Profiling and assessing the risks of image- and performance-enhancing drugs use during the COVID-19 lockdown.

Background: Image and Performance-Enhancing Drugs (IPEDs) can enhance mental and physical capabilities and impact one's overall health. Initially confined in sport environments, IPEDs use has become increasingly widespread in a high-performing society. The present study was aimed at profiling IPEDs use during the COVID-19 lockdown among an international sample of young adults. Methods: A cross-sectional observational study was carried out in eight countries (United Kingdom, Italy, Lithuania, Hungary, Portugal, Spain, Brazil, and Japan) between April and May 2020. The survey questionnaire included validated measurements such as Exercise Addiction Inventory (EAI), Appearance Anxiety Inventory (AAI), and Self-Compassion Scale (SCS) as well as questions about the type of IPEDs, purchasing methods and socio-demographic information. Results: A total of 736 IPEDs users were included in the survey. Their mean age was 33.05 years (±SD = 10.06), and 64.2% were female participants. Overall, 6.8% were found at risk of exercise addiction (EAI >24), 27.6% presented high levels of appearance anxiety, and 24.9% revealed low levels of emotional regulation's self-compassion. Most participants (55.6%) purchased IPEDs through pharmacies/specialized shops, while 41.3% purchased IPEDs on the Internet. Online IPEDs buyers were mainly men who had higher scores on the Exercise Addiction Inventory. One or more IPEDs classifiable as "potentially risky" were used by 66.3% of the sample. Users of "potentially risky IPEDs" were younger and primarily men. They showed higher scores both on the Exercise Addiction Inventory and Appearance Anxiety Inventory. Conclusion: This study profiled users of IPEDs when the most restrictive COVID-19 lockdown policies were implemented in all the participating countries. More targeted post-COVID 19 prevention strategies should be implemented according to the emerged socio-demographic and psychopathological traits and cross-cultural differences emerged. Longitudinal studies will also be needed to determine the long-term effect of the COVID-19 lockdown on IPEDs consumption.

Convolutional Neural Network Model for Intestinal Metaplasia Recognition in Gastric Corpus Using Endoscopic Image Patches.

Gastric cancer (GC) is a significant healthcare concern, and the identification of high-risk patients is crucial. Indeed, gastric precancerous conditions present significant diagnostic challenges, particularly early intestinal metaplasia (IM) detection. This study developed a deep learning system to assist in IM detection using image patches from gastric corpus examined using virtual chromoendoscopy in a Western country. Utilizing a retrospective dataset of endoscopic images from Sant'Andrea University Hospital of Rome, collected between January 2020 and December 2023, the system extracted 200 × 200 pixel patches, classifying them with a voting scheme. The specificity and sensitivity on the patch test set were 76% and 72%, respectively. The optimization of a learnable voting scheme on a validation set achieved a specificity of 70% and sensitivity of 100% for entire images. Despite data limitations and the absence of pre-trained models, the system shows promising results for preliminary screening in gastric precancerous condition diagnostics, providing an explainable and robust Artificial Intelligence approach.

Parental care and overprotection predict worry and anxiety symptoms in emerging adult students.

Anxiety disorders represent a prevalent mental health concern, with escalating rates, especially among emerging adults. University students, in particular, face a myriad of academic and life stressors that can amplify feelings of worry and anxiety. While early parental bonding seem to predict anxiety disorders later in life, the applicability to emerging adult students and its applicability to predict sub-clinical and transdiagnostic anxiety features remain unclear. This study aims to examine i) the relationship between demographic variables and key features of anxiety disorders (i.e., worry and anxiety symptoms); and ii) the predictive association between early parental bonding and anxiety-related features. A sample of 370 university students in Italy (n = 279 females; M age = 20.84 years, SD age = 1.81 years) completed the Parental Bonding Instrument, the Penn State Worry Questionnaire, and the Beck Anxiety Inventory. Females reported higher levels of worry and anxiety compared to males. Significantly higher worry and anxiety symptoms were reported by individuals who experienced affectionless control (low care and high overprotection) as compared to those exposed to optimal parenting (high care and low overprotection). Predictive models indicated that scores of parental care (i.e., the principal component between maternal and paternal care scores) and parental overprotection (i.e., the principal component between maternal and paternal overprotection scores) are robust predictors of worry and anxiety symptoms. However, this relationship showed a gender-specific pattern: lower parental care was more significant in predicting anxiety features in males, while high overprotection was more significant in females. The findings contribute to the comprehension of the risk factors influencing the susceptibility of emerging adult students to anxiety disorders.

