Archivio Istituzionale della Ricerca - Università degli Studi di Pavia
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Is environmental sensitivity relevant to understand parenting? Observational studies with mothers of young children
No full textParents are everyday exposed to intense sensory and emotional stimuli. Hence, it is reasonable that the individual trait of Environmental Sensitivity (ES), capturing individual differences in sensitivity and responsivity to stimuli, holds important implications for parenting. Available evidence suggests that a higher sensitivity to stimuli in parents is mainly a risk factor, but studies are limited for the majority to self-report measures of parenting. Across two independent observational studies involving Italian parents, we investigated the role of ES in parenting during the first year of a child life. In Study 1 (N = 41 mothers and infants tracked from 3 to 9months), a higher ES initially linked to slightly higher parental intrusiveness at 3 months but shifted to less intrusive behaviors by 9 months. No other ES-parenting associations emerged. In Study 2 (N = 55 mothers of children aged 3 months old), findings showed that a higher ES was associated with less attuned parenting behaviors and more parental stress only in the copresence of parental adverse childhood experiences, with a vulnerability effect. In the same sample, a higher ES was associated with more adaptive parental responses to the child, particularly when respiratory sinus arrhythmia, capturing physiological self-regulation, was higher. To conclude, ES was not related to worse parental competences, but rather it made mothers more receptive to environmental (adverse childhood experiences) and inner physiological (respiratory sinus arrhythmia) factors, for better and for worse. We discuss implications for parenting programs and new direction of studies
Exploring the Impact of the Multimodal CAPABLE eHealth Intervention on Health-Related Quality of Life in Patients With Melanoma Undergoing Immune-Checkpoint Inhibition: Prospective Pilot Study
No full textBackground: Patients with melanoma receiving immunotherapy with immune-checkpoint inhibitors often experience immune-related adverse events, cancer-related fatigue, and emotional distress, affecting health-related quality of life (HRQoL) and clinical outcome to immunotherapy. eHealth tools can aid patients with cancer in addressing issues, such as adverse events and psychosocial well-being, from various perspectives. Objective: This study aimed to explore the effect of the Cancer Patients Better Life Experience (CAPABLE) system, accessed through a mobile app, on HRQoL compared with a matched historical control group receiving standard care. CAPABLE is an extensively tested eHealth app, including educational material, remote symptom monitoring, and well-being interventions. Methods: This prospective pilot study compared an exploratory cohort that received the CAPABLE smartphone app and a multisensory smartwatch for 6 months (intervention) to a 2:1 individually matched historical prospective control group. HRQoL data were measured with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 at baseline (T0), 3 months (T1), and 6 months (T2) after start of treatment. Mixed effects linear regression models were used to compare HRQoL between the 2 groups over time. Results: From the 59 eligible patients for the CAPABLE intervention, 31 (53%) signed informed consent to participate. Baseline HRQoL was on average 10 points higher in the intervention group compared with controls, although equally matched on baseline and clinical characteristics. When correcting for sex, age, disease stage, and baseline scores, an adjusted difference in fatigue of −5.09 (95% CI −15.20 to 5.02, P=.32) at month 3 was found. No significant nor clinically relevant adjusted differences on other HRQoL domains over time were found. However, information satisfaction was significantly higher in the CAPABLE group (β=8.71, 95% CI 1.54‐15.88, P=.02). Conclusions: The intervention showed a limited effect on HRQoL, although there was a small improvement in fatigue at 3 months, as well as information satisfaction. When aiming at personalized patient and survivorship care, further optimization and prospective investigation of eHealth tools is warranted
Erasmo promotore di collegi
No full textAffrontando il tema dell’educazione in età moderna è inevitabile rapportarsi con la figura e l’opera di Erasmo da Rotterdam poiché, come ricorda Eugenio Garin, «l’influenza erasmiana va a permeare ogni movimento di educazione e di cultura in Europa» . Per l’umanista olandese l’educazione rappresentò l’obiettivo dominante insieme a quello della pace che, derivati entrambi dall’ideale della philosophia Christi, sottese all’insieme dei suoi scritti fungendo da filo unificante
Pericapsular Nerve Group Versus Fascia Iliaca Compartment Block: Concerns About Integrity of Results From a Network Meta–Analysis
No full textIl suicidio assistito per pazienti con depressione grave. Un’opzione inaccettabile che gli psichiatri devono combattere fermamente
