Frail hypertensive older adults with prediabetes and chronic kidney disease: insights on organ damage and cognitive performance - preliminary results from the CARYATID study

BACKGROUND

Hypertension and chronic kidney disease (CKD) pose significant public health challenges, sharing intertwined pathophysiological mechanisms. Prediabetes is recognized as a precursor to diabetes and is often accompanied by cardiovascular comorbidities such as hypertension, elevating the risk of pre-frailty and frailty. Albuminuria is a hallmark of organ damage in hypertension amplifying the risk of pre-frailty, frailty, and cognitive decline in older adults. We explored the association between albuminuria and cognitive impairment in frail older adults with prediabetes and CKD, assessing cognitive levels based on estimated glomerular filtration rate (eGFR).

METHODS

We conducted a study involving consecutive frail older patients with hypertension recruited from March 2021 to March 2023 at the ASL (local health unit of the Italian Ministry of Health) of Avellino, Italy, followed up after three months. Inclusion criteria comprised age over 65 years, prior diagnosis of hypertension without secondary causes, prediabetes, frailty status, Montreal Cognitive Assessment (MoCA) score < 26, and CKD with eGFR > 15 ml/min.

RESULTS

237 patients completed the study. We examined the association between albuminuria and MoCA Score, revealing a significant inverse correlation (r: 0.8846; p < 0.0001). Subsequently, we compared MoCA Score based on eGFR, observing a significant difference (p < 0.0001). These findings were further supported by a multivariable regression analysis, with albuminuria as the dependent variable.

CONCLUSIONS

Our study represents the pioneering effort to establish a significant correlation between albuminuria and eGFR with cognitive function in frail hypertensive older adults afflicted with prediabetes and CKD.

Cognitive functioning and psychosomatic syndromes in a subjective tinnitus sample

Introduction

Tinnitus is the perception of a sound in the absence of any corresponding external sound source. Current research suggests a relationship among emotional, cognitive, and psychosomatic symptoms and the occurrence or maintenance of chronic tinnitus. This study aimed to detect the prevalence and role of psychosomatic conditions, as defined by the Diagnostic Criteria for Psychosomatic Research (DCPR), and cognitive functioning in a group of patients with tinnitus.

Methods

Sixty-two patients with subjective tinnitus and 62 non-tinnitus controls were recruited from the Otorhinolaryngology Unit of the University of Bari. Pure-tone audiometry was performed in all tinnitus subjects, and sound level tolerance was evaluated. Additionally, tinnitus handicap (Tinnitus Handicap Inventory [THI]), psychopathological symptoms (Symptom Checklist-90, Revised [SCL-90-R]), anxiety (State-Trait Anxiety Inventory [STAI-Y1/2]), depression (Beck Depression Inventory [BDI]), cognitive impairment (Mini-Mental State Examination [MMSE]), executive functions (Frontal Assessment Battery [FAB]), and psychosomatic syndromes (DCPR) were evaluated. Parametric and non-parametric tests were used to detect cognitive and symptomatological differences between patients and controls. The predictivity of these factors for tinnitus severity was studied using multiple regression (Backward Elimination). All tests were considered significant at p < 0.05 (family wise error corrected for each comparison).

Results

69.4% tinnitus patients met multiple DCPR criteria, compared to 32.3% of controls. Tinnitus patients exhibited elevated rates of illness denial (ꭓ2 = 9.02; p < 0.009), demoralization (ꭓ2 = 8.05; p < 0.018), somatization (ꭓ2 = 4.92; p < 0.063) and functional symptoms (ꭓ2 = 5.21; p < 0.06) scoring significantly higher on the BDI, STAI-Y1, and STAI-Y2, and SCL-90-R compared to controls. Patients with tinnitus showed lower MMSE scores, compared to controls (t = -2.282; p < 0.001). No association between tinnitus severity and global cognitive impairment emerged. Conversely, executive function deficits were associated to tinnitus severity. Among the cognitive and psychological factors, only trait anxiety, one or more psychosomatic syndromes, and somatization clusters were strongly correlated with tinnitus severity.

Discussion

Our findings suggest a relationship between tinnitus severity, psychological, psychosomatic symptoms, and frontal impairment. Additionally, the influence of tinnitus on cognitive functions paves the way for integrated, multidisciplinary diagnostic and treatment options for patients. Although preliminary, our findings highlight the importance of early cognitive and psychological screening to improve patients' quality of life.