Culture, sex and social context influence brain-to-brain synchrony: an fNIRS hyperscanning study.

BACKGROUND: Unique interpersonal synchrony occurs during every social interaction, and is shaped by characteristics of participating individuals in these social contexts. Additionally, depending on context demands, interpersonal synchrony is also altered. The study therefore aims to investigate culture, sex, and social context effects simultaneously in a novel role-play paradigm. Additionally, the effect of personality traits on synchrony was investigated across cultures, and a further exploratory analysis on the effects of these variables on pre- and post-session empathy changes was conducted. METHODS: 83 dyads were recruited in two waves from Singapore and Italy and took part in a within-subjects session where they interacted with each other as themselves (Naturalistic Conversation) and as others (Role-Play and Role Reversal). Big Five Inventory (administered pre-session) and Interpersonal Reactivity Index (administered pre- and post-session) were used as measures of personality and empathy respectively, while synchrony was measured using hyperscanning functional near-infrared spectroscopy in the prefrontal cortex. After data-preprocessing and preliminary analyses, a mixture of multiple linear regression and exploratory forward stepwise regression models were used to address the above study aims. RESULTS: Results revealed significant main and interaction effects of culture, sex and social context on brain-to-brain synchrony, particularly in the medial left cluster of the prefrontal cortex, and a unique contribution of extraversion and openness to experience to synchrony in the Italian cohort only. Finally, culture-driven differences in empathy changes were identified, where significant increases in empathy across sessions were generally only observed within the Singaporean cohort. CONCLUSIONS: Main findings indicate lowered brain-to-brain synchrony during role-playing activities that is moderated by the dyad's sex make-up and culture, implying differential processing of social interactions that is also influenced by individuals' background factors. Findings align with current literature that role-playing is a cognitively demanding activity requiring greater levels of self-regulation and suppression of self-related cognition as opposed to interpersonal co-regulation characterized by synchrony. However, the current pattern of results would be better supported by future studies investigating multimodal synchronies and corroboration.

Visual stimulus structure, visual system neural activity, and visual behavior in young human infants.

In visual perception and information processing, a cascade of associations is hypothesized to flow from the structure of the visual stimulus to neural activity along the retinogeniculostriate visual system to behavior and action. Do visual perception and information processing adhere to this cascade near the beginning of life? To date, this three-stage hypothetical cascade has not been comprehensively tested in infants. In two related experiments, we attempted to expose this cascade in 6-month-old infants. Specifically, we presented infants with two levels of visual stimulus intensity, we measured electrical activity at the infant cortex, and we assessed infants' preferential looking behavior. Chromatic saturation provided a convenient stimulus dimension to test the cascade because greater saturation is known to excite increased activity in the primate visual system and is generally hypothesized to stimulate visual preference. Experiment 1 revealed that infants prefer (look longer) at the more saturated of two colors otherwise matched in hue and brightness. Experiment 2 showed increased aggregate neural cortical excitation in infants (and adults) to the more saturated of the same pair of colors. Thus, experiments 1 and 2 taken together confirm a cascade: Visual stimulation of relatively greater intensity evokes relatively greater levels of bioelectrical cortical activity which in turn is associated with relatively greater visual attention. As this cascade obtains near the beginning of life, it helps to account for early visual preferences and visual information processing.

Hyperscanning literature after two decades of neuroscientific research: A scientometric review.

