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Background: Chronic pain is an unpleasant sensory and emotional experience that greatly affects functioning and well-being. Studies link chronic pain and violence against women, with an odds ratio of 2.08 and a 26% prevalence rate. The bio-psycho-social consequences reduce quality of life and cause disability. Despite extensive research, the etiology remains unclear. This study investigates the bio-psycho-social risk factors of chronic pain in women, both victims and non-victims of violence. Methods: A case–control study (December 2023–June 2024) used odds ratios and Fisher’s exact test to explore risk factors associated with chronic pain. Univariate logistic regressions identified significant predictors. Results: The study included 170 women (68 victims), half with chronic pain. Nine risk factors were specific to victims (three biological, six psycho-social), four to non-victims (two biological, two psycho-social), and twenty-three to all women (five biological, eighteen psycho-social). A four-factor model best explained risk in victims and all women, while a two-factor model fit non-victims. Conclusions: The bio-psycho-social model of chronic pain is supported, identifying specific risk factors. These findings can aid anti-violence and healthcare professionals in screening and early intervention.

The impact of male aging on male fertility has only recently become of interest to the scientific community. This study aims to assess the relationship between age and fertility among a sample of men, considering the individual and pathological characteristics. In this retrospective study data of semen analysis and medical history of 1294 Italian male patients were considered. Semen analysis was performed by light microscopy and transmission electron microscopy mathematically elaborated. A generalized linear model was used to explore the influence of male age on semen quality, considering as confounders wine consumption, smoking habits, presence of varicocele, consanguinity and positive semen bacteriological analysis and urethral swab. The mean age of the participants was 36.41 ± 6.379. Male aging without impact of confounders was correlated with a decrease in sperm concentration and motility and an increased in sperm necrosis. Sperm concentration and progressive motility were negatively related to the presence of confounders as wine consumption (sperm motility), urogenital infection (sperm concentration and motility), varicocele (sperm concentration) and consanguinity (sperm motility). Urogenital infection, varicocele and consanguinity positively correlated with sperm necrosis. The most important finding was the observation of a negative effect of male aging on sperm parameters such as concentration, motility, and viability. It is possible to hypothesize age-dependent changes of testicular environment, probably related to reactive oxygen species production. The demonstration, in a large sample of patients, that aging influences sperm quality strongly motivates further research focused on the mechanisms involved in this phenomenon and its effects on offspring fitness.

IntroductionThe ‘Hikikomori’ syndrome (HS) consists of prolonged and severe social withdrawal. It has been studied first in Japan and recently has increasingly drawn the attention of researchers and clinicians all over the world. It is unclear whether it exists in other cultural contexts than Asia. The existing systematic reviews did not provide a quantitative synthesis on its prevalence. In addition, a summary of the co-occurring rates of psychiatric disorders is lacking. To provide a more comprehensive understanding of the clinical picture, it seems important to investigate which psychiatric disorders listed in the classification systems are most frequently associated with this psychological condition affecting young people. This paper describes a systematic review and meta-analysis protocol summarising worldwide prevalence of the HS in general population and clinical samples with psychiatric disorders. The review will also assess the co-occurrence between HS and each psychiatric disorder defined by any version of the Diagnostic and Statistical Manual of Mental Disorders (DSM) or International Classification of Diseases (ICD) in any clinical samples with psychiatric disorders.Methods and analysisA systematic review will be conducted according to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Studies will be included if they use youth aged 12–35 years, recruited from general population or population with psychiatric disorders, if they use international criteria to diagnose HS. No restriction about design or language will be applied. The search will be conducted during the first week of November 2019 by two independent reviewers through the databases Scopus, PubMed, PsycINFO, Web of Science, by examining study references, by looking for conference proceedings/dissertations/theses, by contacting study corresponding authors. Random-effect meta-analysis will be performed by computing effect sizes as logit event rates. Study quality will be assessed through the Newcastle-Ottawa Scale.Ethics and disseminationThe current review does not require ethics approval. The results will be disseminated through conference presentations and publications in peer-reviewed journals.PROSPERO registration numberCRD 42018098747.

Violence against women is a phenomenon that involves at least 35% of women worldwide. Violence can be sexual, physical, and/or psychological, perpetrated by the partner, another family member, or a stranger. Violence is a public health problem because its consequences include higher morbidity, higher mortality, and short and long-term physical and psychological health diseases. Most studies prove an association between any type of violence and some chronic pain diagnoses but no one has done a complete collection of this evidence. This systematic review and meta-analysis aimed to evaluate whether this association is statistically significant, including the largest number of studies. Through the inclusion of 37 articles, the association has been demonstrated. Compared with no history of violence, women who did experience violence showed 2 times greater odds of developing chronic pain. The impact of violence was significant also on fibromyalgia separately, but not on pelvic pain. PROSPERO registration PROSPERO CRD42023425477.