The Placement of Children in Need of Out-of-Home Care: Forms of Care and Differences in Attachment Security and Behavioral Problems in the Italian Context

The current paper investigated differences in secure attachment levels and behavioral problems among four groups of children in out-of-home care in Italy: closed adoption (child and birth parents not in contact following adoption), open adoption (child and birth parents still in contact after placement), foster care (child living temporarily with relatives or unrelated foster parents) and institutional care (child in residential care for large groups of children). One hundred and thirty children aged 10-19 were included in this study. The Attachment Interview for Childhood and Adolescence and the Achenbach Youth Self-Report were employed to measure participants' secure attachment levels and behavioral problems. Both a multivariate analysis of covariance and measured variable path analysis were performed. Age, gender and time elapsed between the request for child protection and placement on out-of-home care were used as covariates. The results showed that adolescents in closed adoption had higher secure attachment scores than those in foster care and institutional care, while adolescents in open adoption scored significantly higher on problem behaviors than those in the other out-of-home care groups. Findings were discussed in terms of limitations and implications for future research.

The role of maladaptive personality traits on psychological stress the mediating effects of COVID-19-related worries and emotional dysregulation

There is increasing evidence that dysfunctional personality traits, related to psychological maladjustment and psychopathology, can play an important role in a person's ability to cope with major stressful events. Relatively little is known about the specific effect of the emotional component on the relationship between maladaptive personality traits and psychological stress. Therefore, the aim of the present study was to investigate the relationship between the maladaptive personality traits of psychoticism, detachment, and negative affect, and psychological stress, considering the effects of COVID-19-related worries and emotional dysregulation. An online survey was administered to 1172 adult participants. A series of path analysis models showed that maladaptive personality traits (psychoticism, detachment, and negative affect) are related to psychological stress. COVID-19-related worries and emotional dysregulation partially explained this association. The results suggest that in the early months of 2022, during the reduction of government restrictions, although the world population was no longer in nationwide lockdown, the COVID-19-related emotional component could still explain, at least in part, the association between maladaptive personality traits and psychological stress.

Relation between fluid intelligence and mathematics and reading comprehension achievements: The moderating role of student teacher relationships and school bonding

Several studies have shown the relevance among students of the quality of their interpersonal relationships for their academic achievement. Nevertheless, most studies available have explored the relation between the cognitive functioning and academic achievement without taking into account the quality of the relationships experienced in the school environment. Furthermore, the studies that have begun to consider the joint role of these factors in the prediction of academic achievement are scant. Therefore, it appears of relevance to deepen the relation between cognitive functioning and quality of school relationships in order to support students' academic achievement and the potential of youth. In this paper, we examined the moderating role of the quality of student-teacher relationships and school bonding (STR-SB) in the associations of fluid intelligence (Gf) with academic achievement among adolescents (N = 219). A multiple-group structural equation modelling analysis revealed that STR-SB quality moderated unexpectedly only the link between Gf and mathematics. The findings support the idea that the quality of student-teacher relationships may be a relevant dimension to be considered to clarify the association between cognitive functioning and academic achievement.

Pre-surgery supportive and goal-oriented strategies are associated with lower post-surgery perceived distress in women diagnosed with breast cancer

BACKGROUND

Psycho-oncology literature pointed out that individual health outcomes may depend on patients' propensity to adopt approach or, conversely, avoidant coping strategies. Nevertheless, coping factors associated with postoperative distress remain unclear, unfolding the lack of tailored procedures to help breast cancer patients manage the psychological burden of scheduled surgery. In view of this, the present study aimed at investigating: 1. pre-/post-surgery distress variations occurring among women diagnosed with breast cancer; 2. the predictivity of approach and avoidant coping strategies and factors in affecting post-surgery perceived distress.

METHODS

N = 150 patients (mean age = 59.37; SD =  ± 13.23) scheduled for breast cancer surgery were administered a screening protocol consisting of the Distress Thermometer (DT) and the Brief-COPE. The DT was used to monitor patients' distress levels before and after surgery (± 7 days), whereas the Brief-COPE was adopted only preoperatively to evaluate patients' coping responses to the forthcoming surgical intervention. Non-parametric tests allowed for the detection of pre-/post-surgery variations in patients' perceived distress. Factor analysis involved the extraction and rotation of principal components derived from the Brief-COPE strategies. The predictivity of such coping factors was investigated through multiple regression (Backward Elimination).