Hyperscanning, a neuroimaging approach introduced in 2002 for simultaneously recording the brain activity of multiple participants, has significantly contributed to our understanding of social interactions. Nevertheless, the existing literature requires systematic organization to advance our knowledge. This study, after two decades of hyperscanning research, aims to identify the primary thematic domains and the most influential documents in the field. We conducted a scientometric analysis to examine co-citation patterns quantitatively, using a sample of 548 documents retrieved from Scopus and their 32,022 cited references. Our analysis revealed ten major thematic domains in hyperscanning research, with the most impactful document authored by Czeszumski and colleagues in 2020. Notably, while hyperscanning was initially developed for functional magnetic resonance imaging (fMRI), our findings indicate a substantial influence of research conducted using electroencephalography (EEG) and functional near-infrared spectroscopy (fNIRS). The introduction of fNIRS and advancements in EEG methods have enabled the implementation of more ecologically valid experiments for investigating social interactions. The study also highlights the need for more research that combines multi-brain neural stimulation with neuroimaging techniques to understand the causal role played by interpersonal neural synchrony in social interactions.

Clinical Outcome of Patients with Gastric, Duodenal, or Rectal Neuroendocrine Tumors after Incomplete Endoscopic Resection.

Objectives: Our aim was to investigate the clinical outcome of patients with well-differentiated gastric, duodenal, and rectal neuroendocrine tumors after treatment with incomplete endoscopic resection due to the finding of microscopic positive resection margins (R1). Methods: This is a retrospective analysis of consecutive patients with type 1 gastric, non-ampullary non-functioning duodenal, or rectal neuroendocrine neoplasms with positive R1 margins after endoscopic resection. The rate of tumor recurrence and progression-free survival were considered to be the study's main endpoints. Statistical analysis was performed using MedCalc® v.17 software and a p-value of <0.05 was considered significant. A Cox proportional-hazard regression was performed to identify risk factors for disease recurrence/progression. Results: After evaluating 110 patients, a total of 58 patients were included in the final analysis (15 gastric NENs, 12 duodenal NENs, and 31 rectal NENs). After evidence of endoscopic R1 resection had been gathered, 26 patients (44.8%) underwent an endoscopic/surgical extension of the previous resection. Tumor progression (all local recurrences) occurred in five out of fifty-eight patients (8.6%) with a median PFS of 36 months. There were no tumor-related deaths. G2 grading and the gastric primary tumor site were the only features significantly associated with the risk of recurrence of the disease (HR: 11.97 [95% CI: 1.22-116.99], HR: 12.54 [95% CI: 1.28-122.24], respectively). Conclusions: Tumor progression rarely occurs in patients with microscopic positive margin excision (R1) after endoscopic resection and does not seem to affect patients' clinical outcomes.

Performance-enhancing substances in sport: A scientometric review of 75 years of research.

The use of performance-enhancing substances not only undermines the core values of sports but also poses significant health risks to athletes. In a fast-evolving doping environment, where sport professionals are constantly seeking novel and illegal means to bypass doping tests, and new substances are regularly detected on the drug market, it is crucial to inform authorities with updated evidence emerging from scientific research. The current study aims to (i) outline the structure of knowledge in the literature on performance enhancers in sports (i.e., most active countries, main sources, most productive authors, and most frequently used keywords); (ii) identify the most impactful documents in the field; and (iii) uncover the main domains of research in the literature. To do so, we conducted a comprehensive scientometric analysis of the literature on doping, sourcing our data from Scopus. Our research involved a document co-citation analysis of 193,076 references, leading to the identification of the 51 most influential documents and seven key thematic areas within the doping literature. Our results indicate that the scientific community has extensively studied the most prevalent doping classes, such as anabolic agents and peptide hormones, and little is still known about the use of contaminated supplements or other types of enhancers identified as emergent trends. Concurrently, technological advancements contributed to the development of more sophisticated doping detection techniques, using blood or urine samples. More recently, the focus has shifted towards the athlete biological passport, with research efforts aimed at identifying biomarkers indicative of doping. The dynamic nature of doping methods underlines the necessity for more robust educational campaigns, aiming at raising awareness among sports professionals and their entourage about the dangers of doping and the intricacies of its control mechanisms.

