; p=0.002; GFI=0.984; NFI=0.949; CFI=0.967; RMSEA=0.061 [95% CI 0.034-0.090]) with large and medium effect sizes on physical (-0.576) and psychological (-0.190) QoL. CONCLUSIONS: The study underscores the pivotal role of psychological dimensions in influencing CS levels and their relationships with QoL in patients with FM.

Whole-Body Cryostimulation as an Adjunctive Treatment for Neurophysiologic Tinnitus and Associated Disorders: Preliminary Evidence from a Case Study.

BACKGROUND: Tinnitus, which is often associated with reduced quality of life, depression, and sleep disturbances, lacks a definitive treatment targeting its pathophysiological mechanism. Inflammatory markers like TNF-α have been linked to tinnitus, thereby underlining the necessity for innovative therapies. This case study investigates the potential benefits of a multi-approach rehabilitation intervention involving whole-body cryostimulation (WBC) for a 47-year-old male suffering from chronic neurophysiologic tinnitus, who had underwent various unsuccessful treatments from 2005. METHODS: the patient underwent a personalized, multidisciplinary rehabilitation intervention covering diet, pharmacotherapy, physiotherapy and physical activity classes tailored to the patient's needs and capacities, repetitive transcranial magnetic stimulation (rTMS), and whole-body cryostimulation (WBC). RESULTS: The adjunctive WBC intervention resulted in a significant progressive improvement in tinnitus severity (tinnitus handicap inventory Δ% = -46.3%, VAS tinnitus score Δ% = -40%). Additional positive outcomes were noted in sleep quality (PSQI Δ% = -41.67%), emotional wellbeing (BDI Δ% = -41.2%), and quality of life (SF-36, WHO-5 Δ% = +16.5). CONCLUSIONS: This study supports the existing literature suggesting the potential of WBC as an adjunct in a multi-approach intervention in ameliorating tinnitus severity and tinnitus-associated disorders. However, randomized controlled trials in larger populations, which specifically consider WBC's effects on tinnitus, are necessary to confirm these findings and to explore the mechanisms that underlie the observed improvements.

A multi-design investigation of perfectionism risk profiles for traumatic injury in sport.

Every year, many university athletes find themselves experiencing sports injuries while practicing their sport. Not all athletes are equal to each other, and some get injured more often. Individual differences in personality could explain these differences. This study focuses on how within-person combinations of perfectionistic strivings and perfectionistic concerns are associated with the risk of traumatic injury in university athletes. Two most prominent person-oriented approaches of perfectionism (the tripartite and 2x2 models) were tested in a retrospective (N=143) and a prospective (N=98) sample. Cluster analyses identified perfectionism profiles consistent with the two theoretical models in both samples. Furthermore, the profile with high levels of perfectionistic strivings and concerns was found to be the most at risk of experiencing a traumatic injury using both designs. This study supports the tripartite model of perfectionism in recognizing the exacerbating role of perfectionistic strivings on the maladaptive effect of perfectionistic concerns. Coaches and sports specialists will need to consider monitoring athletes' levels of PC, especially in conjunction with high PS levels, to reduce the risk of injury in athletes.

Spatial variations of conductivity of self-assembled monolayers of dodecanethiol on Au/mica and Au/Si substrates.

Determining the conductivity of molecular layers is a crucial step in advancing towards applications in molecular electronics. A common test bed for fundamental investigations on how to acquire this conductivity are alkanethiol layers on gold substrates. A widely used approach in measuring the conductivity of a molecular layer is conductive atomic force microscopy. Using this method, we investigate the influence of a rougher and a flatter gold substrate on the lateral variation of the conductivity. We find that the roughness of the substrate crucially defines this variation. We conclude that it is paramount to adequately choose a gold substrate for investigations on molecular layer conductivity.

"I Am on Top!": An Interactive Intervention Program to Promote Self-Regulation Processes in the Prevention of the Use of Doping in Sports High Schools.

The use of substances to improve sports performance is a widespread phenomenon among adolescents. Several anti-doping programs have been developed, mainly based on knowledge-based evidence. The main aim of the present study was to implement an anti-doping intervention in sports high school students, based on a psychological framework, such as Socio-Cognitive Theory, through the development of a Serious Game (SG), i.e., digital learning based on the game. The experimental design included an intervention group (n = 167; F = 37.7%; Meanage = 17.5 years; SD = 0.58) and a control group (n = 112; F = 42%; Meanage = 17.6; SD = 1). Both of the groups completed the same questionnaire on two different occasions (i.e., time 1 and time 2) for measuring doping intention, self-regulatory efficacy to resist social pressure for the use of substances, moral disengagement, and doping knowledge. Data were analyzed through repeated measures of Group X Time ANOVA, demonstrating some degree of efficacy of the intervention, in particular in terms of the decrease in doping intention and the strengthening of doping knowledge. Moreover, the study demonstrated that the score obtained during the implementation of the SG could partially represent a coherent measure of the participants' beliefs regarding doping. These results could be considered a starting point for future research to better develop technological anti-doping interventions.