No full text: The debate on assisted suicide for patients suffering from severe depression raises complex issues spanning clinical, ethical, scientific, medico-legal, and cultural domains. This position paper asserts that such an option is unacceptable in the context of depressive illness, even in its most severe and treatment-resistant forms. Depression is not an irreversible or terminal condition: there are multiple therapeutic options available, including spontaneous and late remissions, and suicidal ideation must be seen as a core symptom of the disorder, not as a rational choice. Scientifically, there are no reliable biomarkers to define the "incurability" of depression, and prognosis is often uncertain. Ethically, the principle of non-maleficence prohibits physicians from contributing to a patient's death, while the vulnerability of individuals with severe depression impairs their decision-making capacity. From a medico-legal standpoint, it is extremely difficult to assess competence in such contexts with any degree of certainty. Culturally and symbolically, psychiatry must reaffirm its healing mandate and resist dangerous shifts that could legitimize stigma or suicidal contagion. In conclusion, psychiatrists cannot and must not adopt the role of facilitators of death. Instead, they are called to provide care, instil hope, and protect patients, even in the most challenging clinical scenarios
From Pregnancy to Breastfeeding: The Role of Maternal Exercise in Preventing Childhood Obesity
No full textLow adherence to healthy lifestyle behaviors during pregnancy and lactation is strongly associated with a higher risk of childhood obesity. This narrative review aims to elucidate and summarize the pivotal role played by physical activity (PA) during pregnancy and breastfeeding, highlighting the potential mechanisms linking PA in these periods to the prevention of childhood obesity. Maternal exercise during pregnancy and breastfeeding significantly reduces the risk of childhood obesity by enhancing fetal metabolism, supporting healthy maternal weight management, and promoting improved breastfeeding practices. Pregnancy and the postpartum period represent critical windows for implementing preventive strategies that benefit both the mother and child. Encouraging an active lifestyle during pregnancy and breastfeeding is a vital public health strategy with extensive benefits. Healthcare professionals play a crucial role in creating supportive environments and providing tailored guidance to empower mothers to engage in regular PA. This approach not only enhances individual health outcomes but also contributes to the broader goal of fostering healthier communities
Valorizzazione di biomasse di scarto per la preparazione di nuovi materiali per photoreforming e preconcentrazione di inquinanti emergenti
No full textTowards the Identification of Patients’ Needs for Promoting Robotics and Allied Digital Technologies in Rehabilitation: A Systematic Review
No full textBackground/Objectives: Robotic rehabilitation holds great potential for improving patient outcomes, but the integration of these technologies into clinical practice is hindered by a lack of comprehensive tools for assessing patients’ needs. This systematic review aimed to identify gaps in the current literature, with a focus on methodologies and tools for evaluating such needs, particularly those based on the International Classification of Functioning, Disability, and Health (ICF) framework. Methods: A systematic review of qualitative studies published between 2021 and 2023 was conducted, updating a previous (2020) review. Studies were identified through PubMed, Scopus, and Web of Science using inclusion criteria focused on qualitative methods capturing patients’ experiences with robotic and technological rehabilitation devices. Results: The review analyzed 19 new studies and 20 from the prior review, revealing a reliance on semi-structured interviews targeting small, heterogeneous populations. No studies employed standardized ICF-based tools, and gaps were noted in the exploration of conditions such as Parkinson’s disease, frailty, or conditions that allowed for multi-device experiences. Conclusions: The findings emphasize the necessity for tailored surveys grounded in the ICF framework to completely evaluate the needs of patients suffering from sensory, motor, and/or cognitive disorders caused by different health conditions. This work lays the foundation for more inclusive, effective, and patient-centered robotic rehabilitation strategies
Qualitative vs. quantitative morphology of seeds of an Italian critically endangered Hawkweed as predictor of germination capacity
No full textSeed phenotyping through non-destructive imaging techniques may be vital for obtaining seed quality and viability information, aiding in plant species conservation and de-extinction. We used X-ray microtomography followed by a germination test on a seed sample of the rare and threatened Hieracium australe subsp. australe to compare qualitative and quantitative morphological traits as predictors of germination capacity. Five qualitative classes based on embryo structure integrity were assigned; eighteen morphometric parameters were defined via 3D image analysis examining outer seed shape and internal embryo structure; “germinated,” “ungerminated” and “dead” outcomes were recorded. The multinomial logistic model applied to the qualitative classes allowed to correctly classify 72.7% of “germinated” seeds but failed to predict “ungerminated” and “dead” seeds. Univariate analysis of morphometric parameters showed no significant differences in mean values among the three germination outcomes. However, unsuccessful germination was associated with smaller seed size, increased pericarp thickness, and higher radicle-to-seed length ratio. Multivariate discriminant analysis of eleven uncorrelated morphometric parameters highlighted "mean embryo-pericarp distance" as indicative of germination capacity specific to Hieracium, while "embryo “porosity" and “embryo surface/volume ratio” were associated with “dead” seeds obtaining an overall correct classification of 72.7% of the “germinated” seeds and 70.0% of the “dead” ones