Childhood experiences and sleep problems: A cross-sectional study on the indirect relationship mediated by stress, resilience and anxiety.

BACKGROUND: Childhood experiences either adverse (ACE) or benevolent (BCE) can indirectly impact sleep quality in adult life, which in turn are modulated by the interplay of a variety of factors such as depression, anxiety, resilience and mental health problems. METHODS: A cross-sectional observational study was conducted across the UK and the Middle Eastern countries during the COVID-pandemic on 405 participants. An online survey used a combination of questionnaires to assess ACE and BCEs. The following tools were then used to assess the contribution of resilience, stress, depression and anxiety respectively: Brief Resilience Scale (BRS), Perceived Stress Scale (PSS-10), Patient Health Questionnaire-2 (PHQ-2) and General Anxiety Disorder-2 (GAD-2) scale on childhood experiences. The extent of sleep disturbances experienced over a period of seven days was assessed using the PROMIS Sleep Disturbance Short-Form Tool. A serial-parallel mediation model was used to evaluate the impact of the mediators on childhood experiences and sleep quality. RESULTS: Over 50% of the cohort were from Middle Eastern countries. Four or more BCEs were experienced by 94.3% of the cohort. In contrast, 67.9% of participants experienced at least one ACE before the age of 18 years, with moderate levels of stress, mild depression and anxiety were reported in 3.7%, 13% and 20% of participants respectively. Whilst 25.4% of participants reported having had four or more ACEs, with higher reports in the middle easter countries (32%). ACEs were found to correlate with sleep disturbance whilst BCEs showed an inverse correlation. The relationship between ACE and sleep disturbances was shown to be mediated by stress, and anxiety, but not by resilience or depression. Resilience and stress, and resilience and anxiety serially mediated the interaction between ACE and sleep disturbance. With regards to BCE, an inverse association with sleep disturbance was recorded with similar mediators of stress and anxiety observed. CONCLUSION: This study confirms the negative effects of ACEs, and the positive effects of BCEs on sleep in adulthood which are both mediated predominantly by psychological resilience, anxiety and stress. Strategies aimed at improving psychological resilience as well as addressing stress and anxiety may help improve sleep quality.

Beyond Parental Acceptance and Rejection: A Commentary on the Findings From Empirical Studies on Forgiveness and Vengeance in the Muslim World.

Drawing on the framework of interpersonal acceptance-rejection theory (IPARTheory), this special issue edited by Ronald P. Rohner, Sumbleen Ali, and Jennifer E. Lansford explores forgiveness and vengeance within the context of the Muslim world. Examination of the precursors of forgiveness and vengeance holds significance because vengeance typically correlates with adverse physical and psychological health outcomes. We suggest ways to advance research outlined in the special issue, such as assessing cross-cultural invariance and using diverse research designs. Moreover, increasing the diversity of socioeconomic status in studies conducted in the Muslim world and exploring hypotheses in high-income countries are necessary for contextually nuanced research. Overall, this special issue offers valuable insights into the dynamics of forgiveness and vengeance and highlights the role of culture and gender on psychological well-being across diverse contexts.

Anxious about rejection, avoidant of neglect: Infant marmosets tune their attachment based on individual caregiver's parenting style.

Children's secure attachment with their primary caregivers is crucial for physical, cognitive, and emotional maturation. Yet, the causal links between specific parenting behaviors and infant attachment patterns are not fully understood. Here we report infant attachment in New World monkeys common marmosets, characterized by shared infant care among parents and older siblings and complex vocal communications. By integrating natural variations in parenting styles and subsecond-scale microanalyses of dyadic vocal and physical interactions, we demonstrate that marmoset infants signal their needs through context-dependent call use and selective approaches toward familiar caregivers. The infant attachment behaviors are tuned to each caregiver's parenting style; infants use negative calls when carried by rejecting caregivers and selectively avoid neglectful and rejecting caregivers. Family-deprived infants fail to develop such adaptive uses of attachment behaviors. With these similarities with humans, marmosets offer a promising model for investigating the biological mechanisms of attachment security.

