Implications of disease-modifying therapies for multiple sclerosis on immune cells and response to COVID-19 vaccination.

Introduction: Disease-modifying therapies (DMTs) have been shown to improve disease outcomes in multiple sclerosis (MS) patients. They may also impair the immune response to vaccines, including the SARS-CoV-2 vaccine. However, available data on both the intrinsic immune effects of DMTs and their influence on cellular response to the SARS-CoV-2 vaccine are still incomplete.

On the Construct of Subjective Risk Intelligence and Its Relationships with Personality, Emotional Intelligence and Coping Strategies: A Comparison between Adolescents and Adults.

The complexity of today's scenario has made it necessary to investigate the need for individuals to make choices that entail increasing exposure to risk and uncertainty. Among the individual resources that could help people to cope with situations of uncertainty, the new construct of subjective risk intelligence (SRI), known as a person's ability to effectively weigh the pros and cons of a decision in situations where not all the outcomes are foreseen, would seem to play a prominent role. Considering that personality and coping strategies have been shown to be significantly related in previous research, the present study investigates the relationships between subjective risk intelligence, emotional intelligence, personality traits and coping strategies in both adults and adolescents.

Cross-sectional analysis of the humoral response after SARS-CoV-2 vaccination in Sardinian multiple sclerosis patients, a follow-up study.

Monitoring immune responses to SARS-CoV-2 vaccination and its clinical efficacy over time in Multiple Sclerosis (MS) patients treated with disease-modifying therapies (DMTs) help to establish the optimal strategies to ensure adequate COVID-19 protection without compromising disease control offered by DMTs. Following our previous observations on the humoral response one month after two doses of BNT162b2 vaccine (T1) in MS patients differently treated, here we present a cross-sectional and longitudinal follow-up analysis six months following vaccination (T2, n=662) and one month following the first booster (T3, n=185). Consistent with results at T1, humoral responses were decreased in MS patients treated with fingolimod and anti-CD20 therapies compared with untreated patients also at the time points considered here (T2 and T3).

Courage as Mediator between Positive Resources and General/Domain-Specific Well-Being Indices.

Background: the current post-pandemic situation has exacerbated the effects already present due to the recent socio-economic crises belonging to the first two decades of this century: perception of instability, fears, concern for the future, underemployment, undignified work. This situation has negatively impacted life in general, career paths, and perceived quality of life, especially for new generations. Positive resources such as optimism and hope can have a positive effect in countering these effects which are impacting student academic satisfaction, life satisfaction, and flourishing.

Do patients' and referral centers' characteristics influence multiple sclerosis phenotypes? Results from the Italian multiple sclerosis and related disorders register.

Background: Multiple sclerosis (MS) is characterized by phenotypical heterogeneity, partly resulting from demographic and environmental risk factors. Socio-economic factors and the characteristics of local MS facilities might also play a part.

Methods: This study included patients with a confirmed MS diagnosis enrolled in the Italian MS and Related Disorders Register in 2000-2021.

Psychometric Investigation of the Workplace Social Courage Scale (WSCS): New Evidence for Measurement Invariance and IRT Analysis.

This study, after presenting a review of the existent literature on courage and social courage in the workplace, has the purpose of providing new evidence about the psychometric properties of an Italian-language version of the Workplace Social Courage Scale (WSCS), verifying its measurement invariance across gender and the discrimination properties of its items through IRT analysis. The aim of the research is testing the Italian version of the WSCS; for this scope, four studies have been conducted on four different samples analyzing the factorial structure, the internal consistency, the measurement invariance across gender, and the convergent and concurrent validity. The results support the psychometric properties in terms of factor structure, reliability, validity, and utility, showing positive relationships with the criterion variables: satisfaction of work-related basic needs, prosocial rule breaking and work performance.

The Relationship between Subjective Risk Intelligence and Courage with Working Performance: The Potential Mediating Effect of Workplace Social Courage.

There is a growing attention toward the construct of courage from a psychological point of view; recently, courage has been related with numerous positive individual behaviors and outcomes, such as coping strategies and subjective wellbeing, and an increasing number of studies explore the role of courage in the working and organizational environments. The present study is aimed to analyze the effect that individual courage-together with risk intelligence-and workplace social courage have on working performance; Methods: The participants are 961 Italian workers, balanced by gender; the measures used are: Courage, Subjective Risk Intelligence Scale, Workplace Social Courage Scale, and Performance Scale. Data were analyzed using Structural Equation Models; Results: The results show the effect of subjective risk intelligence and courage on working performance, both directly and through the mediation of workplace social courage; Conclusions: Suggestions for further research and practical implications are discussed.

