IRIS Università degli Studi dell'Aquila
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C-Reactive Protein elevation and subsequent atrial fibrillation detection after ischemic stroke treated with mechanical thrombectomy: an inverse probability weighting analysis
No full textBackground and aims: Mechanical thrombectomy (MT) is an effective treatment for acute ischemic stroke due to large vessel occlusion (LVO). Atrial fibrillation (AF) can be known before the stroke (or prevalent AF) or be newly detected after stroke (post-stroke AF). Inflammation plays a critical role in the pathogenesis of post-stroke AF making inflammatory markers valuable for early detection of post-stroke AF. This study investigated the predictive value of C-reactive protein (CRP) and other inflammatory biomarkers in predicting post-stroke AF in acute ischemic stroke patients treated with MT. Methods: This observational multicentre retrospective cohort study included 849 patients with anterior circulation LVO treated with MT across four centres from 2016 to 2023. Patients were divided into post-stroke AF and NO-AF groups, excluding those with prevalent AF. Baseline demographics, clinical and procedural variables, and inflammatory biomarkers, including CRP, were collected at admission and 24 hours post-procedure. Baseline characteristics were balanced using inverse probability weighting (IPW). Logistic regression and receiver operating characteristic (ROC) analyses assessed the predictive value of CRP for post-stroke AF. Results: The study included 849 patients with a median age of 66 years (IQR 54-76) and 477 (56.2%) were female. Post stroke AF was detected in 186 (21.9%) patients while 663 (78.1%) did not experience AF during admission. In the weighted population CRP levels, both admission and 24 hours post-procedure, were higher in post-stroke AF patients. In logistic regression analysis admission and 24-h CRP levels were associated with increased probability of post-stroke AF, respectively (OR 1.01; 95% CI 1.00-1.03, p<0.001) and (OR 1.02, 95% CI 1.01-1.03, p < 0.001) following MT. We observed that the model combining age, sex, hypertension, heart failure, alcoholism, coronary artery disease, diabetes mellitus, smoking, previous TIA and ischemic stroke and admission CRP (AUC 0.723, 95% CI 0.71-0.74) and 24h CRP (AUC 0.704, 95% CI 0.69-0.72) had good predictive accuracy, with optimal cutoff values of 4.25 for admission CRP and 14.69 for 24-h CRP to detect post-stroke AF. Subgroup analysis indicated CRP predictive relevance, particularly in hypertensive patients. Conclusions: Our findings suggest CRP is associated with post-stroke AF in stroke patients due to LVO, highlighting inflammation's role in AF pathogenesis. Measuring CRP at admission and 24 hours may enable early detection and timely anticoagulation. Incorporating CRP into clinical pathways could improve individualized risk assessment, warranting further studies to validate its predictive utility and explore additional markers
Isolation of Actinobacteria from Date Palm Rhizosphere with Enzymatic, Antimicrobial, Antioxidant, and Protein Denaturation Inhibitory Activities
Get PDFArid ecosystems constitute a promising source of actinobacteria producing new bioactive molecules. This study aimed to explore different biological activities of actinomycetes isolated from the rhizosphere of Phoenix dactylifera L. in the Ghardaia region, Algeria. A total of 18 actinobacteria were isolated and studied for their enzymatic and antimicrobial activities. All isolates shared cellulase and catalase activity; most of them produced amylase (94%), esterase (84%), lecithinase and lipoproteins (78%), caseinase (94%), and gelatinase (72%). The isolates could coagulate (56%) or peptonize (28%) skim milk. Overall, 72% of the isolates exhibited significant antibacterial activity against at least one test bacteria, while 56% demonstrated antifungal activity against at least one test fungi. Based on enzyme production and antimicrobial activity, isolate SGI16 was selected for secondary metabolite extraction by ethyl acetate. The crude extract of SGI16 was analyzed using DPPH and BSA denaturation inhibition tests, revealing significant antioxidant power (IC50 = 7.24 ± 0.21 μg mL-1) and protein denaturation inhibitory capacity (IC50 = 492.41 ± 0.47 μg mL-1). Molecular identification based on 16S rDNA analysis showed that SGI16 belonged to the genus Streptomyces. The findings highlight that date palms' rhizosphere actinobacteria are a valuable source of biomolecules of biotechnological interest
How Do the Timing of Early Rehabilitation Together with Cognitive and Functional Variables Influence Stroke Recovery? Results from the CogniReMo Italian Multicentric Study
Get PDFShort-term effectiveness of guselkumab in psoriatic arthritis patients and axial involvement: results from a real-life multicentre cohort