Heart rate variability alterations in takotsubo syndrome and related association with psychological factors: a systematic review and meta-analysis.

Psychological factors may have a precipitant role in takotsubo syndrome (TS). Aberrant Heart Rate Variability (HRV) has been reported in TS, suggesting inflexibility of the autonomous nervous system. Nevertheless, results on HRV alterations and their link with psychological factors in TS are conflicting. This work aimed to systematically explore whether TS may be associated with HRV alterations and their association with specific psychological profiles in TS patients. A literature search was conducted across databases (Pubmed, Scopus, PsycInfo, Web of Science) and empirical studies including TS patients which were evaluated in one or more HRV indices were retrieved. HRV and psychological outcomes were extracted. 10 empirical studies with 194 TS patients were included. Results showed significant alteration of HRV in TS patients, with indices compared to controls, and a progressive increase over time. Nevertheless, retrieved data presented mixed results, as also shown by a large heterogeneity in the meta-analytic findings. 2 studies found significant relationships between HRV alterations and trait-rather than state-psychological outcomes (i.e., coping strategies and emotional arousal), pointing to the need to explore the role of psychological vulnerabilities, rather than single traumatic stressors, in the association between HRV and TS.

Personality in Chronic Headache: A Systematic Review with Meta-Analysis.

Background: Chronic headache (CH) is a condition that includes different subtypes of headaches and that can impair different life domains. Personality traits can play a relevant role both in the development and in coping with this medical condition. The first aim of the present study is to realize a systematic review of the personality traits associated with CH compared to healthy controls; the second objective is to carry out a quantitative meta-analysis with the studies using the same instrument to assess personality traits. Method: The literature search encompassed articles published from 1988 until December 2022 on the major databases in the field of health and social sciences: PubMed, Scopus, PsychInfo, and Web of Science. Results: Thirteen studies were included in the systematic review, but only three studies were deeply explored in a meta-analysis since the only ones used a common instrument for personality assessment (Minnesota Multiphasic Personality Inventory). According to the meta-analysis, different subtypes of CH patients scored higher than healthy controls on Hypochondriasis and Hysteria Scales. The systematic review showed higher levels of depressive and anxious personality dimensions and pain catastrophizing in CH compared to healthy controls. Moreover, frequent-chronic forms and medication-overuse headache were the most symptomatic and frail categories showing higher levels of dysfunctional personality traits and psychopathological symptoms. Conclusions: These results seem to confirm a "neurotic profile" in patients suffering from CH. The identification of the main personality traits involved in the onset and maintenance of headache disorders represents an important objective for developing psychological interventions.

The role of sense of presence in expressing cognitive abilities in a virtual reality task: an initial validation study.

There is a raised interest in literature to use Virtual Reality (VR) technology as an assessment tool for cognitive domains. One of the essential advantages of transforming tests in an immersive virtual environment is the possibility of automatically calculating the test's score, a time-consuming process under natural conditions. Although the characteristics of VR can deliver different degrees of immersion in a virtual environment, the sense of presence could jeopardize the evolution of these practices. The sense of presence results from a complex interaction between human, contextual factors, and the VR environment. The present study has two aims: firstly, it contributes to the validation of a virtual version of the naturalistic action test (i.e., virtual reality action test); second, it aims to evaluate the role of sense of presence as a critical booster of the expression of cognitive abilities during virtual reality tasks. The study relies on healthy adults tested in virtual and real conditions in a cross-over research design. The study's results support the validity of the virtual reality action test. Furthermore, two structural equation models are tested to comprehend the role of sense of presence as a moderator in the relationship between cognitive abilities and virtual task performance.

Sports activity limitation during the COVID-19 pandemic in young Italian athletes: impact on mental health in children, adolescents, and young adults.

