PARSEG: a computationally efficient approach for statistical validation of botanical seeds' images

Human recognition and automated image validation are the most widely used approaches to validate the output of binary segmentation methods but, as the number of pixels in an image easily exceeds several million, they become highly demanding from both practical and computational standpoint. We propose a method, called PARSEG, which stands for PArtitioning, Random Selection, Estimation, and Generalization; being the basic steps within this procedure. Suggested method enables us to perform statistical validation of binary images by selecting the minimum number of pixels from the original image to be used for validation without deteriorating the effectiveness of the validation procedure. It utilizes binary classifiers to accomplish image validation and selects the optimal sample of pixels according to a specific objective function. As a result, the computational complexity of the validation experiment is substantially reduced. The procedure's effectiveness is illustrated by considering images composed of approximately 13 million pixels from the field of seed recognition. PARSEG provides roughly the same precision of the validation process when extended to the entire image, but it utilizes only about 4% of the original number of pixels, thus reducing, by about 90%, the computing time required to validate a binary segmented image.

The Women4Health cohort: a unique cohort to study women-specific mechanisms of cardio-metabolic regulation

Aims

Epidemiological research has shown relevant differences between sexes in clinical manifestations, severity, and progression of cardiovascular and metabolic disorders. To date, the mechanisms underlying these differences remain unknown. Given the rising incidence of such diseases, gender-specific research on established and emerging risk factors, such as dysfunction of glycaemic and/or lipid metabolism, of sex hormones and of gut microbiome, is of paramount importance. The relationships between sex hormones, gut microbiome, and host glycaemic and/or lipid metabolism are largely unknown even in the homoeostasis status. Yet this knowledge gap would be pivotal to pinpoint to key mechanisms that are likely to be disrupted in disease context.

Methods and results

Here we present the Women4Health (W4H) cohort, a unique cohort comprising up to 300 healthy women followed up during a natural menstrual cycle, set up with the primary goal to investigate the combined role of sex hormones and gut microbiota variations in regulating host lipid and glucose metabolism during homoeostasis, using a multi-omics strategy. Additionally, the W4H cohort will take into consideration another ecosystem that is unique to women, the vaginal microbiome, investigating its interaction with gut microbiome and exploring-for the first time-its role in cardiometabolic disorders.

Conclusion

The W4H cohort study lays a foundation for improving current knowledge of women-specific mechanisms in cardiometabolic regulation. It aspires to transform insights on host-microbiota interactions into prevention and therapeutic approaches for personalized health care.

The Bradley-Terry Regression Trunk approach for Modeling Preference Data with Small Trees

This paper introduces the Bradley-Terry regression trunk model, a novel probabilistic approach for the analysis of preference data expressed through paired comparison rankings. In some cases, it may be reasonable to assume that the preferences expressed by individuals depend on their characteristics. Within the framework of tree-based partitioning, we specify a tree-based model estimating the joint effects of subject-specific covariates over and above their main effects. We, therefore, combine a tree-based model and the log-linear Bradley-Terry model using the outcome of the comparisons as response variable. The proposed model provides a solution to discover interaction effects when no a-priori hypotheses are available. It produces a small tree, called trunk, that represents a fair compromise between a simple interpretation of the interaction effects and an easy to read partition of judges based on their characteristics and the preferences they have expressed. We present an application on a real dataset following two different approaches, and a simulation study to test the model's performance. Simulations showed that the quality of the model performance increases when the number of rankings and objects increases. In addition, the performance is considerably amplified when the judges' characteristics have a high impact on their choices.

Near-Infrared Spectroscopy and Machine Learning for Accurate Dating of Historical Books

Non-destructive, fast, and accurate methods of dating are highly desirable for many heritage objects. Here, we present and critically evaluate the use of near-infrared (NIR) spectroscopic data combined with three supervised machine learning methods to predict the publication year of paper books dated between 1851 and 2000. These methods provide different accuracies; however, we demonstrate that the underlying processes refer to common spectral features. Regardless of the machine learning method used, the most informative wavelength ranges can be associated with C-H and O-H stretching first overtone, typical of the cellulose structure, and N-H stretching first overtone from amide/protein structures. We find that the expected influence of degradation on the accuracy of prediction is not meaningful. The variance-bias decomposition of the reducible error reveals some differences among the three machine learning methods. Our results show that two out of the three methods allow predictions of publication dates in the period 1851-2000 from NIR spectroscopic data with an unprecedented accuracy of up to 2 years, better than any other non-destructive method applied to a real heritage collection.