ObjectiveThe study was aimed to compare the impact of thumb base osteoarthritis (TBOA) on pain, function, and quality of life in patients with erosive or non-erosive hand osteoarthritis (HOA).MethodsThis observational retrospective study included 232 patients: 64 with erosive HOA (EHOA) and concomitant TBOA, 36 with isolated EHOA, 97 with non-erosive HOA (non-EHOA) and TBOA, and 35 with isolated non-EHOA. Hand pain by a visual analogue scale (VAS), Functional Index for Hand Osteoarthritis (FIHOA) score, Health Assessment Questionnaire (HAQ), the Medical Outcomes Study 36-Item Short Form (SF-36), and the possible correlations between VAS and FIHOA with radiological score were assessed.ResultsNo differences were found between EHOA with TBOA and isolated EHOA in VAS and FIHOA scores; opposite, there was a significant difference in VAS (p < 0.01) and FIHOA (p < 0.001) between subjects with non-EHOA and TBOA and patients with only non-EHOA. VAS and FIHOA values resulted slightly higher in patients with EHOA and TBOA vs non-EHOA and TBOA; they were significantly more elevated in EHOA and TBOA group compared to isolated non-EHOA (p ≤ 0.001) and in isolated EHOA vs isolated non-EHOA (p < 0.01 and p < 0.001, respectively). HAQ, SF-36 resulted significantly better in isolated non-EHOA patients compared to the other groups. Finally, we observed a significant correlation between FIHOA and all the Kallman scales in EHOA patients with TBOA and between FIHOA and Kallman’s thumb score in non-EHOA-TBOA group.ConclusionsEHOA has a more severe clinical burden than non-EHOA; the presence of TBOA appeared an important determinant of pain and disability in non-EHOA.Key Points• Each subset of HOA can have a different impact on pain and functionality, with EHOA determining more severe effects on hand symptoms and disability than non-EHOA.• The presence of TBOA appeared an important determinant of pain and disability in non-EHOA, but not in EHOA.• Our findings support the need for an individualized therapy for each phenotype of hand osteoarthritis.

Background The rapid digital transformation of healthcare organizations requires the acquisition of not only clinical but also digital and telemedicine competencies, starting from the academic path. However, despite the emergence of global and national initiatives, the integration of digital health training into medical education remains inconsistent. Objectives Through a multicentric study, this research aimed to (i) investigate the digital and eHealth literacy profiles among medical students and residents, (ii) assess their experiences, attitudes, and intentions toward telemedicine, and (iii) identify determinants of interest in future telemedicine utilization, focusing on the interplay between technical, behavioral, and educational factors. Methods A cross-sectional web-based survey was conducted (July 2024–February 2025) across five Italian universities. The survey explored two components of the readiness of future physicians, technical and behavioural. For the technical readiness, items from the IT-eHEALS scale and the DIGCOMP framework were included. Data were analyzed using nonparametric tests, random forest modeling, and multivariable logistic regression to identify predictors of telemedicine readiness. Results A total of 438 participants (285 students, 153 residents; 62% female) completed the survey. While 68% had heard of telemedicine, only 22% reported personal experience and 13% academic exposure. Most respondents expressed strong interest in telemedicine (83%) and a desire for specific training (83%). eHealth literacy was moderate-to-high (mean IT-eHEALS = 25.9 ± 5.6), though higher-order evaluative skills showed variability across institutions. Logistic regression identified technology enthusiasm (OR = 4.76; p  = 0.001), smartphone confidence (OR = 3.20; p  = 0.015), and eHEALS score ( p  = 0.050) as independent predictors of telemedicine readiness, with a significant interaction between enthusiasm and confidence ( p  = 0.021). Conclusions Medical trainees show high motivation but uneven preparedness for telemedicine in practice. Educational reforms should embed structured, longitudinal digital-health training that combines technical proficiency with critical, ethical, and behavioral competencies. Strengthening digital readiness at all stages of medical education is essential to prepare physicians for technology-enabled, patient-centered healthcare.

Obsessive-compulsive disorder (OCD) is a seriously impairing psychiatric condition that affects 1%-3% of youth. Investigating the quality of life (QOL) is an important issue for treatment planning of this disorder, as targeting symptoms without taking it into account may bias assessment and prognosis when the patient presents with reduced symptoms that do not correspond to improved QOL. However, QOL in young individuals with OCD has been understudied. This meta-analysis summarized current evidence that assessed differences in global, social and school QOL dimensions, between children/adolescents with OCD and screened controls. Age, sex and OCD severity were examined as moderators. Case-control studies were included if children/adolescents with primary OCD were compared with screened controls on validated self-reported QOL outcomes. Online databases (January 1966-January 2016) were searched. Five case-control studies were included (n=543, 17 effect sizes overall). On global QOL, a large effect size emerged ( =-1.16, <0.001), suggesting that individuals with OCD had lower global QOL than controls. Moderate effect sizes emerged for school ( =-0.61, <0.01) and social QOL ( =-0.54, <0.01), respectively, indicating worse QOL on these domains for individuals with OCD. For samples with higher OCD severity, global QOL of individuals with OCD was lower than that for controls ( =-0.02, <0.05). For samples with lower percentages of females, global QOL of individuals with OCD was more impaired ( =0.02, <0.001). Age was not correlated with effect sizes. Assessment and treatment should target QOL for young males suffering from more severe OCD. The small number of included studies highlighted that QOL is under-recognized. Future research should focus on additional QOL domains and compare which ones are impaired among individuals with OCD compared with other psychiatric conditions. Overall, the results pointed out the importance of addressing QOL in both practice and research on assessment and treatment of children/adolescents with this condition.

