Study of the excess mortality associated with the SARS-CoV-2 pandemic in the Local Health Authorities and Districts of the Autonomous Region of Sardinia - quinquennium 2017-2021.

Background: Based on the indications of the Italian National Recovery and Resilience Plan and the Ministerial Decree n°77/2022, detecting specific populations' social-welfare needs is essential to reorganize the national and regional health service. The present analysis studies the impact of pandemic and pre-pandemic conditions in terms of mortality on Sardinian health service organizational subunits to indirectly investigate the need for specific social and health interventions. Design: Retrospective observational mortality study on the Sardinian resident population, surveyed by the Italian National Institute of Statistics (Istat) from 2017 to 2021. Methods: The database was built by crossing demographic data from the Istat divided into 21 five-year age groups (0-4 to 100+). Mortality and excess mortality were calculated with a focus on local health authorities and districts. The analysis were made considering three age groups (0-64, ≥ 65, 0-100+) and comparing the individual years 2020 and 2021 with the pre-pandemic triennium 2017-2019. To better understand the phenomenon of excess mortality, the old age index was calculated for the Local Health Authority and District for each year of the quinquennium considered. Results: Standardized mortality ratios increased in the biennium of the SARS-CoV-2 pandemic compared to the baseline 2017-2019. A global increaseof the Standardized mortality ratios in all districts (2021) was measured, including those with Standardized mortality ratios already increasing in 2020. Notably, the Standardized mortality ratios (2020 and 2021) were often increased by the 0-64 age group. The regional excess mortality (0-100+) confirmed an increase in mortality compared to the baseline, with a slight decrease from 2020 to 2021. Conclusions: Sardinia presents peculiar demographic and geographical characteristics. Monitoring mortality rates and excess mortality confirms to be crucial to constantly re-modulating health interventions and planning of the supply of services, including the equitable allocation of resources based on actual health needs. Sardinia should embrace the concept of "age-friendly community" and create communities designed to promote active aging and social participation.

Antimicrobial Activity of Grapefruit Seed Extract on Edible Mushrooms Contaminations: Efficacy in Preventing Pseudomonas spp. in Pleurotus eryngii.

Pleurotus eryngii is an edible mushroom that suffers significant losses due to fungal contamination and bacteriosis. The Pseudomonadaceae family represents one of the most frequent etiologic agents. Grapefruit seed extract (GSE) is a plant extract that contains different bioactive components, such as naringin, and exhibits a strong antibacterial and antioxidant activity. Over the last decade, GSE use as an alternative to chemical treatments in the food sector has been tested. However, to our knowledge, its application on mushroom crops has never been investigated. This study focuses on evaluating GSE efficacy in preventing P. eryngii yellowing. GSE antibiotic activity, inhibitory and bactericidal concentrations, and antibiofilm activity against several microorganisms were tested with the Kirby-Bauer disk diffusion assay, the broth microdilution susceptibility test, and the Crystal violet assay, respectively. In vitro, the extract exhibited antimicrobial and antibiofilm activity against Staphylococcus aureus 6538 and MRSA (wild type), Escherichia coli ATCC 8739, and Pseudomonas spp. (Pseudomonas aeruginosa 9027, P. fluorescens (wild type)). GSE application in vivo, in pre- and post-sprouting stages, effectively prevented bacterial infections and subsequent degradation in the mushroom crops: none of the P. eryngii treated manifested bacteriosis. Our findings support the use of GSE as an eco-friendly and sustainable alternative to chemical treatments for protecting P. eryngii crops from bacterial contamination, consequently ensuring food safety and preventing financial losses due to spoilage. Furthermore, GSE's potential health benefits due to its content in naringin and other bioactive components present new possibilities for its use as a nutraceutical in food fortification and supplementation.

Involving medical students in re-orienting health services: a photovoice study.

Introduction: Healthcare reorientation aims for health services focused not exclusively on diseases but also on prevention and health promotion. The implementation depends strongly on professionals' willingness to actively participate in the reorientation. An effective strategy to boost reorientation is to reorient education and role definition of future professionals. This paper examines whether photovoice can be a suitable method to i) increase future health professionals' awareness of users' needs and expectations; and ii) enable a process of critical reflection on role definition and health services organisation. Methods: One hundred and seventy-two medical students participated in the photovoice project. Participants were asked to produce one photo combined with a caption, responding to a pre-identified question: "What is, in your opinion, the main aspect affecting users' satisfaction/dissatisfaction in a healthcare facility?". Participants discussed their photos in group discussions (n = 16) and participated in data analysis sessions (n = 4). Results: Participants' contributions revolved around how services were delivered (e.g., kindness, accessibility, attention to additional needs) rather than the service provided. The students showed their empathic side and proposed smart and inclusive solutions to improve overall users' experience. Conclusions: This study demonstrated the value of using photovoice to reach medical students and to integrate health promotion into their professional identities. The photovoice process, teamwork, and discussions opened a breach into traditional thinking regarding aspects of healthcare services that are taken for granted or are overlooked. Furthermore, participants' proposals often implied a change in the behaviour of professionals - their future selves - towards patients and low-cost improvements of organisational practices.

Clinical applications of EEG power spectra aperiodic component analysis: A mini-review.

OBJECTIVE: The present mini-review summarizes recent clinical findings related to the analysis of the aperiodic component of EEG (electroencephalographic) power spectra, making them quickly accessible to medical specialists and health researchers, with the aim of boosting related research. METHODS: Based on our experience about clinicians' literature-searching, we queried the PubMed database with terms related to EEG power spectra aperiodic component analysis and selected clinical studies that referenced such terms in the title/abstract, and were published in the last five years. RESULTS: A total of 11 journal articles, dealing with 9 different neurologic and psychiatric conditions published between 1st January 2016 - April 1st 2021, were surveyed. CONCLUSIONS: All the reviewed studies focused on exploring the pathophysiological significance of the aperiodic component and its correlation with disease presence, stage, and severity. Despite the heterogeneity of pathologies, it was possible to cluster most of them according to the mechanism underlying slope alterations, namely hypo-/hyper-excitability. It was also possible to identify some counterintuitive findings, probably related to compensation mechanisms of disease-specific neurophysiological alterations. SIGNIFICANCE: All the findings seem to support the role of the aperiodic activity as index of excitation/inhibition balance, with promising clinical applications that might challenge the traditional approach to pathologies diagnosis/treatment/follow-up.

A multivariate analysis of the association between corticostriatal functional connectivity and psychosis-like experiences in the general community.

Dysfunction of dorsal corticostriatal (CST) circuitry is thought to play an important role in psychosis. Here, we use multivariate analysis to characterize covariance between CST functional connectivity and psychosis-like experiences (PLEs) in non-clinical individuals. In 353 healthy adults (155 males), we use partial least squares (PLS) to identify latent variables (LV) describing covariance between seven PLE questionnaire measures and functional connectivity estimated between each of six striatal seed regions and the rest of the brain using multiband resting-state fMRI. Hypothesis-driven PLS of the dorsal caudate (DC) seed identified one significant LV, accounting for 23.88% of covariance, with loadings from nearly all PLE subscales. Cortical regions implicated in this LV comprise anterior cingulate and left dorsolateral prefrontal cortex. Lower connectivity between these cortical areas and the DC seed was associated with more severe PLEs. Using multivariate modeling, we identified an association between dorsal CST connectivity and PLEs in the general community that implicates similar brain regions to those identified in patient groups. Our results highlight that the severity of both positive/negative symptom-like PLEs is related with functional coupling between the DC and dorsolateral PFC, suggesting this neural circuit may play a role in mediating risk for general psychosis-related psychopathology.