Correction to: Using sentiment analysis to evaluate the impact of the COVID-19 outbreak on Italy's country reputation and stock market performance

[This corrects the article DOI: 10.1007/s10260-023-00690-5.].

Using sentiment analysis to evaluate the impact of the COVID-19 outbreak on Italy's country reputation and stock market performance

During the recent Coronavirus disease 2019 (COVID-19) outbreak, the microblogging service Twitter has been widely used to share opinions and reactions to events. Italy was one of the first European countries to be severely affected by the outbreak and to establish lockdown and stay-at-home orders, potentially leading to country reputation damage. We resort to sentiment analysis to investigate changes in opinions about Italy reported on Twitter before and after the COVID-19 outbreak. Using different lexicons-based methods, we find a breakpoint corresponding to the date of the first established case of COVID-19 in Italy that causes a relevant change in sentiment scores used as a proxy of the country's reputation. Next, we demonstrate that sentiment scores about Italy are associated with the values of the FTSE-MIB index, the Italian Stock Exchange main index, as they serve as early detection signals of changes in the values of FTSE-MIB. Lastly, we evaluate whether different machine learning classifiers were able to determine the polarity of tweets posted before and after the outbreak with a different level of accuracy.

Threshold-based Naïve Bayes classifier

The Threshold-based Naïve Bayes (Tb-NB) classifier is introduced as a (simple) improved version of the original Naïve Bayes classifier. Tb-NB extracts the sentiment from a Natural Language text corpus and allows the user not only to predict how much a sentence is positive (negative) but also to quantify a sentiment with a numeric value. It is based on the estimation of a single threshold value that concurs to define a decision rule that classifies a text into a positive (negative) opinion based on its content. One of the main advantage deriving from Tb-NB is the possibility to utilize its results as the input of post-hoc analysis aimed at observing how the quality associated to the different dimensions of a product or a service or, in a mirrored fashion, the different dimensions of customer satisfaction evolve in time or change with respect to different locations. The effectiveness of Tb-NB is evaluated analyzing data concerning the tourism industry and, specifically, hotel guests’ reviews from all hotels located in the Sardinian region and available on Booking.com. Moreover, Tb-NB is compared with other popular classifiers used in sentiment analysis in terms of model accuracy, resistance to noise and computational efficiency.

Cost-Utility Analysis of Pharmacogenetic Testing Based on CYP2C19 or CYP2D6 in Major Depressive Disorder: Assessing the Drivers of Different Cost-Effectiveness Levels from an Italian Societal Perspective

Background and Objectives

Major depressive disorder (MDD) is a common and severe psychiatric disorder that has enormous economical and societal costs. As pharmacogenetics is one of the key tools of precision psychiatry, we analyze the cost–utility of test screening of CYP2C19 and CYP2D6 for patients suffering from major depressive disorder (MDD) and try to understand the main drivers that influence the cost–utility.

Methods

We developed two pharmacoeconomic nonhomogeneous Markov models to test the cost–utility, from an Italian societal perspective, of pharmacogenetic testing genetic to characterize the metabolizing profiles of cytochrome P450 (CYP) 2C19 and CYP2D6 in a hypothetical case study of patients suffering from major depressive disorder (MDD). The model considers different scenarios of adjustment of antidepressant treatment according to the patient’s metabolizing profile or treatment over a period of 18 weeks. The uncertainty of model parameters is tested through both a probabilistic sensitivity analysis and a one-way deterministic sensitivity analysis, and these results are used in a post-hoc analysis to understand the main drivers of three alternative cost-effectiveness levels (“poor,” “standard,” and “high”). These drivers are first evaluated from an exploratory multidimensional perspective and next from a predictive perspective as the probability that a patient belongs to a specific cost-effectiveness level is estimated on the basis of a restricted set of parameters used in the original pharmacoeconomic model.