IntroductionObsessive-compulsive disorder (OCD) is a mental health condition associated with severe impairment in a variety of quality of life domains, an increased physical health burden, and a higher risk of general medical conditions and mortality compared with the general population. While there is a large amount of literature on psychological quality of life, a systematic review of perceived physical health in OCD is lacking. A quantitative summary might suggest that policy makers also focus the evaluation on perceived physical health and develop new strategies also aimed at this outcome. The current paper presents a protocol for the first systematic review and meta-analysis aimed at summarising perceived physical health in OCD by specifically examining perceived physical health status, bodily pain and role limitations due to physical problems in patients with OCD compared with controls. The review will also investigate potential demographic and clinical moderators of perceived physical health status (age, gender, OCD severity, publication date, methodological quality).Methods and analysisA systematic review and meta-analysis will be conducted according to PRISMA guidelines. Studies will be included if using a clinical group with a current primary diagnosis of OCD established by international standardised criteria, if measuring perceived physical health status, and if using screened or community participants as controls. No publication date or language restriction will be applied. An online systematic search of electronic databases (Scopus, PubMed, PsycINFO, EMBASE, Cochrane Library), and examination of conference proceedings and theses/dissertations will be conducted by independent reviewers. Risk of bias will be assessed through the Newcastle-Ottawa Scale.Ethics and disseminationThe current review does not require ethics approval. The results will be disseminated through publications in peer-reviewed journals.PROSPERO registration number2018 CRD42018106194.

Violence against women impacts a minimum of 35% of the global female population, encompassing sexual, physical, and psychological forms. Perpetrators of this violence include partners, family members, or strangers. Its ramifications are substantial, evident in the prevalence of chronic pain reported by between 48% and 84% of women who have experienced abuse, with an odds ratio of 2.08. Notably associated diagnoses include pelvic/vaginal pain, fibromyalgia, irritable bowel syndrome/bowel symptoms, abdominal pain, migraine/headache, and back and neck pain. These diagnoses significantly limit a woman’s ability to participate in daily activities, such as exercising or working, leading to genuine disability. Despite substantial evidence, the precise cause and etiology of these conditions remain unclear. Adhering to the bio-psycho-social model, it is conceivable that chronic pain in victims of violence cannot be attributed to a single factor alone, but rather to a combination of all three: biological, psychological, and social factors. Uncovering these factors could have significant clinical and legal implications. On one hand, it would be possible to conduct screenings to avoid developing chronic pain. and guide individuals toward the correct treatment. On the other hand, victims could seek compensation for chronic pain resulting from violence. Considering the limited knowledge about the causes of chronic pain and the absence of tools to identify risk factors or a set of tests for evaluating victims of violence, the goal of the research described in this project protocol is to pinpoint the specific contributing factors for chronic pain due to violence victimization. Additionally, it aims to devise a comprehensive protocol for assessing these factors in forensic science.

Obsessive-compulsive disorder (OCD) is one of the leading causes of disability and reduced quality of life (QOL), with impairment in a number of domains. However, there is a paucity of literature on the association between severity of OCD symptoms and QOL, and the data that do exist are inconsistent. In addition, the role of severity in QOL has not been summarized as yet from a cross-generational perspective (ie, across childhood/adolescence and adulthood). Through meta-regression techniques, the current study summarized evidence about the moderator role of severity of OCD symptoms on differences in global QOL between individuals with OCD and controls. Online databases were searched, and cross-sectional case-control studies comparing participants of all ages with OCD with controls on self-report QOL measures were included. Random-effect meta-regression techniques were used to comment on the role of illness severity in global QOL in individuals with OCD. Thirteen studies were included. A positive significant association emerged between OCD severity and effect sizes on global QOL: in samples with higher severity, there were narrower differences in QOL between patients with OCD and controls than in samples with lower severity. Such positive association was confirmed by a sensitivity analysis conducted on studies including only adults, where the difference in QOL ratings between patients and controls was significantly narrower when OCD severity was higher. Conversely, a negative association between severity and QOL was found in those studies including only children/adolescents, where the difference in QOL was significantly larger between patients and controls when OCD severity was higher. QOL remains an important issue to address in the management of OCD in all age groups, irrespective of illness severity. Even in those with lower severity ratings, QOL may be considered as an important marker of treatment response.