Explore the vast range of titles available.

Telemedicine services can be classified into the macro-categories of specialist Telemedicine, Tele-health and Tele-assistance. From a regulatory perspective, in Italy, the first provision dedicated to the implementation of Telemedicine services is represented by the Agreement between the Government and the Regions on the document bearing “Telemedicine—National guidelines,” approved by the General Assembly of the Superior Health Council in the session of 10th July 2012 and by the State Regions Conference in the session of 20th February 2014. Scientifically, several studies in the literature state that information and communication technologies have great potential to reduce the costs of health care services in terms of planning and making appropriate decisions that provide timely tools to patients. Another clear benefit is the equity of access to health care. The evolution of telemedicine poses a series of legal problems ranging from the profiles on the subject of authorization and accreditation to those concerning the protection of patient confidentiality, the definition and solution of which, in the absence of specific regulatory provisions, is mainly left to the assessment of compatibility of the practices adopted so far, with the general regulatory framework. In terms of professional liability, it is necessary to first clarify that the telemedicine service is comparable to any diagnostic-therapeutic health service considering that the telemedicine service does not replace the traditional health service, but integrates the latter to improve its effectiveness, efficiency and appropriateness.

Background:Chronic pain and inflammation are common features of rheumatic conditions such as Psoriatic Arthritis (PsA) and Axial Spondyloarthritis (axSpA), often necessitating prolonged medication use for effective management. Maintaining drug retention is essential for achieving disease control and improving patients’ quality of life. In recent years, several studies have turned their attention to real-world scenarios, examining the extended-term usage of biologic disease-modifying antirheumatic drugs (bDMARDs) in spondyloarthritis; furthermore, the factors linked to the retention rate of bDMARDs in remain a pivotal question to be addressed.Objectives:This study investigates the influence of pain catastrophizing, a psychological response to pain, on the drug retention rates of PsA and axSpA patients.Methods:A two-year prospective multicenter observational study involved 135 PsA and 71 axSpA patients. To assess the drug discontinuation rate, any occurrence of withdrawal therapy and adverse events recognized or suspected as linked to therapies were recorded. Pain Catastrophizing, including its domains of Helplessness, Rumination, and Magnification, was assessed using the Pain Catastrophizing Scale (PCS). Univariable and multivariable regression analyses were utilized to identify factors associated with drug retention.Results:In the PsA group, patients who discontinued therapy early had higher baseline disease activity and a higher incidence of comorbid fibromyalgia. Notably, pain catastrophizing, specifically the domains of Helplessness, Magnification, and Rumination, were significantly elevated in PsA patients who interrupted their treatment. The univariable linear regression (Table 1) confirmed fibromyalgia comorbidity, corticosteroids assumption, Disease Activity for Psoriatic Arthritis (DAPSA) at baseline and PC levels as predictors for drug suspension within two years follow-up. Of note, the multivariable logistic regression (model adjusted for age, sex, DAPSA and corticosteroids use) showed significant relationship between PsA participants drug discontinuation and PCS (OR 1.04, 95% CI 1.004- 1.074, p=0.02), helplessness (OR 1.09, 95% CI 1.01-1.18, p=0.03), rumination (OR 1.10, 95% CI 1.01- 1.20), but not for magnification domain (OR1.15, 95% CI 0.97-1.36, p=0.09). In axSpA, drug discontinuation was more frequent among females, those with shorter disease duration, higher baseline disease activity, and elevated levels of pain catastrophizing. Of note, the univariable logistic regression (Table 2) established female gender, baseline Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), PCS and all its components helplessness, magnification, and rumination as disease predictor of treatment suspension before two years follow-up. However, limited events in axSpA patients precluded a multivariate analysis.Conclusion:Pain catastrophizing has emerged as a significant factor affecting drug retention in PsA and axSpA patients. The findings from the study discussed here shed light on the importance of assessing and addressing pain catastrophizing in clinical practice. By recognizing and intervening in the psychological aspects of pain, healthcare providers can contribute to better outcomes for patients with PsA and axSpA, ultimately improving their quality of life and overall well-being.Table 1.Two-year discontinuation (PsA participants)UnivariableIndependent variablesOR95%CIpFibromyalgia3.221.42-7.280.005CCS2.351.02-5.400.04TJ1.101.02-1.180.01PP1.091.00- 1.180.04PtGa1.31.12 1.49<0.0001DAPSA1.061.02 1.100.001PCS1.051.02 1.08<0.0001Helplessness1.121.05 1.190.001Rumination1.131.05 1.21<0.001Magnification1.221.05 1.420.009Table 2.Two-year discontinuation (AxSpA participants)UnivariableIndependent variablesOR95%CIpSex3.681.01 13.400.04BASDAI1.811.281398 2.5723260.001Asdas pcr2.491.304764 4.7234660.006PCS1.131.05533 1.202472<0.0001Helplessness1.241.092015 1.4093920.001Rumination1.251.07672 1.4577350.004Magnification1.351.024664 1.7890550.03REFERENCES:NIL.Acknowledgements:NIL.Disclosure of Interests:None declared.