Adaptation and Validation of the Subjective Risk Intelligence Scale for Italian Adolescents (SRIS-A).

Subjective Risk Intelligence (SRI) is the ability to consider risky and uncertain situations as opportunities rather than threats. SRI is constituted by four dimensions: attitude toward uncertainty, imaginative capability, problem solving self-efficacy and stress management. Adolescence is a period in life in which individuals face crucial life-tasks, that nowadays become complex due to uncertainty about future life and career.

The Psychological Impact of Coronavirus Pandemic Restrictions in Italy. The Mediating Role of the Fear of COVID-19 in the Relationship between Positive and Negative Affect with Positive and Negative Outcomes.

Italy was quickly hit hard by the coronavirus. 'Lockdown' has significantly impacted the psychological health, personal wellbeing and quality of life of the people. The study aims to explore the relationship between positive and negative affect, as well as positive (spiritual well-being and flourishing) and negative outcomes (psychological distress caused by a traumatic life event in terms of perception of PTSD symptoms) on Italian adults during the lockdown period.

Prolonged B-cell depletion after rituximab in AQP4-IgG-positive neuromyelitis optica spectrum disorder.

Rituximab (a B-cell depleting monoclonal antibody) is increasingly utilized for treatment of different immune-mediated neurologic disorders, including aquaporin-4-IgG-positive neuromyelitis optica spectrum disorder (AQP4-IgG-NMOSD). After an initial treatment course, the drug is generally reinfused when peripheral blood B-cells levels re-increase >1% (usually after 6-12 months), or at fixed pre-planned 6-month intervals. We describe the unusual case of a 40-year-old woman with AQP4-IgG-NMOSD who showed a prolonged B-cell depletion for nearly five years after a single rituximab reinfusion.

Management Systems to Structure Continuous Quality Improvement.

Objectives: This review describes the processes and effectiveness of the primary management systems that structure and sustain consistent behaviors and result in a transformed culture of continuous quality improvement (CQI) from top to bottom throughout the Henry Ford medical laboratory enterprise.

Methods: Through a 17-year focus to achieve a functional CQI enterprise, quality management systems were developed and continuously improved by teams of laboratory leaders, managers, and quality specialists to coordinate and standardize human efforts, and provide actionable knowledge and data to engage improvement efforts at all levels of work. Lean and ISO 15189 discipline and requirements were addressed in annual management review of functionality and effectiveness to close gaps and further refine the management systems.

Deviation Management: Key Management Subsystem Driver of Knowledge-Based Continuous Improvement in the Henry Ford Production System.

Objectives: To develop a business subsystem fulfilling International Organization for Standardization 15189 nonconformance management regulatory standard, facilitating employee engagement in problem identification and resolution to effect quality improvement and risk mitigation.

Methods: From 2012 to 2016, the integrated laboratories of the Henry Ford Health System used a quality technical team to develop and improve a management subsystem designed to identify, track, trend, and summarize nonconformances based on frequency, risk, and root cause for elimination at the level of the work.

Results: Programmatic improvements and training resulted in markedly increased documentation culminating in 71,641 deviations in 2016 classified by a taxonomy of 281 defect types into preanalytic (74.

A Proposed Set of Metrics to Reduce Patient Safety Risk From Within the Anatomic Pathology Laboratory.

Background: Anatomic pathology laboratory workflow consists of 3 major specimen handling processes. Among the workflow are preanalytic, analytic, and postanalytic phases that contain multistep subprocesses with great impact on patient care. A worldwide representation of experts came together to create a system of metrics, as a basis for laboratories worldwide, to help them evaluate and improve specimen handling to reduce patient safety risk.

MR imaging of ovarian masses: classification and differential diagnosis.

Objective: We propose a Magnetic Resonance Imaging (MRI) guided approach to differential diagnosis of ovarian tumours based on morphological appearance.

Background: Characterization of ovarian lesions is of great importance in order to plan adequate therapeutic procedures, and may influence patient's management. Optimal assessment of adnexal masses requires a multidisciplinary approach, based on physical examination, laboratory tests and imaging techniques.