RESULTS

The Wilcoxon Signed-Rank Test yielded a significant variation in DT mean scores (TW = -5,68 < -zα/2 = -1,96; p < .001) indicative of lower perceived distress following surgery. The four coping factors extracted and Varimax-rotated were, respectively: 1. cognitive processing (i.e., planning + acceptance + active coping + positive reframing); 2. support provision (i.e., instrumental + emotional support); 3. emotion-oriented detachment (i.e., self-blame + behavioral disengagement + humor + denial); 4. goal-oriented detachment (i.e., self-distraction). Among these factors, support provision (B = .458; β = - .174; t = - 2.03; p = .045), encompassing two approach coping strategies, and goal-oriented detachment (B = .446; β = - .176; t = - 2.06; p = .042), consisting of one avoidant strategy, were strongly related to post-surgery distress reduction.

CONCLUSION

The present investigation revealed that the pre-surgery adoption of supportive and goal-oriented strategies led to postoperative distress reduction among breast cancer patients. These findings highlight the importance of timely psychosocial screening and proactive interventions in order to improve patients' recovery and prognosis.

Investigating defensive functioning and alexithymia in substance use disorder patients

BACKGROUND

Substance Use Disorder (SUD) causes a great deal of personal suffering for patients. Recent evidence highlights how defenses and emotion regulation may play a crucial part in the onset and development of this disorder. The aim of this study was to investigate potential differences in the defensive functioning between SUD patients and non-clinical controls. Secondly, we aimed at investigating the relationships between alexithymia and maladaptive/assimilation defenses.

METHODS

The authors assessed defensive functioning (Response Evaluation Measure-71, REM-71), personality (MMPI-II), and alexithymia (TAS-20) of 171 SUD patients (17% female; mean age = 36.5), compared to 155 controls. Authors performed a series of ANOVAs to investigate the defensive array in SUD patients compared to that of non-clinical controls. Student t test for indipendent samples was used to compare clinical characteristics between the SUD group and the controls. To investigate the role of single defenses in explaining alexithimia's subscores, stepwise multiple regression analysis were carried out on socio-demographic characteristics of participants (gender, age, and years of education), with REM-71 defenses as predictors.

RESULTS

SUD patients presented a more maladaptive/assimilation (Factor 1) defensive array (p < .001). Among SUD sub-groups, Alcohol Use Disorder patients showed more disfuncional defenses. Factor 1 defenses were related to a worse psychological functioning. In addition, alexyhimia (particularly DIF) was strongly related to Factor 1 defenses, expecially Projection (38% of variance explained, β = .270, p < .001).

CONCLUSION

The REM-71 and the TAS-20 might be useful screening instruments among SUD patients.

Fabrication and characterization of AlN-based flexible piezoelectric pressure sensor integrated into an implantable artificial pancreas

This study reports on the fabrication and characterization of an event detection subsystem composed of a flexible piezoelectric pressure sensor and the electronic interface to be integrated into an implantable artificial pancreas (IAP) for diabetic patients. The developed sensor is made of an AlN layer, sandwiched between two Ti electrodes, sputtered on Kapton substrate, with a preferential orientation along c-axis which guarantees the best piezoelectric response. The IAP is made of an intestinal wall-interfaced refilling module, able to dock an ingestible insulin capsule. A linearly actuated needle punches the duodenum tissue and then the PDMS capsule to transfer the insulin to an implanted reservoir. The device is located at the connection of the needle with the linear actuator to reliably detect the occurred punching of the insulin-filled capsule. Finite Element Analysis (FEA) simulations were performed to evaluate the piezoelectric charge generated for increasing loads in the range of interest, applied on both the sensor full-area and footprint area of the Hamilton needle used for the capsule punching. The sensor-interface circuit was simulated to estimate the output voltage that can be obtained in real operating conditions. The characterization results confirmed a high device sensitivity during the punching, in the low forces (0-4 N) and low actuator speed (2-3 mm/s) ranges of interest, meeting the requirement of the research objective. The choice of a piezoelectric pressure sensor is particularly strategic in the medical field due to the request of self-powered implantable devices which do not need any external power source to output a signal and harvest energy from natural sources around the patient.