Results

The models for CYP2C19 and CYP2D6 indicate that screening has an incremental cost-effectiveness ratio of 60,000€ and 47,000€ per quality-adjusted life year (QALY), respectively. The probabilistic sensitivity analysis shows that the treatments are cost-effective for a 75,000€ willingness to pay (WTP) threshold in 58% and 63% of the Monte Carlo replications, respectively. The post-hoc analysis highlights the factors that allow us to clearly discriminates poor cost-effectiveness from high cost-effectiveness scenarios and demonstrates that it is possible to predict with reasonable accuracy the cost-effectiveness of a genetic test and the associated therapeutic pattern.

Conclusions

Our findings suggest that screenings for both CYP2C19 and CYP2D6 enzymes for patients with MDD are cost-effective for a WTP threshold of 75,000€ per QALY, and provide relevant suggestions about the most important aspects to be further explored in clinical studies aimed at addressing the cost-effectiveness of genetic testing for patients diagnosed with MDD.

Application of Eye Tracking Technology in Medicine: A Bibliometric Analysis

Eye tracking provides a quantitative measure of eye movements during different activities. We report the results from a bibliometric analysis to investigate trends in eye tracking research applied to the study of different medical conditions. We conducted a search on the Web of Science Core Collection (WoS) database and analyzed the dataset of 2456 retrieved articles using VOSviewer and the Bibliometrix R package. The most represented area was psychiatry (503, 20.5%) followed by neuroscience (465, 18.9%) and psychology developmental (337, 13.7%). The annual scientific production growth was 11.14% and showed exponential growth with three main peaks in 2011, 2015 and 2017. Extensive collaboration networks were identified between the three countries with the highest scientific production, the USA (35.3%), the UK (9.5%) and Germany (7.3%). Based on term co-occurrence maps and analyses of sources of articles, we identified autism spectrum disorders as the most investigated condition and conducted specific analyses on 638 articles related to this topic which showed an annual scientific production growth of 16.52%. The majority of studies focused on autism used eye tracking to investigate gaze patterns with regards to stimuli related to social interaction. Our analysis highlights the widespread and increasing use of eye tracking in the study of different neurological and psychiatric conditions.

Protocol for a pharmacogenetic study of antidepressants: characterization of drug-metabolizing profiles of cytochromes CYP2D6 and CYP2C19 in a Sardinian population of patients with major depressive disorder

The effectiveness of antidepressants shows high interindividual variability ranging from full symptomatologic remission to treatment-resistant depression. Many factors can determine the variation in the clinical response, but a fundamental role is played by genetic variation within the genes encoding for the enzymes most involved in the metabolism of antidepressant drugs: the CYP2D6 and CYP2C19 isoforms of the cytochrome P450 system. This study is poised to clarify whether the different metabolizing phenotypes related to CYP2D6 and CYP2C19 could have an impact on the clinical efficacy of antidepressants and whether the frequency of these phenotypes of metabolization shows differences in the population of Sardinian patients compared to other Caucasian populations. The sample is being recruited from patients followed-up and treated at the Psychiatric Unit of the Department of Medical Science and Public Health, University of Cagliari and the University Hospital Agency of Cagliari (Italy). The study design includes three approaches: (1) a pharmacogenetic analysis of 80 patients diagnosed with MDD resistant to antidepressant treatment compared to 80 clinically responsive or remitted patients; (2) a prospective arm (N = 30) of the study where we will test the impact of genetic variation within the CYP2D6 and CYP2C19 genes on clinical response to antidepressants and on their serum levels and (3) the assessment of the socio-economic impact of antidepressant therapies, and estimation of the cost-effectiveness of the pharmacogenetic test based on CYP genes.

Cost utility analysis of Remdesivir and Dexamethasone treatment for hospitalised COVID-19 patients - a hypothetical study

Background

Sars-Cov-2 is a novel corona virus associated with significant morbidity and mortality. Remdesivir and Dexamethasone are two treatments that have shown to be effective against the Sars-Cov-2 associated disease. However, a cost-effectiveness analysis of the two treatments is still lacking.

Objective

The cost-utility of Remdesivir, Dexamethasone and a simultaneous use of the two drugs with respect to standard of care for treatment Covid-19 hospitalized patients is evaluated, together with the effect of Remdesivir compared to the base model but based on alernative assumptions.

Methods

A decision tree for an hypothetical cohort of Covid-19 hospitalized patients, from an health care perspective and a one year horizon is specified. Efficacy data are retrieved from a literature review of clinical trials, whilst costs and utility are obtained from other published studies.