Dual targeting of cell-surface tumour antigens and soluble TGF beta by CAR-T cells – a novel approach to cancer immunotherapy
No full textLiver cancer is a significant public health concern worldwide, being one of the solid tumours that pose a major challenge (Villanueva A., 2019). According to projections by the International Agency for Research on Cancer (IARC), the number of cases is expected to reach approximately one million annually by 2025. The most prevalent type of primary liver cancer is Hepatocellular carcinoma (HCC), which accounts for around 90% of liver cancer cases. The Tumour Microenvironment (TME) of HCC is characterized by a complex interaction between the tumour and various components of the surrounding environment. This environment plays a crucial role in tumour initiation, growth, and treatment response. Various immune components, such as tumour-infiltrating lymphocytes (TILs), myeloid-derived suppressor cells (MDSCs), regulatory T cells (Tregs), and tumour-associated macrophages (TAMs), interact dynamically to monitor and fight tumours (Hao X. et al., 2021). However, this immune response is weakened by the presence of immunosuppressive cells like MDSCs, Tregs, and TAMs, and signalling molecules like Transforming Growth Factor beta (TGFb), which create an environment that suppresses the immune system, allowing the tumour to evade immune detection and progress (Chen C., Wang Z., Ding Y., Qin Y., 2023). The advent of effector immune cells (T or NK lymphocytes or macrophages) armed with chimeric antigen receptors (CAR) directed to tumour antigens have shown potential for cancer treatment, but still, their activity is transient and limited to several haematological tumours. In this research thesis, engineering Jurkat T cells with CARs directed against MICA and B7H6 tumour associated antigens in HCC and the expression of a secreted soluble anti TGF beta scFv aimed at neutralising TGF-beta present in the tumour microenvironment suggest possible ways of stopping TGF beta signalling and promoting T cell cytotoxicity in vitro. This new generation of CARs is referred to as ABCARs in this work and is projected to endow immune cells with long term anti-tumour activity in the case of solid tumours, which constitute the largest proportion (>90%) of human cancers. In this work, the immune effector T cells used, the Jurkats, were transduced with the lentiviral constructs and co-cultured with the target cancer cells were the HepG2. Investigating T cell activation, HepG2 mortality, cytokine release in co-cultures and TGF beta blocking activity were relevant in supporting the advantage of these constructs over conventional CARs as demonstrated in the results section.Il cancro al fegato rappresenta un grave problema di salute pubblica in tutto il mondo, essendo uno dei tumori solidi che rappresentano una sfida importante (Villanueva A, 2019). Secondo le proiezioni dell’Agenzia Internazionale per la Ricerca sul Cancro (IARC), il numero di casi dovrebbe raggiungere circa un milione all’anno entro il 2025. Il tipo più diffuso di cancro primario al fegato è il carcinoma epatocellulare (HCC), che rappresenta circa 90 casi. % dei casi di cancro al fegato. Il microambiente tumorale (TME) dell'HCC è caratterizzato da una complessa interazione tra il tumore e varie componenti dell'ambiente circostante. Questo ambiente svolge un ruolo cruciale nell’iniziazione, nella crescita e nella risposta al trattamento del tumore. Vari componenti immunitari, come i linfociti infiltranti il tumore (TIL), le cellule soppressorie di derivazione mieloide (MDSC), le cellule T regolatorie (Treg) e i macrofagi associati al tumore (TAM), interagiscono dinamicamente per monitorare e combattere i tumori (Hao X. et al., 2021). Tuttavia, questa risposta immunitaria è indebolita dalla presenza di cellule immunosoppressive come MDSC, Treg e TAM, che creano un ambiente che sopprime il sistema immunitario, consentendo al tumore di eludere il rilevamento e il progresso immunitario (Chen C., Wang Z., Ding Y., Qin Y., 2023). L’avvento di cellule immunitarie effettrici (linfociti T o NK o macrofagi) armate di recettori antigenici chimerici (CAR) diretti verso gli antigeni tumorali ha mostrato un potenziale per il trattamento del cancro, ma la loro attività è transitoria e limitata a diversi tumori ematologici. In questa tesi di ricerca, riporto come l'ingegneria delle cellule T Jurkat con CAR diretti contro gli antigeni associati al tumore MICA e B7H6 nell'HCC e l'espressione di un scFv anti TGF beta solubile secreto volto a neutralizzare il TGF-beta presente nel microambiente tumorale potrebbero suggerire possibili modi di fermare la segnalazione beta del TGF e promuovere la citotossicità delle cellule T in vitro. Questa nuova generazione di CAR viene denominata ABCAR in questo lavoro e si prevede che conferisca alle cellule immunitarie un'attività antitumorale a lungo termine nel caso dei tumori solidi, che costituiscono la percentuale maggiore (>90%) dei tumori umani. In questo lavoro, le cellule T effettrici immunitarie utilizzate erano le Jurkat, che sono state trasdotte con i costrutti lentivirali, mentre le cellule tumorali bersaglio erano le HepG2. Lo studio dell'attivazione delle cellule T, della mortalità dell'HepG2, del rilascio di citochine nelle co-colture e dell'attività beta bloccante del TGF sono stati rilevanti nel supportare la mia ipotesi, come dimostrato nella sezione dei risultati