Confidence in Attachment Relationships and Marital Status as Protective Factors for Self-Perceived Parental Role and In-Person Visitation with Children Among Incarcerated Fathers

The study aimed at investigating the role of confidence in attachment relationships and marital status as protective factors for incarcerated fathers' self-perceived parental role and in-person contacts with their children. Participants included 150 inmate fathers and 145 nonincarcerated control fathers who provided background sociodemographic information and completed two self-reports, the Attachment Style Questionnaire and the Self-Perception of Parental Role. A two-phased cluster analytic plan allowed us to highlight two profiles of self-perceived parental roles, with incarceration and low confidence in attachment relationships increasing the risk of the less optimal of the two profiles. Higher confidence in attachment relationships and having a stable romantic relationship increased the likelihood of incarcerated fathers engaging in frequent contacts with their children, while the profile of self-perceived parental role had no effect. Implications for practice are discussed, and suggestions for further research are provided.

Fe3O4/γ-Fe2O3 nanoparticle multilayers deposited by the Langmuir-Blodgett technique for gas sensors application

Fe3O4/γ-Fe2O3 nanoparticles (NPs) based thin films were used as active layers in solid state resistive chemical sensors. NPs were synthesized by high temperature solution phase reaction. Sensing NP monolayers (ML) were deposited by Langmuir-Blodgett (LB) techniques onto chemoresistive transduction platforms. The sensing ML were UV treated to remove NP insulating capping. Sensors surface was characterized by scanning electron microscopy (SEM). Systematic gas sensing tests in controlled atmosphere were carried out toward NO2, CO, and acetone at different concentrations and working temperatures of the sensing layers. The best sensing performance results were obtained for sensors with higher NPs coverage (10 ML), mainly for NO2 gas showing interesting selectivity toward nitrogen oxides. Electrical properties and conduction mechanisms are discussed.

Antibacterial coatings on haemodialysis catheters by photochemical deposition of silver nanoparticles

Antibacterial coatings on catheters for acute dialysis were obtained by an innovative and patented silver deposition technique based on the photo-reduction of the silver solution on the surface of catheter, with consequent formation of antibacterial silver nanoparticles. Aim of this work is the structural and morphological characterization of these medical devices in order to analyze the distribution and the size of clusters on the polymeric surface, and to verify the antibacterial capability of the devices treated by this technique against bacterial proliferation. The structure and morphology of the silver nanoparticles were investigated by using scanning and transmission electron microscopy. The antimicrobial capability of the catheters after silver deposition was confirmed by antibacterial tests with Escherichia coli. Both scanning electron microscopy analysis and antibacterial tests were performed also after washing catheters for 30 days in deionized water at 37°C, relating these data to thermogravimetric analysis and to energy dispersive spectroscopy, in order to check the resistance of coating and its antimicrobial capability after the maximum time of life of these devices.

The effects of the focus ion beam milling process on the optical properties of semiconductor nanostructures

In this work, the effects of the focus ion beam (FIB) milling process on the optical properties of semiconductor nanostructures were investigated. With this aim, a sensitive materials system based on InGaAs/GaAs quantum dots with well known and excellent optical properties was selected for the FIB treatment. The FIB technique was used to locally remove a metallic mask deposited on top of the quantum dot sample. The photoluminescence (PL) signal, collected from the circular openings, was used to infer the possible damage effects of the ion beam on the properties of the dots.

Critical issues in the focused ion beam patterning of nanometric hole matrixes on GaAs based semiconducting devices

This work investigates the critical issues in the focused ion beam (FIB) nanopatterning of semiconducting devices. Matrixes of holes with diameter of about 150 nm were drilled by FIB on the topmost layers of a quantum dot based device. In order to study the presence of artefacts in the active region of the device, the milling parameters were investigated. A careful analysis of the ion beam effects on the structural and morphological features of the holes, mainly due to the heterogeneous composition of the layers to be milled, demonstrated that important deviations from the expected structures, in terms of size, shape and geometry of the holes, as well as layer amorphization and damage, occur.

Correlation between shape and electronic states in nanostructures

We show how the electronic states of quantum wires and quantum dots can be evaluated exactly starting from the profile of the nanostructure observed by transmission electron microscopy, scanning tunneling microscopy and atomic force microscopy. The calculated quantization energies reproduce the energy position of the luminescence resonances in the optical spectra of different samples, without fitting parameters.