Results

Remdesivir, if health care costs are related to the days of hospitalization, is a cost saving strategy. Dexamethasone is cost effective with an ICER of <DOLLAR/>5208/QALY, and the concurrent use of Remdesivir and Dexamethasone is the most favorable strategy for higher level of willingness to pay thresholds. Moreover, if Remdesivir has a positive effect on mortality the utility is three times higher respect to base case. Whereas, if health care costs are not related to the length of patient hospitalization Remdesivir has an ICER respect to standard of care of <DOLLAR/>384412.8/QALY gained, which is not cost effective. We also find that Dexaamethasone is cost effective respect to standard care if we compute the cost for live saved with an ICER of <DOLLAR/>313.79 for life saved. The uncertainty of the model parameters is also tested through both a one-way deterministic sensitivity analysis and a probabilistic sensitivity analysis.

Conclusion

We find that the use of Remdesivir and/or Dexamethasone is effective from an economic standpoint.

On the Use of Markov Models in Pharmacoeconomics: Pros and Cons and Implications for Policy Makers

We present an overview of the main methodological features and the goals of pharmacoeconomic models that are classified in three major categories: regression models, decision trees, and Markov models. In particular, we focus on Markov models and define a semi-Markov model on the cost utility of a vaccine for Dengue fever discussing the key components of the model and the interpretation of its results. Next, we identify some criticalities of the decision rule arising from a possible incorrect interpretation of the model outcomes. Specifically, we focus on the difference between median and mean ICER and on handling the willingness-to-pay thresholds. We also show that the life span of the model and an incorrect hypothesis specification can lead to very different outcomes. Finally, we analyse the limit of Markov model when a large number of states is considered and focus on the implementation of tools that can bypass the lack of memory condition of Markov models. We conclude that decision makers should interpret the results of these models with extreme caution before deciding to fund any health care policy and give some recommendations about the appropriate use of these models.

The effect of single and repeated tDCS sessions on motor symptoms in Parkinson's disease: a systematic review

OBJECTIVES

to update understanding of the effectiveness of transcranial direct current stimulation (tDCS) on motor dysfunction in Parkinson's disease, since the last review was published in 2016.

METHODS

in order to identify suitable publications for inclusion, an online search of the Pubmed, Scopus and Cochrane databases was carried out. Searches of relevant full-text articles were performed through specific keywords. The final database check was performed in July 2019. Papers were restricted to studies investigating motor rehabilitative effects of tDCS in adult patients with Parkinson's disease. Studies involving either single or repeated tDCS sessions with a sham or controlled trial type design (which incorporated outcomes on motor performance measures) were considered. As studies varied widely in terms of methodology, a qualitative analysis of the selected studies was performed using the Newcastle-Ottawa Quality Assessment Scale or the Delphi list (depending on the study design).

RESULTS

twenty-nine studies were retained in this systematic review. Of the studies included, fifteen involved single tDCS session (patients = 256) and fourteen involved repeated tDCS sessions (patients = 294). Eight investigations of single tDCS and ten investigations of repeated tDCS demonstrated significant results. Studies involving multi- target stimulation demonstrated significant improvements on mobility (p=0.006), balance (by 50.9%), gait velocity (by 29%), fall reduction (p0.05) compared to mono-target stimulations.

CONCLUSIONS

despite increasing evidence that tDCS may improve motor symptoms, the results showed that fully optimized tDCS protocols are not yet established.

Adult separation anxiety differentiates patients with complicated grief and/or major depression and is related to lifetime mood spectrum symptoms

BACKGROUND

Increasing literature has been focused on complicated grief (CG) and its distinctiveness from other potentially loss related mental disorders such as major depression (MD). In this regard, symptoms of separation distress seem to play a key role. The aim of this study was to compare the clinical features of CG to those of MD and of CG+MD, with particular attention to separation anxiety.

METHODS

Fifty patients with CG (26 with and 24 without MD) and 40 with MD were consecutively recruited. Assessments included: SCID-I/P, Inventory of Complicated Grief (ICG), Adult Separation Anxiety Symptom Questionnaire (ASA-27), Work and Social Adjustment Scale (WSAS), Mood Spectrum-Self Report (MOODS-SR)-lifetime version.