Introduction: The closure of sports centres was implemented as a preventive measure to mitigate the transmission of SARS-CoV-2. Given the observed global decline in physical activity and concurrent rise in sedentary behaviour, even among younger age groups, a retrospective cross-sectional study was undertaken to evaluate the effects of this measure on mental health in children, adolescents, and young adults during the initial phases of the COVID-19 pandemic. Methods: A total of 1,717 non-professional athletes (age range: 6-25; 53.9% males, 44.6% females) completed an online questionnaire including widely used and validated measures for mental health assessment (SDQ and PGWB-S) and questions regarding sociodemographic characteristics (such as gender), physical activity, and screen time. The association between mental health and sociodemographic characteristics, physical activity, and screen time was evaluated by using univariate and multivariable logistic regression models. Results: In children and adolescents, the incidence of psychological difficulties was associated with not being physically active (OR = 1.49; 95% CI: 1.09, 2.07; p = 0.015). Engaging in physical activity during the period of closures, particularly if more than twice a week, was significantly associated with less psychological difficulties for children/adolescents (OR = 0.54; 95% CI: 0.35, 0.82; p = 0.004) and psychological symptoms (i.e., psychological well-being lower than the median) for youth/young adults (OR = 0.25; 95% CI: 0.14, 0.45; p < 0.001). More psychological difficulties were also found in males for children and adolescents (OR = 1.37; 95% CI: 1.06, 1.79; p = 0.018). However, young adult males showed less psychological symptoms than females (OR = 0.35; 95% CI: 0.22, 0.55; p = 0.001). Additionally, a greater amount of screen time was associated with a higher incidence of psychological symptoms in the whole sample. Conclusions: Our results confirm the positive impact of physical activity on mental health during the COVID-19 pandemic among younger age groups. They also provide valuable insights into the risk-benefit relationship of interrupting sports activities as a preventive measure for infectious diseases.

Influence of surface characteristics of implant materials on MRSA biofilm formation and effects of antimicrobial treatment.

Introduction: One of the main causes of treatment failure in bacterial prosthetic joint infections (PJI) is biofilm formation. The topography of the biofilm may be associated with susceptibility to antimicrobial treatment. The aims of this study were to assess differences in topography of biofilms on different implant materials and the correlation thereof with susceptibility to antimicrobial treatment. Methods: Methicillin-resistant Staphylococcus aureus (MRSA) 7-day mature biofilms were generated on disks made from titanium alloys (Ti-6Al-7Nb and Ti-6Al-4V), synthetic polymer and orthopedic bone cement, commonly used in implant surgery. The surface topography of these implant materials and the biofilms cultured on them was assessed using atomic force microscopy. This provided detailed images, as well as average roughness (Ra) and peak-to-valley roughness (Rt) values in nanometers, of the biofilm and the material surfaces. Bacterial counts within biofilms were assessed microbiologically. Antimicrobial treatment of biofilms was performed by 24-h exposure to the combination of rifampicin and ciprofloxacin in concentrations of 1-, 5- and 10-times the minimal bactericidal concentration (MBC). Finally, treatment-induced differences in bacterial loads and their correlation with biofilm surface parameters were assessed. Results: The biofilm surfaces on titanium alloys Ti-6Al-7Nb (Ra = 186 nm) and Ti-6Al-4V (Ra = 270 nm) were less rough than those of biofilms on silicone (Ra = 636 nm). The highest roughness was observed for biofilms on orthopedic bone cement with an Ra of 1,551 nm. Interestingly, the roughness parameters of the titanium alloys themselves were lower than the value for silicone, whereas the surface of the bone cement was the roughest. Treatment with 1- and 5-times the MBC of antibiotics resulted in inter-material differences in colony forming units (CFU) counts, ultimately showing comparable reductions of 2.4-3.0 log CFU/mL at the highest tested concentration. No significant differences in bacterial loads within MRSA biofilms were observed between the various implant materials, upon exposure to increasing concentrations of antibiotics. Discussion: The surface parameters of MRSA biofilms were determined by those of the implant materials on which they were formed. The antibiotic susceptibility of MRSA biofilms on the various tested implant materials did not differ, indicating that the efficacy of antibiotics was not affected by the roughness of the biofilm.

Spatial and cross-sectoral input spillover effects: the case of the Italian tourism industry.

The aim of this paper is to extend the literature on multisectoral industries productivity such as tourism by simultaneously analysing the multidimensional nature of the Italian tourism sector in the period 2011-2020, considering both cross-sectoral and spatial spillover effects. To further improve our analysis, we consider two fundamental features for policy decisions: high spatial detail of analysis and the multipurpose nature of the tourism industry. Empirical findings confirm the hypotheses that the productivity level of the Italian tourism industry depends on its ability to make to most of the different input factors coming from different sectors and on (positive and negative) input spillovers.

Understanding Nociplastic Pain: Building a Bridge between Clinical Psychology and Medicine.

Chronic pain (CP), defined as pain lasting more than three months, is a significant healthcare challenge with considerable economic costs [...].