Atezolizumab-Induced Acrodermatitis and Pustular Psoriasis in a Patient with Non-Small Cell Lung Cancer: A Rare Case Report.

Introduction: Immune checkpoint inhibitors are new drugs approved for the treatment of many types of malignancies. Despite their wide use and unquestionable clinical benefits, these agents have also been associated with a unique spectrum of side effects known as immune-related adverse events. In this study, we report the first case of atezolizumab-induced pustular psoriasis and acrodermatitis. Case Presentation: A 61-year-old woman presented to our department with erythematous-desquamative and pustular lesions involving all hands and feet fingers, inguinal region, and trunk, associated to severe psoriatic onychodystrophy. She was affected by non-small-cell lung carcinoma from 12 years, and 7 months before admission, she started a treatment with atezolizumab. Conclusion: Immune checkpoint inhibitors such as atezolizumab are linked to a plethora of adverse events. Identifying and treating certain adverse skin events, particularly in cancer patients, can be a challenge, leading oncologists to discontinue immunotherapy. Our case shows how it is necessary to have a shared therapeutic algorithm in order to manage serious skin reactions in cancer patients and avoid disruption of the oncotherapy.

Type 3 gastric neuroendocrine neoplasms: the rising promise of conservative endoscopic management.

Gastric neuroendocrine neoplasms (g-NENs) are rare tumors arising from the gastric enterochromaffin-like cells. Recent data suggests an increased detection rate, attributed to more frequent esophagogastroduodenoscopies. While type 3 g-NENs were historically deemed aggressive, emerging research indicates potential for conservative management, especially endoscopic resection, in well-differentiated, small tumors. European guidelines now advocate for endoscopic intervention in selected cases, but North American guidelines remain more conservative. Key factors influencing outcomes are tumor size, grading, and depth of gastric wall infiltration. Endoscopic resection has shown promise for tumors confined to submucosal layers without lymphovascular invasion. Given the complexities, a multidisciplinary team approach is essential for management decisions. Current insights are largely based on retrospective studies, underscoring the need for prospective research to optimize endoscopic approaches.

Gastric juice analysis in clinical practice: why, how, and when. The experience with EndoFaster.

Gastric juice analysis may be useful for clinical purposes, including the detection of H. pylori infection and diffuse atrophic gastritis on gastric mucosa. EndoFaster is a novel device which performs real-time analysis of gastric juice revealing the infection and hypochlorhydria by measuring ammonium concentrations and pH levels. This review aimed to evaluate the clinical applications of such a tool. By considering data from overall 11 studies, the values of sensitivity, specificity, positive predictive value, negative predictive value, accuracy, positive likelihood ratio, and negative likelihood ratio were 90%, 86%, 67%, 96%, 87%, 8.5, and 0.13, respectively, for H. pylori diagnosis, and 83%, 92%, 58%, 97%, 91%, 9.9 and 0.2, respectively, for suspecting diffuse atrophic gastritis. The very high value of negative predictive values for both H. pylori and mucosal atrophy would allow avoiding to perform useless negative gastric biopsies when the results of the test are negative. Some promising data suggest that gastric juice analysis may be useful also to diagnose H. pylori infection in patients with chronic active gastritis without evidence of bacteria at histology, as well as in predicting persistent acid reflux in patients on proton pump inhibitor therapy for reflux disease.

Systematic review and meta-analysis: Risk of gastric cancer in patients with first-degree relatives with gastric cancer.