Daily Management System of the Henry Ford Production System: QTIPS to Focus Continuous Improvements at the Level of the Work.

Objectives: To support our Lean culture of continuous improvement, we implemented a daily management system designed so critical metrics of operational success were the focus of local teams to drive improvements.

Methods: We innovated a standardized visual daily management board composed of metric categories of Quality, Time, Inventory, Productivity, and Safety (QTIPS); frequency trending; root cause analysis; corrective/preventive actions; and resulting process improvements.

Results: In 1 year (June 2013 to July 2014), eight laboratory sections at Henry Ford Hospital employed 64 unique daily metrics.

Autoantibodies in breast cancer sera are not epiphenomena and may participate in carcinogenesis.

Background: The objective of this work was to demonstrate that autoantibodies in breast cancer sera are not epiphenomena, and exhibit unique immunologic features resembling the rheumatic autoimmune diseases.

Methods: We performed a comprehensive study of autoantibodies on a collection of sera from women with breast cancer or benign breast disease, undergoing annual screening mammography. All women in this study had suspicious mammography assessment and underwent a breast biopsy.

Histologic validation of vacuum sealed, formalin-free tissue preservation, and transport system.

We describe five validation trials of new vacuum sealing technologies that change the approach to the preanalytic "front end" of specimen transport, handling, and processing and illustrate their adaptation and integration into existing Lean laboratory operations with reduction in formalin use and personnel exposure to this toxic and potentially carcinogenic fixative. These trials provide histologic assessment by numerous pathologists of tissues processed in this new paradigm and define the financial advantages of applying this technology to the postanalytic or "back end" process of tissue storage. We conclude that the TisssueSAFE and SealSAFE vacuum sealing systems are both promising technologies for preserving fresh human specimens that can promote a safer environment by markedly reducing formalin use in operating room theaters and can minimize formalin use by laboratories.

Anti-centrosome antibodies in breast cancer are the expression of autoimmunity.

Centrosome abnormalities have been observed in nearly all human solid tumors, but their role in tumorigenesis is unclear. We have demonstrated that autoantibodies reacting with antigens in centrosomes are frequently found in BC sera. In this work, we attempted to characterize the centrosome antigens associated with BC.

Developing and pilot testing practical measures of preanalytic surgical specimen identification defects.

Accurate patient identification is a National Patient Safety Goal. Misidentification of surgical specimens is associated with increased morbidity, mortality, and costs of care. The authors developed 12 practical, process-based, standardized measures of surgical specimen identification defects during the preanalytic phase of pathology testing (from the operating room to the surgical pathology laboratory) that could be used to quantify the occurrence of these defects.

A multi-element psychosocial intervention for early psychosis (GET UP PIANO TRIAL) conducted in a catchment area of 10 million inhabitants: study protocol for a pragmatic cluster randomized controlled trial.

Background: Multi-element interventions for first-episode psychosis (FEP) are promising, but have mostly been conducted in non-epidemiologically representative samples, thereby raising the risk of underestimating the complexities involved in treating FEP in 'real-world' services.

Methods/design: The Psychosis early Intervention and Assessment of Needs and Outcome (PIANO) trial is part of a larger research program (Genetics, Endophenotypes and Treatment: Understanding early Psychosis - GET UP) which aims to compare, at 9 months, the effectiveness of a multi-component psychosocial intervention versus treatment as usual (TAU) in a large epidemiologically based cohort of patients with FEP and their family members recruited from all public community mental health centers (CMHCs) located in two entire regions of Italy (Veneto and Emilia Romagna), and in the cities of Florence, Milan and Bolzano. The GET UP PIANO trial has a pragmatic cluster randomized controlled design.

Study of amended reports to evaluate and improve surgical pathology processes.

Background: : Amended surgical pathology reports record defects in the process of transforming tissue specimens into diagnostic information.

Objective: : Systematic study of amended reports tests 2 hypotheses: (a) that tracking amendment frequencies and the distribution of amendment types reveals relevant aspects of quality in surgical pathology's daily transformation of specimens into diagnoses and (b) that such tracking measures the effect, or lack of effect, of efforts to improve surgical pathology processes.

Materials And Methods: : We applied a binary definition of altered reports as either amendments or addenda and a taxonomy of defects that caused amendments as misidentifications, specimen defects, misinterpretations, and report defects.