The role of laparoscopic distal gastrectomy in elderly patients.

INTRODUCTION: The aim of this study was to search in the recent literature for scientific evidence about the role of laparoscopic distal gastrectomy (LDG) in the treatment of gastric cancer (GC) in elderly patients. EVIDENCE ACQUISITION: An analysis of the literature of the last twenty years (from 2001 to 2021) was then carried out. EVIDENCE SYNTHESIS: It showed how the characteristics of the general population, which is aging, and of patients undergoing surgery for GC, also increasingly elderly and, therefore, more fragile, have changed. CONCLUSIONS: We have traced the evolution of minimally invasive treatment, with specific regard to LDG, highlighting how this method is not only able to allow an oncologically correct treatment similar to the traditional technique, but, above all, offers short-term advantages especially in elderly patients.

Experimental drugs for fallopian cancer: promising agents in the clinical trials and key stumbling blocks for researchers.

INTRODUCTION: Fallopian tube carcinoma (FC) as a single entity is a rare disease. Although its diagnosis is increasing thanks to the widespread use of prophylactic salpingectomy, there are no clinical trials exclusively designed for FC. AREAS COVERED: This review aims at identifying the most promising trials and future therapeutic pathways in the setting of FC. EXPERT OPINION: Hot topics in FC treatment include the consequences of using PARP inhibitors (PARPi) as first-line therapy, ways to overcome platinum resistance, and the role of immunotherapy. Patient selection is a key point for future development of target therapies. Next-generation sequencing (NGS) is one of the most investigated technologies both for drug discovery and identification of reverse mutations, involved in resistance to PARPi and platinum. New, promising molecular targets are emerging. Notwithstanding the disappointing outcomes when used by itself, immunotherapy in FC treatment could still have a role in combination with other agents, exploiting synergistic effects at the molecular level. The development of cancer vaccines is currently hampered by the high variability of tumor neoantigens in FC. Genomic profiling could be a solution, allowing the synthesis of individualized vaccines.

Assessment Tasks and Virtual Exergames for Remote Monitoring of Parkinson's Disease: An Integrated Approach Based on Azure Kinect.

Motor impairments are among the most relevant, evident, and disabling symptoms of Parkinson's disease that adversely affect quality of life, resulting in limited autonomy, independence, and safety. Recent studies have demonstrated the benefits of physiotherapy and rehabilitation programs specifically targeted to the needs of Parkinsonian patients in supporting drug treatments and improving motor control and coordination. However, due to the expected increase in patients in the coming years, traditional rehabilitation pathways in healthcare facilities could become unsustainable. Consequently, new strategies are needed, in which technologies play a key role in enabling more frequent, comprehensive, and out-of-hospital follow-up. The paper proposes a vision-based solution using the new Azure Kinect DK sensor to implement an integrated approach for remote assessment, monitoring, and rehabilitation of Parkinsonian patients, exploiting non-invasive 3D tracking of body movements to objectively and automatically characterize both standard evaluative motor tasks and virtual exergames. An experimental test involving 20 parkinsonian subjects and 15 healthy controls was organized. Preliminary results show the system's ability to quantify specific and statistically significant (p < 0.05) features of motor performance, easily monitor changes as the disease progresses over time, and at the same time permit the use of exergames in virtual reality both for training and as a support for motor condition assessment (for example, detecting an average reduction in arm swing asymmetry of about 14% after arm training). The main innovation relies precisely on the integration of evaluative and rehabilitative aspects, which could be used as a closed loop to design new protocols for remote management of patients tailored to their actual conditions.

Alexithymia and psychological distress in fibromyalgia and chronic migraine: A cross-sectional study.

OBJECTIVE: Several studies have shown a strong association between alexithymia and psychological distress in both healthy and clinical populations. The aim of this study was to investigate the prevalence and association between alexithymia and psychological distress in individuals with fibromyalgia (FM) and chronic migraine (CM) compared with healthy controls (HC). METHODS: A cross-sectional study was conducted. Two hundred fifty women with FM (age: 51.2 ± 10.5) and 250 women with CM (age: 46.1 ± 11.5) were assessed with the Toronto Alexithymia Scale (TAS-20) and the Hospital Anxiety and Depression Scale (HADS) and compared with HCs (n = 280; age: 51.8 ± 9.0) by one-way analyses of variance. A moderation analysis was performed to examine the moderation effect of groups on the relationship between alexithymia and psychological distress. RESULTS: Differences between groups showed significantly higher scores for TAS-20 [F(2,755) = 11.7, p < .001] and HADS [F(2,763) = 31.7, p < .001] in FM, compared with CM and HCs. The moderation analysis showed that both clinical groups and TAS-20 (ß = 0.20, p < .001) were significant predictors, as well as the interaction terms. The slope of the correlation curve was more pronounced in the patient groups, indicating that the degree of alexithymia had a significantly higher influence on the HADS total score in the patient groups. CONCLUSION: The results suggest a common psychological dysregulation in FM and CM, with a slight but greater prevalence of alexithymia and psychological distress in FM. These data suggest that although there is a similar psychological substrate, it is expressed in a different expression of somatic symptoms.