Intersensory interactions predicted by the sensory precision hypothesis have been infrequently examined by distorting the reliability of size perception by touch. Consequently, participants were asked to see one size and manually feel another unseen size either with bare fingers or with fingers sleeved in rigid tubes to decrease the precision of touch. Their subsequent visual estimates of the perceived size favored the more precise modality. Experiment 1 (N = 46) varied the intersensory discordance to examine whether the estimate arose from trivial response biases or from perceptual binding effects. Experiment 2 (N = 32) examined the presence of the perceptual effect in the absence of discordant sensory cues. Results favored a perceptual interpretation because the haptic and visual cues merged regardless of the discordance amount only when the stimulation arose from separate sources. The observed interaction between touch imprecision and visual bias is consistent with computational models of optimal perception.

When do haptic estimates of discordant visual-haptic size capture vision? Observers looked at a square through a minifying lens (50%) whilst they simultaneously touched the square from below through a hand-concealing cloth. Their subsequent match of the square's size, rendered by touching a set of comparison squares, was haptically biased when they practised estimating the square's size (Experiment 1, N = 72), when they actively explored rather than passively touched the square (Experiment 2, N = 24), but not when they were uninformed before inspecting the square that they would estimate its size (Experiment 3, N = 36). Evidently, the haptic exploratory strategies occasioned by the practise influenced the integration of the felt size and the seen size by weighing the haptic input more than the visual input, and this weight shifting manifested itself by strengthening haptic capture. À quel moment les estimations haptiques de la taille lors d'une discordance visuelle-haptique capturent-t-elles la vision ? Des observateurs devaient regarder un carré à travers une lentille réductrice (50%) en touchant stimulanément le carré sous un linge cachant leur main. Leur comparaison subséquente de la taille du carré, réalisée en touchant une série de carrés de comparaison, fut haptiquement biaisée lorsqu'ils s'étaient exercés à estimer la taille du carré (Expérience 1, N = 72) et lorsqu'ils avaient exploré le carré activement plutôt que passivement (Expérience 2, N = 72), mais ce ne fut pas le cas quand ils n'étaient pas informés qu'ils devraient estimer le taille du carré avant de l'explorer (Expérience 3, N = 36). évidemment, les stratégies d'exploration haptique dues à la pratique ont influencé l'intégration des tailles senties et observées en accordant plus de poids à l'information haptique que visuelle, et cette asymétrie dans la pondération s'est manifestée par un renforcement de la capture haptique.

Earlier research on soldiers in war has focused mainly on the fighting effectiveness of soldiers in relation to their ideological orientations and primary group ties, but neglected to consider the impact of combat on the individual participant. The present study is an interpretive analysis of individual war experiences, based on published personal documents of Vietnam veterans. A review of the literature revealed evidence suggesting that many combatants had experienced a transformation of their personal identity. In social psychological terms, this change appeared to implicate the role of nonnormative social structures for identity formation and alteration. A systematic analysis of 18 first-person accounts of combat in Vietnam explored the hypothesis that combatants who either witnessed or participated in breaches of normative social structures would be unable to maintain a stable conception of their identity. In a quantitative content analysis, each document was scored on a set of analytic categories, defining grades of identity change and structural instability. The results supported the hypothesis (r =.76). The test-retest reliability of scores was assessed by a probabilistic model developed for this purpose, which may be an important contribution to the methodology for analyses of personal documents. In the second step, an interpretive analysis of the narrative material provided further support to the hypothesis. Ordering the documents in terms of the degree of identity change revealed four categories of self conceptions: the divided self, the reformed self, the unformed self, and the actualized self. When documents were ordered in terms of stability of social structure, four categories of experienced reality emerged: the formless structure, the vacillating structure, the hidden structure, and the normative structure. These two sets of categories were found to be highly correlated in the collection of documents. The relevance of these results for understanding personality in social structures was discussed. The issues addressed were (1) the theoretical significance of personal documents in synthesizing a \"Weltanschauung\" of war; (2) the empirical significance of ethnomethodology for investigating the hypothesis; (3) the methodological limitations of the study; and (4) its implications for the understanding of biographies in their social context.

Kim Worley and colleagues report the whole-genome sequence of the common marmoset, Callithrix jacchus , the first New World monkey to be sequenced. We report the whole-genome sequence of the common marmoset ( Callithrix jacchus ). The 2.26-Gb genome of a female marmoset was assembled using Sanger read data (6×) and a whole-genome shotgun strategy. A first analysis has permitted comparison with the genomes of apes and Old World monkeys and the identification of specific features that might contribute to the unique biology of this diminutive primate, including genetic changes that may influence body size, frequent twinning and chimerism. We observed positive selection in growth hormone/insulin-like growth factor genes (growth pathways), respiratory complex I genes (metabolic pathways), and genes encoding immunobiological factors and proteases (reproductive and immunity pathways). In addition, both protein-coding and microRNA genes related to reproduction exhibited evidence of rapid sequence evolution. This genome sequence for a New World monkey enables increased power for comparative analyses among available primate genomes and facilitates biomedical research application.