RESULTS

Patients with MD reported significantly higher ASA-27 scores than patients with CG either alone or with MD. In all groups, ASA-27 total scores were significantly correlated with the MOODS-SR total scores and with those of its depressive component and rhythmicity domain. No significant differences were reported in the WSAS scores.

LIMITATIONS

Major limitations are the small sample size and the use of lifetime instruments.

CONCLUSIONS

Our results suggest a correlation between adult separation anxiety symptoms and lifetime mood spectrum symptoms both in patients with CG and MD. Further studies are needed to better understand the role of adult separation anxiety in the development of these disorders and for their nosographic autonomy as well.

A survey on virtual environment applications to fear of public speaking

BACKGROUND

Social Anxiety Disorder (SAD) is one of the most prevalent anxiety disorders in Europe and comprises the fear of public speaking as its typical sub-type. Cognitive-Behavioural Therapy (CBT) is the intervention of choice for SAD, and it includes exposure to anxiety-provoking stimuli to induce systematic desensitization and reduce anxiety. Similarly, exposure therapy per se has been used and found effective, although it is not as specific as CBT for the treatment of SAD. Interestingly, exposure to anxiety-provoking situations can be achieved in Virtual Environments (VEs) through the simulation of social situations allowing individuals with public speaking anxiety to live and develop real exposure-like reactions. The Virtual Reality Exposure Therapy (VRET) is the treatment of anxiety disorders based on such VEs.

AIM

This article aims to provide an overview of the scientific literature related to the applications of Virtual Reality to the treatment of fear of public speaking.

MATERIALS AND METHODS

We conducted the literature review on PubMed and Google Scholar for studies including the fear-of-public-speaking VEs.

RESULTS AND CONCLUSIONS

Reviewed studies addressed two main aspects: the design parameters of the VEs for adequate reactions to synthetic social stimuli, and the efficacy of VEs for fear of public speaking treatment. VEs resulted effective for triggering as-if-real reactions in relation to public speaking. VE-based exposures reduced public speaking anxiety measurements, decreased scores and maintained them at 3 month follow-up. Studies comparing VRET to pharmacological therapy are lacking, and there are few randomized controlled trials that compare VRET to CBT, especially on fear of public speaking treatment.

Cognitive, psychological and psychiatric effects of ionizing radiation exposure

Radiation exposure leads to an increased risk for cancer and, possibly, additional ill-defined non-cancer risk, including atherosclerotic, cardiovascular, cerebro-vascular and neurodegenerative effects. Studies of brain irradiation in animals and humans provide evidence of apoptosis, neuro-inflammation, loss of oligo-dendrocytes precursors and myelin sheaths, and irreversible damage to the neural stem compartment with long-term impairment of adult neurogenesis. With the present paper we aim to present a comprehensive review on brain effects of radiation exposure, with a special focus on its impact on cognitive processes and psychological functions, as well as on their possible role in the pathophysiology of different psychiatric disorders.

Subthreshold mood symptoms in patients with fibromyalgia and rheumatoid arthritis

OBJECTIVES

Although several findings have highlighted the prevalence of Axis I psychiatric disorders in fibromyalgia (FM) and rheumatoid arthritis (RA), very little information is available on the prevalence of subthreshold mood symptoms in these conditions. Therefore, we aimed at comparing the prevalence of subthreshold mood symptoms in rheumatic patients suffering from FM and RA. The hypothesis is that subthreshold mood symptoms are more represented in FM, given the evidence of higher rates of Axis I psychopathology in FM than in RA.

METHODS

Sixty patients suffering from FM and 50 from RA, assessed according to the American College of Rheumatology (ACR) criteria, selected in a Rheumatology Department, were included in the study. The subthreshold affective symptoms were assessed by means of the Mood Spectrum-Self Report (MOODS-SR).

RESULTS

The results showed that FM patients presented significantly higher scores than RA patients in 'mood depressive', 'cognition depressive' domains and in total depressive component.

CONCLUSIONS

The present study demonstrates that subthreshold depressive symptoms are more represented in FM than in RA patients. This fact could play a role in the worse quality of life and in the major perception of pain which characterises FM.