Enterotomy Closure after Minimally Invasive Distal Gastrectomy with Intracorporeal Anastomosis: A Multicentric Study.

INTRODUCTION: Despite progressive improvements in technical skills and instruments that have facilitated surgeons performing intracorporeal gastro-jejunal and jejuno-jejunal anastomoses, one of the big challenging tasks is handsewn knot tying. We analysed the better way to fashion a handsewn intracorporeal enterotomy closure after a stapled anastomosis. METHODS: All 579 consecutive patients from January 2009 to December 2019 who underwent minimally invasive partial gastrectomy for gastric cancer were retrospectively analysed. Different ways to fashion intracorporeal anastomoses were investigated: robotic versus laparoscopic approach; laparoscopic high definition versus three-dimensional versus 4K technology; single-layer versus double-layer enterotomies. Double-layer enterotomies were analysed layer by layer, comparing running versus interrupted suture; the presence versus absence of deep corner suture; and type of suture thread. RESULTS: Significantly lower rates of bleeding (p = 0.011) and leakage (p = 0.048) from gastro-jejunal anastomosis were recorded in the double-layer group. Barbed suture thread was significantly associated with reduced intraluminal bleeding and leakage rates both in the first (p = 0.042 and p = 0.010) and second layer (p = 0.002 and p = 0.029). CONCLUSIONS: Double-layer sutures using barbed suture thread both in first and second layer to fashion enterotomy closure result in lower intraluminal bleeding and anastomotic leak rates.

Perceived Anxiety, Coping, and Autonomic Function in Takotsubo Syndrome Long after the Acute Event.

BACKGROUND: Anxiety and depressive disorders represent predisposing factors for the autonomic dysfunctions that characterize the acute phase of Takotsubo syndrome (TS). However, there is insufficient data on this relationship after the acute event. The present study aimed at evaluating the psychological and autonomic status of patients with a history of TS. METHODS: Ten TS patients whose acute event occurred at least 1 year prior to the evaluation and nine healthy age- and sex-matched subjects were evaluated. The cardiovascular assessment included a clinical examination, beat-to-beat heart rate monitoring to assess heart rate variability, and a psychological examination using the 16 Personality Factors-C Form (16PF), the Acceptance and Action Questionnaire-II, the Coping Orientations to Problems Experienced (COPE), the Beck Depression Inventory-II, and the State-Trait Anxiety Inventory (STAI). RESULTS: TS patients scored significantly higher on the STAI (i.e., Anxiety Trait), 16PF (i.e., Tension), and COPE (i.e., Transcendental Orientation). TS patients also showed lower heart rate variability. Moreover, a significant inverse correlation was found between sympathetic tone (LF/HF ratio) and coping orientation. CONCLUSIONS: Long after the acute event, TS patients are characterized by elevated anxiety, high tension, and a specific religious coping strategy.

Adolescents' Characteristics and Peer Relationships in Class: A Population Study.

BACKGROUND: This study aimed to investigate differences in adolescents' social relationships with classmates of diverse gender, socioeconomic status, immigrant background, and academic achievement. METHODS: A population of 10th-grade students (N = 406,783; males = 50.3%; Mage = 15.57 years, SDage = 0.75) completed the Classmates Social Isolation Questionnaire (CSIQ), an instrument specifically designed to measure two distinct but correlated types of peer relationships in class: peer acceptance and peer friendship. To obtain reliable comparisons across diverse adolescent characteristics, the measurement invariance of the CSIQ was established by means of CFAs and then latent mean differences tests were performed. RESULTS: Immigrant background, academic achievement, and socioeconomic status all proved to be important factors influencing relationships with classmates, while being a male or a female was less relevant. Being a first-generation immigrant adolescent appears to be the foremost risk factor for being less accepted by classmates, while having a low academic achievement is the greatest hindrance for having friends in the group of classmates, a finding that diverges from previous studies. CONCLUSIONS: This population study suggests that adolescent characteristics (especially immigrant background, socioeconomic status, and academic achievement) seem to affect social relationships with classmates.