The Italian Dystonia Registry is a multicenter data collection system that will prospectively assess the phenomenology and natural history of adult-onset dystonia and will serve as a basis for future etiological, pathophysiological and therapeutic studies. In the first 6 months of activity, 20 movement disorders Italian centres have adhered to the registry and 664 patients have been recruited. Baseline historical information from this cohort provides the first general overview of adult-onset dystonia in Italy. The cohort was characterized by a lower education level than the Italian population, and most patients were employed as artisans, builders, farmers, or unskilled workers. The clinical features of our sample confirmed the peculiar characteristics of adult-onset dystonia, i.e. gender preference, peak age at onset in the sixth decade, predominance of cervical dystonia and blepharospasm over the other focal dystonias, and a tendency to spread to adjacent body parts, The sample also confirmed the association between eye symptoms and blepharospasm, whereas no clear association emerged between extracranial injury and dystonia in a body site. Adult-onset dystonia patients and the Italian population shared similar burden of arterial hypertension, type 2 diabetes, coronary heart disease, dyslipidemia, and hypothyroidism, while hyperthyroidism was more frequent in the dystonia population. Geographic stratification of the study population yielded no major difference in the most clinical and phenomenological features of dystonia. Analysis of baseline information from recruited patients indicates that the Italian Dystonia Registry may be a useful tool to capture the real world clinical practice of physicians that visit dystonia patients.

In 1992 the Japanese macaque was the first species for which the homology of the entire karyotype was established by cross-species chromosome painting. Today, there are chromosome painting data on more than 50 species of primates. Although chromosome painting is a rapid and economical method for tracking translocations, it has limited utility for revealing intrachromosomal rearrangements. Fortunately, the use of BAC-FISH in the last few years has allowed remarkable progress in determining marker order along primate chromosomes and there are now marker order data on an array of primate species for a good number of chromosomes. These data reveal inversions, but also show that centromeres of many orthologous chromosomes are embedded in different genomic contexts. Even if the mechanisms of neocentromere formation and progression are just beginning to be understood, it is clear that these phenomena had a significant impact on shaping the primate genome and are fundamental to our understanding of genome evolution. In this report we complete and integrate the dataset of BAC-FISH marker order for human syntenies 1, 2, 4, 5, 8, 12, 17, 18, 19, 21, 22 and the X. These results allowed us to develop hypotheses about the content, marker order and centromere position in ancestral karyotypes at five major branching points on the primate evolutionary tree: ancestral primate, ancestral anthropoid, ancestral platyrrhine, ancestral catarrhine and ancestral hominoid. Current models suggest that between-species structural rearrangements are often intimately related to speciation. Comparative primate cytogenetics has become an important tool for elucidating the phylogeny and the taxonomy of primates. It has become increasingly apparent that molecular cytogenetic data in the future can be fruitfully combined with whole-genome assemblies to advance our understanding of primate genome evolution as well as the mechanisms and processes that have led to the origin of the human genome.

Background The aim of this study was to evaluate the efficacy and safety of COVID-19 vaccines in patients undergoing haemodialysis in Italy compared to the general population. Methods In this cohort study, 118 dialysis centres from 18 Italian Regions participated. Individuals older than 16 years on dialysis treatment for at least 3 months, who provided informed consent were included. We collected demographic and clinical information, as well as data on vaccination status, hospitalisations, access to intensive care units and adverse events. We calculated the incidence, hospitalisation, mortality, and fatality rates in the vaccinated dialysis cohort, adjusted for several covariates. The incidence rates of infection in the dialysis cohort and the general population were compared through Standardised Incidence Rate Ratio. Results The study included 6555 patients vaccinated against SARS-CoV-2 infection according to the schedule recommended in Italy. Between March 2021 and May 2022, there were 1096 cases of SARS-CoV-2 infection, with an incidence rate after completion of the three-dose vaccination cycle of 37.7 cases per 100 person-years. Compared to the general population, we observed a 14% reduction in the risk of infection for patients who received three vaccine doses (Standardised Incidence Rate Ratio: 0.86; 95% Confidence Interval: 0.81–0.91), whereas no statistically significant differences were found for COVID-19-related hospitalisations, intensive care unit admissions or death. No safety signals emerged from the reported adverse events. Conclusions The vaccination program against SARS-CoV-2 in the haemodialysis population showed an effectiveness and safety profile comparable to that seen in the general population. Graphical abstract