BACKGROUND: Gastric cancer ranks fourth in terms of global cancer-related deaths. Timely identification of high-risk populations is crucial to reduce mortality. Although a family history of gastric cancer increases risk, European and British guidelines report weak recommendations and low-quality evidence about the management of these patients. AIM: To quantify the association in case-control studies of patients with gastric cancer with first-degree relatives with gastric cancer compared to those who do not. METHODS: We conducted a systematic review and meta-analysis of case-control studies up to November 2023. Data extraction was performed independently by two reviewers. The heterogeneity of effects across studies was quantified by I2 . We calculated odds ratios (OR) with 95% confidence intervals (CI) using random effects models. RESULTS: We included 30 studies in the systematic review. In all studies, a first-degree family history of gastric cancer represented a risk factor for gastric cancer. We included 21 studies on the risk of gastric cancer. There was a significantly increased association between gastric cancer and having first-degree relative(s) with gastric cancer, but with significant heterogeneity among studies (OR = 2.92; 95% CI 2.402-3.552; p < 0.001; I2 = 81.85%; p < 0.001). CONCLUSION: This meta-analysis highlights the relevance of patients' family history of gastric cancer and the importance of this risk factor for the early detection of neoplastic conditions.

Endoscopic management of gastric, duodenal and rectal NETs: Position paper from the Italian Association for Neuroendocrine Tumors (Itanet), Italian Society of Gastroenterology (SIGE), Italian Society of Digestive Endoscopy (SIED).

The present paper reflects the position of the Italian Association for Neuroendocrine Tumors (Itanet), the Italian Society of Gastroenterology (SIGE), and the Italian Society of Digestive Endoscopy (SIED) regarding the management of patients affected by gastric, duodenal, and rectal neuroendocrine neoplasms (NENs) amenable to endoscopic treatment. The key questions discussed in this paper are summarized in Table 1. Data were extracted from the MEDLINE database through searches; expert opinions and recommendations are provided in accordance with the available scientific evidence and the authors' expertise. Recommendations are presented alongside a level of evidence and grade of recommendation based on the GRADE system. This paper specifically focuses on subgroups of NENs considered suitable for endoscopic management according to current international guidelines: i. well-differentiated gastric neuroendocrine tumors (gNET) type 1 < 2 cm and selected cases of type 3; ii. well-differentiated duodenal, non-functioning, non-ampullary NET with size < 2 cm; and well-differentiated rectal NET with size < 2 cm.

Fifty years of research on questionable research practises in science: quantitative analysis of co-citation patterns.

Questionable research practises (QRPs) have been the focus of the scientific community amid greater scrutiny and evidence highlighting issues with replicability across many fields of science. To capture the most impactful publications and the main thematic domains in the literature on QRPs, this study uses a document co-citation analysis. The analysis was conducted on a sample of 341 documents that covered the past 50 years of research in QRPs. Nine major thematic clusters emerged. Statistical reporting and statistical power emerged as key areas of research, where systemic-level factors in how research is conducted are consistently raised as the precipitating factors for QRPs. There is also an encouraging shift in the focus of research into open science practises designed to address engagement in QRPs. Such a shift is indicative of the growing momentum of the open science movement, and more research can be conducted on how these practises are employed on the ground and how their uptake by researchers can be further promoted. However, the results suggest that, while pre-registration and registered reports receive the most research interest, less attention has been paid to other open science practises (e.g. data sharing).

Perceptions of sexism interact with perceived criticism on women's response to sexist remarks in different relationship types.

Sexism is a widespread form of gender discrimination, which can take the form of criticism towards women based on gender stereotypes. However, little is known about how perceived criticism and sexism shape one's construal of criticism from various interpersonal sources. The present study investigated whether perceived criticism, perceived sexism and the source of criticism (mother, father, workplace supervisor, romantic partner) interact to influence upset levels in response to criticism. 178 participants completed perceived criticism (PC) ratings for the four relationships and 95 female participants also completed the Schedule of Sexist Events scale. Participants read experimental vignettes describing scenarios of criticism from different sources and rated how upset they would feel in each scenario. Perceived sexism significantly moderated the effect of PC on upset levels only for sexist-related criticism from romantic partners and supervisors. Female participants with low perceived sexism show higher levels of upset as PC increased for sexist-related criticism from supervisors whereas female participants with high perceived sexism show lower levels of upset as PC increased for sexist-related criticism from romantic partners. These findings contribute towards understanding how perceived criticism and perceived sexism influence affective reactions to criticism across interpersonal sources.