Lifetime post-traumatic stress symptoms are related to the health-related quality of life and severity of pain/fatigue in patients with fibromyalgia

OBJECTIVES

The aim of the present study was to investigate the impact of lifetime potentially traumatic events, including losses, and of post-traumatic stress symptoms on the severity of illness and health-related quality of life in patients with fibromyalgia (FM).

METHODS

Seventy patients with FM, diagnosed according to the American College of Rheumatology criteria, were consecutively enrolled at the Unit of Rheumatology of the University of Pisa, Italy. Assessments included: SCID-I/P; the Fibromyalgia Impact Questionnaire (FIQ) and the Medical Outcomes Study Short Form-36 Health Survey (MOS SF-36), for the severity of pain; the Health-Related Quality of Life (HRQoL); the Trauma and Loss Spectrum Self-Report (TALS-SR) life-time version.

RESULTS

The FIQ total score was related to the number of loss events (Domain I) and to symptoms of grief reactions (Domain II) and re-experiencing (Domain V) of the TALS-SR. The 'VAS fatigue' scores (FIQ) were significantly related to the TALS-SR symptoms of grief reactions (Domain II) and re-experiencing (Domain V). The Mental Component Summary and Bodily Pain scores of the MOS SF-36 were significantly related to all TALS-SR domains, the latter with the exception of the VIII (Arousal).

CONCLUSIONS

Our results corroborate the presence of a relationship between the lifetime exposure to potentially traumatic events, in particular loss events, and lifetime post-traumatic stress symptoms and the severity of illness and HRQoL in patients with FM.

Impact of traumatic loss on post-traumatic spectrum symptoms in high school students after the L'Aquila 2009 earthquake in Italy

BACKGROUND

On April 6th 2009, the town of L'Aquila, Italy, was struck by an earthquake (6.3 on the Richter scale) that lead large parts of the town to be destroyed and the death of 309 people. Significant losses in the framework of earthquakes have been reported as a major risk factor for PTSD development. Aim of this study was to investigate post-traumatic spectrum symptoms in a sample of adolescents exposed to the L'Aquila 2009 earthquake 21 months earlier, with particular attention to the impact of loss.

METHODS

475 students (203 women and 272 men), attending the last year of High School in L'Aquila, were assessed by: Trauma and Loss Spectrum-Self Report (TALS-SR) and Impact of Event Scale (IES). The presence of full and partial PTSD was also assessed.

RESULTS

72 students (15.2%) reported the loss of a close friend or relative in the framework of the earthquake. Full PTSD was reported by 146 (30.7%) students and partial PTSD by 149 (31.4%) students. There was a significant difference reported in PTSD between bereaved and non bereaved subjects. Significantly higher post-traumatic symptom levels were reported by bereaved subjects.

LIMITATIONS

The lack of information on the relationship with the deceased and the number of losses experienced, besides the use of self report instruments are the limitations of this study.

CONCLUSIONS

Our results show high rates of post-traumatic spectrum symptoms in adolescents who survived the L'Aquila earthquake. Having experienced the loss of a close friend or a relative in the framework of the earthquake seems to be related to higher PTSD rates and more severe symptomatology. These results highlight the need to carefully explore adolescents exposed to a significant loss as consequence of an earthquake.

Orthorexia nervosa in the general population: a preliminary screening using a self-administered questionnaire (ORTO-15)

OBJECTIVE

Orthorexia, from the Greek words orthos (straight, proper) and orexis (appetite), is a newly conceptualized disorder characterized by distorted eating habits and cognitions concerning supposedly healthy nutrition. In this article we present preliminary results of a wider research aimed to investigate the diffusion of Orthorexia in the general population and to highlight its characteristics and particularly the relationship with Eating Disorder and Obsessive-Compulsive Disorder.

METHOD

One-hundred and seventy seven adult subjects from the general population, were administered the ORTO-15 test, a selfadministered questionnaire specifically designed to assess orthorexic symptomatology; note that statistical analyses were repeated twice, referring to different diagnostic thresholds (40/35).

RESULTS

Orthorexia had a 57.6% prevalence in our sample, using the 40-point threshold, with a female/male ratio 2:1; the figure was sensibly lower with the 35-point threshold (21%).

CONCLUSION

The results of this study highlight the diffusion of Orthorexia which may constitute an important risk factor for mental and physical health, but also the opportunity of more specific diagnostic instruments, so to facilitate a thorough understanding of this disorder.