Get PDFObjective: To evaluate the short-term effectiveness of guselkumab in patients with psoriatic arthritis (PsA) and suggestive features of axial involvement in a prospective "real-life" multicentre cohort. Methods: Between June 2022 and June 2023, PsA patients with axial involvement were evaluated if treated at least for 4 months with guselkumab. The effectiveness was evaluated by BASDAI, ASDAS, DAPSA, and achievement of BASDAI ≤ 4, also exploiting predictive factors. In a group of patients, MRI findings on sacroiliac joints were assessed before and after guselkumab administration. Results: Sixty-seven patients with PsA and suggestive features of axial involvement (age 53.4 ± 11.2 years, male sex 26.9%) were treated with guselkumab. After 4 months, a significant reduction of BASDAI, ASDAS, and DAPSA was observed. A ΔBASDAI of -2.11 ± 0.43 was estimated assessing the mean difference values before and after guselkumab administration and 52.2% of patients reached a BASDAI ≤ 4. In 27 patients, MRI findings on sacroiliac joints were assessed before and after guselkumab administration. A reduction of 0.80 or larger of the sacroiliac joint lesion score was observed in the majority of patients (70.3%) based on MRI improvements, paralleling with the clinical response.No life-threatening side effects were recorded; 17.9% of patients reported minor adverse events mainly injection site reactions. Conclusions: The short-term effectiveness of guselkumab in patients with PsA and suggestive features of axial involvement was shown. Although further studies are needed, our multicentre "real-life" study may suggest the clinical usability of guselkumab in this context
An Optimal Algorithm for Geodesic Mutual Visibility on Hexagonal Grids
No full textFor a set of robots (or agents) moving in a graph, two properties are highly desirable: confidentiality (i.e., a message between two agents must not pass through any intermediate agent) and efficiency (i.e., messages are delivered through shortest paths). These properties can be obtained if the Geodesic Mutual Visibility (GMV) problem is solved: oblivious robots move along the edges of the graph, without collisions, to occupy some vertices that guarantee they become pairwise geodesic mutually visible. This means there is a shortest path (i.e., a “geodesic”) between each pair of robots along which no other robots reside. In this work, we optimally solve GMV on finite hexagonal grids Gk. This, in turn, requires first solving a graph combinatorial problem, i.e. determining the maximum number of mutually visible vertices in Gk
Engineering Digital Systems for Humanity: a Research Roadmap
Get PDFAs testified by new regulations like the European AI Act, worries about the human and societal impact of (autonomous) software technologies are becoming of public concern. Human, societal, and environmental values, alongside traditional software quality, are increasingly recognized as essential for sustainability and long-term well-being. Traditionally, systems are engineered taking into account business goals and technology drivers. Considering the growing awareness in the community, in this paper, we argue that engineering of systems should also consider human, societal, and environmental drivers. Then, we identify the macro and technological challenges by focusing on humans and their role while co-existing with digital systems. The first challenge considers humans in a proactive role when interacting with digital systems, i.e., taking initiative in making things happen instead of reacting to events. The second concerns humans having a reactive role in interacting with digital systems, i.e., humans interacting with digital systems as a reaction to events. The third challenge focuses on humans with a passive role, i.e., they experience, enjoy or even suffer the decisions and/or actions of digital systems. The fourth challenge concerns the duality of trust and trustworthiness, with humans playing any role. Building on the new human, societal, and environmental drivers and the macro and technological challenges, we identify a research roadmap of digital systems for humanity. The research roadmap is concretized in a number of research directions organized into four groups: development process, requirements engineering, software architecture and design, and verification and validation
Asymptotic results for dynamic contagion processes with different exciting functions and application to risk models
Get PDFA class of point processes is introduced, the so-called dynamic contagion processes having different exciting functions. This is a generalization of that of Hawkes processes as well as of Cox processes with Poisson shot-noise intensity. To define this class the cluster form representation is considered in a way such that the intensity function captures both the self-excited and externally excited jumps by using different exciting functions, that allows us to describe different generations of offspring. For this generalized class, we investigate some asymptotic behaviors such as the Law of Large Numbers, the Central Limit Theorem and the Large Deviation Principle. An application associated with risk models is also discussed under the assumption that the dynamics of contagion claims arrivals have different exciting functions
Constructivist approach in genetic counseling: medical, psychological and familiar implications into patient-centered approach
Get PDFAim of the present Doctoral thesis entitled ‘Constructivist approach in genetic counseling: medical, psychosocial and familiar implications into patient-centered approach’ was to investigate the scientific landscape of the role of biopsychosocial approaches in the context of genetic counseling.
