Maurizio Castellano

Background/Objectives: Regular consumption of dietary fiber (DF) has been associated with non-communicable disease prevention and health benefits. As a result, having the ability to quickly and correctly estimate DF intake would allow the identification of at-risk groups and the development of public programs aimed at improving their intake. In this study, the authors translate and cross-culturally adapt a validated short food frequency questionnaire for the assessment of DF intake, thus adapting it to the Italian population. Methods: The process followed a six-step standardized protocol, and the pre-final version was tested among 40 volunteers. Six experts in nutrition performed the content validity study: Scale-level Content Validity Indexes based on Average (S-CVI/Ave) and Universal Agreement (S-CVI/UA) were calculated (cut-off = 0.83). Results: Both S-CVI/Ave and S-CVI/UA were 1.00 ± 0.0, higher than the cut-off value. The preliminary qualitative analysis showed an average DF intake of 21.5 ± 7.2 g/day, which is below the suggested national and international dietary targets, and mainly derives from fruits, vegetables, bread, and cereals. Based on their DF intake, subjects were classified as low (40%), moderate (37.5%), and high (22.5%) consumers. Conclusions: The translation and cross-cultural adaptation of a validated short food frequency questionnaire to assess DF intake provided us with a tool suitable for the Italian population. Its application in a real case has enabled the identification of three consumption classes, which can support the design of future studies and interventions.

Adolescence is a central phase for the development of a person’s identity, involving complex multidimensional changes and increasing vulnerability to distress. This study aimed to investigate the psychological well-being of adolescent students in Brescia (Northern Italy), two years after the beginning of the COVID-19 pandemic. An online survey investigated the extent and the reasons reported by high school students (13–21 years) for their emotional distress (ED), also considering other factors such as physical activity, nutrition, sleep and smartphone overuse. The main reasons for ED were classified through a qualitative analysis of the free-text answers. A total of 1686 students agreed to participate, and 50% showed a presence of ED. According to a multiple logistic analysis, adolescents were more at risk of ED if they were female (AdjOR 2.3), older (AdjOR 1.6), slept less than 8 h (AdjOR 1.5), perceived increased anxiety (AdjOR 3.4), and adopted certain eating behaviors, e.g., comfort food consumption (AdjOR 2.0). According to free-text answers, the main reasons for ED were “school pressure”, “relationships with family and peers”, “negative emotional states” and “the pandemic”. The results show a high level of ED among adolescents, and the reported reasons may help to better address their psychological needs after the pandemic.

Adolescence is a central phase for the development of a person’s identity involving complex multidimensional changes and increasing vulnerability to distress. The aim of this study was to investigate the psychological well-being of adolescent students in Brescia (Northern Italy), two years after the beginning of the Covid-19 pandemic. An online survey investigated the extent and the reasons reported by high school students for their emotional distress (ED), also considering other factors such as physical activity, diet, sleep and smartphone overuse. The main reasons for ED were classified through a qualitative analysis of the freetext answers. 1686 students agreed to participate, 50% showed a presence of ED. According to a multiple logistic analysis, the main factors associated to ED were female gender (AdjOR 2.3, p<0.0001), age (AdjOR 1.6, p<0.0001), sleep duration <8 hours (AdjOR 1.5, p=0.0003), anxiety perception (AdjOR 3.4, p<0.0001), and certain eating behaviors, e.g. comfort food consumption (AdjOR 2.0, p<0.0001). According to free-text answers, the main reasons for ED were: “school pressure”, “ relationships with family and peers”, “negative emotional states” and “the pandemic”. The results show a high level of ED among adolescents and the reported reasons may help to better address their psychological needs after the pandemic.