Gender differences in the correlations between cortisol levels or DHEA-S/cortisol ratio and panic-agoraphobic dimensions in healthy subjects

Introduction

A link between anxiety and disfunctions of the Hypotalamic-pituitary-adrenal (HPA) axis has been widely reported in both normal and pathological anxiety, but research findings are controversial.

Objectives

To explore gender differences in the relationships between cortisol and neurosteroids and subthreshold anxiety dimensions.

Aims

To investigate the possible correlations between serum cortisol and dehydroepiandrosterone sulphate (DHEA-S) levels, or DHEA-S/cortisol ratio, and the subthreshold panic dimensions in a sample of healthy subjects.

Methods

Forty-two Italian civilians, without current or lifetime psychiatry disorders, were recruited and assessed by means of the Structured Clinical Interview for DSM-IV (SCID-I/P) and a specific questionnaire, the so-called Panic Agoraphobic Spectrum-Self Report lifetime version (PAS-SR), for assessing subthreshold panic-agoraphobic dimensions.

Results

The results showed the presence of significant negative correlations between the cortisol levels and the total scores of the PAS-SR and of the following domains: separation sensitivity, panic like symptoms and medication/substance sensitivity. The PAS-SR total and the panic-like symptoms domain scores were related positively to the DHEAS/cortisol ratio. When the sample was distinguished in women and men, it turned out that this correlations were present only in women.

Conclusions

This findings would indicate that cortisol levels are related to subthreshold panic-agoraphobic symptoms, with a gender specificity. Therefore, further studies are needed to investigate those subthreshold conditions in order to indentify possible gender differences that may account for phenotypes at higher risk for psychiatric disorders.

Weekly topotecan as a salvage therapy in heavily pre-treated patients with recurrent platinum-resistant epithelial ovarian cancer

16076

Background: The prognosis of patients with recurrent epithelial ovarian cancer is extremely poor after several lines of chemotherapy; this situation becomes more and more difficult to manage in the presence of a platinum-resistance condition. Topotecan 1.5mg/m2 on days 1 through 5 of a 21-day cycle is often employed as a second-line chemotherapy also for platinum-resistant epithelial ovarian cancer. In this phase II study we investigated the safety as well response rate of weekly topotecan as a salvage therapy in heavily pretreated patients with recurrent platinum-resistant epithelial ovarian cancer (RprEOC). Methods: To be elegible for the study patients had to be considered resistant to platinum and paclitaxel pretreated. Eleven patients (median age 51 yrs, range 45 - 70) with performance status 0–2 affected by RprEOC with measurable disease, were planned to receive weekly topotecan. They had received at least 3 prior lines of chemotherapy. Topotecan was administered at the dose of 2.0 mg/m2 via a 30-minute i.v. infusion once every week until disease progression or unacceptable toxicity. Results: All patients were evaluable for toxicity and clinical response. All the 11 pts enrolled had stage III-IV disease. Median number of chemotherapy cycles was 5 (range 3 - 8). A total of 62 cycles were administered. Dose reduction was necessary for 12% of the cycles. Main toxicities included anemia (12%), leucopenia (18%), thrombocytopenia (15%) and asthenia (20%). No deaths were attributable to therapy. No one showed complete response, while two partial response (18.2%) and four stable disease (36.4%) were observed. Five pts (45.4%) progressed on therapy. The median progression-free interval was 13 weeks. Conclusion: Salvage therapy for patients with ovarian cancer who failed several platinum and paclitaxel treatments remains a therapeutic challenge. Topotecan administered at low weekly dosage (2.0 mg/m2) is an active option in the subset of heavily RprEOC and it seems also to be a more tolerable regimen compared to the classical 5-day schedule.

No significant financial relationships to disclose.

Detection of Bacillus species in selected meals from an apulian catering service

The authors have started a microbiological survey of the meals given in a factory canteen in the town of Bari with the evaluation of food contamination from the bacteria of the genus Bacillus. In the examined meals, all the detected Bacillus species have the potential to cause food-borne illnesses, even if the relatively low bacterial counts are not dangerous for healthy consumers. The study underlines the need of guidelines to enstablish which levels of food contamination are significant potential risks to all community catering service users.