The thesis is articulated in 2 parts: theoretical and scientific sections.
The Theoretical Section exploited the research perspective in the genetic counseling pointing out the focus how to put the discoveries from genetic research to use in healthcare. Aim was to describe the produced potential new ways of predicting risk, of diagnosis, and disease prevention and treatment. Particularly, the genetic counseling process was analyzed in its several aspects:
- providing information about test options
- assessing psychological well-being
- helping patients and families communicate about genetic risk
- facilitating adaptation to grief and loss, interpreting results
- assisting with decision-making and referrals
The application of the biopsychosocial model seems essential in the context of genetic counseling: health as the result of multiple interacting biological, psychological, and social factors, and recognizes that behavior can be explained in terms of multiple contexts or levels of organization that mutually influence each other.
Considering the genetic counseling might ask for individual adaptive dynamics, psychological distress seemed to be a matter of debate that was the starting point of experimental investigation of the thesis.
The Scientific Section was structured on three studies based on the primary endpoint to contribute to model the psychological and behavioral implications to boost the efficiency of genetic counseling by multidisciplinary approach. Aim of Scientific Section was to highlight the relevance of clinical setting based on a patient-centered approach, tailoring clinical practice on the integration of physical, mental, and social factors to patients’ and relatives’ wellbeing, to enhance healthcare and patient lives. Scope was to investigate the genetic counseling impact in the disclosure toward to health management and Quality of Life of patients.
During the PhD program n.3 studies have been conducted as follow:
Study 1. BRCA genetic result disclosure for women with breast cancer: influence of +/- predisposition genetic mutation (observational study design)
Study 2. Patient perspective in perceived comparative genetic mutation risk: an exploratory review (review study design)
Study 3. Perceived cancer risk and genetic counselling: a biopsychological perspective to boost lifestyle medicine (observational study design)
General objective of observational studies (n.1 and n.3 of the above list) was to examine a) the psychological impact of disclosure of BRCA genetic result, b) the emotional health of patients and, c) the role of cancer worry in the psychological dimensions of patients undergoing genetic testing
The mediating role of affect in the association between parent attachment and moral disengagement. A cross-sectional study in adolescence
No full textThe current study explored the association between parent attachment and moral disengagement, addressing the mediating effects of affect (i.e. positive affect, negative affect, and social safeness). Through a cross-sectional design, the research was carried out with 410 participants (meanage = 15.35 years, SDage = 1.10 years; rangeage = 14–17 years) whose 199 (48.5%) were girls and the remaining 211 (51.5%) were boys. Participants performed the Inventory of Parent and Peer Attachment (IPPA), the Positive and Negative Affect Schedule (PANAS), the Social Safeness and Pleasure Scale (SSPS), and the Moral Disengagement Scale (MDS). The results revealed that parent attachment affected adolescents’ moral disengagement through the mediating effect of all facets of affects, including positive affect, negative affect, and social safeness. These findings provide new insights into the mechanisms linking parent attachment and adolescents’ disposition toward moral disengagement. Based on these findings, a key recommendation is the implementation of family-based interventions that enhance secure parent-child attachment, as this may serve as a protective factor against moral disengagement in adolescents. Limitations and future research directions are discussed