Background of the Study. Nonalcoholic fatty liver disease (NAFLD) is the most common liver disease in western countries. Lifestyle interventions are recommended as the primary therapy for NAFLD. Methodology. In this clinical trial, NAFLD patients were enrolled in a 12-month dietary intervention aimed to improve their eating habits according to the Mediterranean pattern, with scheduled appointments every three months. After the exclusion of steatosis, healthy subjects were recruited and received general advice based on current Italian food-based dietary guidelines. Results. One hundred and fifty five subjects aged 2059years underwent (i) liver ultrasound (US), (ii) clinical and anthropometric evaluations, (iii) blood tests, and (iv) assessment of dietary habits. According to US evaluation, 73 of them had severe, moderate, or mild liver steatosis (NAFLD patients) and 82 had no liver steatosis (healthy controls). Fifty-eight NAFLD patients and 73 controls completed the study. Among NAFLD patients, 26 (45) downgraded steatosis severity, 12 of which achieved complete steatosis regression (21). Three of the healthy controls developed NAFLD. The NAFLD patients improved their dietary habits and reduced BMI and waist circumference, during the study period, more than healthy controls. Liver steatosis remission/regression was independent of changes in BMI or liver enzymes and was more frequent among patients with mild steatosis at baseline. Conclusions. Mediterranean dietary advices, without a personalised meal planning, were efficient in reducing/remitting NAFLD, especially among patients with mild disease, which argues in favour of early identification and lifestyle intervention. This trial is registered with NCT03300661.

Background: Cooking skills (CS) have the potential to improve self-care behaviours and healthy development among adolescents. The COVID-19 pandemic has affected lifestyles worldwide, and the present study aims to investigate the level of CS after the pandemic, as well as its associations with nutrition knowledge and eating behaviours among a cohort of Italian adolescents. Methods: We submitted an online survey about lifestyle changes to students aged 13–21 years during the pandemic. Based on overall culinary abilities, we divided respondents into high, medium and low CS. Worsening or improvement in diet quality was detected by assigning an eating habit index (EHI; 0–54). Results: Out of the 1686 questionnaires collected, 21.5%, 63.6% and 14.9% reported high, medium and low CS, respectively. The EHI scores were statistically higher among students who were able to cook more than 20 recipes compared to those reporting no cooking abilities (30.2 ± 5.9 vs. 26.6 ± 5.7; p = 0.0001). High CS significantly correlated with better EHI (OR 1.44; p = 0.009), lower consumption of ultra-processed food (OR 1.80; p < 0.0001) and better nutrition knowledge (OR 1.42; p = 0.007). Conclusions: Adolescents with good CS showed better nutrition knowledge and healthier eating habits, including lower consumption of ultra-processed foods. Projects aimed to improve CS in adolescents can therefore promote healthier development.

Objective: Some evidence suggests that most benign nodules exhibit no significant size increase during 5 years of follow‐up, although conflicting results have emerged. The aim of the present study is to evaluate the frequency and the magnitude of growth in benign nodules during 120 months of follow‐up.Design: We reviewed the medical and imaging records of patients who were submitted to ultrasound‐guided FNA of thyroid nodules at our hospital from January 2007 to March 2009. We selected only patients with benign nodules who underwent annual ultrasound evaluation in our Department.Results: Among 966 selected patients, 289 were lost during follow‐up, meaning that the total number of patients analysed was 677 (474 women and 203 men), with a mean age of 45.6 (16–71) years. In 559/677 patients (82.7%), the size of the nodule remained stable during follow‐up; 42 (6.2%) patients experienced spontaneous nodule shrinkage, and 75 (11.1%) patients showed nodule growth. Patients with or without nodule growth during follow‐up were superimposable at baseline for age, gender, TSH values, number of patients on levothyroxine treatment and nodule characteristics. All baseline variables in predicting nodular growth were entered to an adjusted multivariate logistic regression model. None of the parameters taken into account was associated with nodular growth.Conclusions: In conclusion, the majority of benign nodules remained stable over the period of monitoring. On the basis of our experience, we recommend ultrasound examination at a distance of 2 and 5 years following cytological evaluation, then every 4–5 years from then on.

In the age of Evidence-Based Medicine, Clinical Guidelines (CGs) are recognized to be an indispensable tool to support physicians in their daily clinical practice. Medical Informatics is expected to play a relevant role in facilitating diffusion and adoption of CGs. However, the past pioneering approaches, often fragmented in many disciplines, did not lead to solutions that are actually exploited in hospitals. Process Mining for Healthcare (PM4HC) is an emerging discipline gaining the interest of healthcare experts, and seems able to deal with many important issues in representing CGs. In this position paper, we briefly describe the story and the state-of-the-art of CGs, and the efforts and results of the past approaches of medical informatics. Then, we describe PM4HC, and we answer questions like how can PM4HC cope with this challenge? Which role does PM4HC play and which rules should be employed for the PM4HC scientific community?