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Polycystic ovarian syndrome (PCOS) is the most common endocrinological disorder in women, in which, besides chronic anovulation/oligomenorrhea and ovarian cysts, hyperandrogenism plays a critical role in a large fraction of subjects. Inositol isomers—myo-Inositol and D-Chiro-Inositol—have recently been pharmacologically effective in managing many PCOS symptoms while rescuing ovarian fertility. However, some disappointing clinical results prompted the reconsideration of their specific biological functions. Surprisingly, D-Chiro-Ins stimulates androgen synthesis and decreases the ovarian estrogen pathway; on the contrary, myo-Ins activates FSH response and aromatase activity, finally mitigating ovarian hyperandrogenism. However, when the two isomers are given in association—according to the physiological ratio of 40:1—patients could benefit from myo-Ins enhanced FSH and estrogen responsiveness, while taking advantage of the insulin-sensitizing effects displayed mostly by D-Chiro-Ins. We need not postulate insulin resistance to explain PCOS pathogenesis, given that insulin hypersensitivity is likely a shared feature of PCOS ovaries. Indeed, even in the presence of physiological insulin stimulation, the PCOS ovary synthesizes D-Chiro-Ins four times more than that measured in control theca cells. The increased D-Chiro-Ins within the ovary is detrimental in preserving steroidogenic control, and this failure can easily explain why treatment strategies based upon high D-Chiro-Ins have been recognized as poorly effective. Within this perspective, two factors emerge as major determinants in PCOS: hyperandrogenism and reduced aromatase expression. Therefore, PCOS could no longer be considered a disease only due to increased androgen synthesis without considering the contemporary downregulation of aromatase and FSH receptors. Furthermore, these findings suggest that inositols can be specifically effective only for those PCOS phenotypes featured by hyperandrogenism.

Objective: This study was designed to examine the classification accuracy of verbal fluency (VF) measures as performance validity tests (PVT).Method: Student volunteers were assigned to the control...

The currently accepted theory on the influence of DNA mutations on carcinogenesis (the Somatic Mutation Theory, SMT) is facing an increasing number of controversial results that undermine the explanatory power of mutated genes considered as “causative” factors. Intriguing results have demonstrated that several critical genes may act differently, as oncogenes or tumor suppressors, while phenotypic reversion of cancerous cells/tissues can be achieved by modifying the microenvironment, the mutations they are carrying notwithstanding. Furthermore, a high burden of mutations has been identified in many non-cancerous tissues without any apparent pathological consequence. All things considered, a relevant body of unexplained inconsistencies calls for an in depth rewiring of our theoretical models. Ignoring these paradoxes is no longer sustainable. By avoiding these conundrums, the scientific community will deprive itself of the opportunity to achieve real progress in this important biomedical field. To remedy this situation, we need to embrace new theoretical perspectives, taking the cell–microenvironment interplay as the privileged pathogenetic level of observation, and by assuming new explanatory models based on truly different premises. New theoretical frameworks dawned in the last two decades principally focus on the complex interaction between cells and their microenvironment, which is thought to be the critical level from which carcinogenesis arises. Indeed, both molecular and biophysical components of the stroma can dramatically drive cell fate commitment and cell outcome in opposite directions, even in the presence of the same stimulus. Therefore, such a novel approach can help in solving apparently inextricable paradoxes that are increasingly observed in cancer biology.

Objective The purpose of this study was to determine whether basic manual dexterity (BMD) could be an important parameter in selecting students for the Degree in Dentistry (CLOPD) and to assess whether initial manual dexterity in students admitted to the CLOPD can improve with training in pre-clinical and clinical practice. Design Observational study. Setting The study was carried out at the Catholic University of Rome, in five consecutive academic years. Subjects and methods Four hundred and thirty-three subjects (262 males and 171 females) were tested (10 different exercises) in five consecutive years. Two retests were performed after three and five years respectively from the beginning of the experimentation. Main outcome measures The scores of individual exercises were averaged for each candidate, assessing the mean value of basic manual dexterity score (BMDS). Results It was possible to observe some differences among candidates coming from different types of high schools, since those having a prior university degree or a scientific high school degree proved better than those with classical or vocational high school qualifications (p < 0.05). A statistically significant improvement of BMDS has been observed in students who attended the CLOPD for at least 32 months. Conclusions Data obtained revealed that basic manual dexterity is not essential in the selection of dental students. Students who could follow training significantly improved in their manual ability.

In the last years, the use of tests with predictive value for scholastic progress has become widespread. While there is an aptitude test already in use for admission to our Dental School, we have also been conducting, without consequence to their admission, an investigation into the manual dexterity of candidate students. The aim of this test is to investigate basic manual dexterity, not ability following exercise. As previous, no such specific test had been formulated; the choice of test criteria we made was new. The tests investigated over five consecutive Academic years the ability to discern characteristics of a surface, to distinguish between different types of consistency, hand–eye co-ordination, the graphic activities, laterality and muscular strength. A re-test for some years was conducted afterwards. The results provided an overall evaluation: insufficient; sufficient; good; very good; excellent. Students who came from non-technical high schools showed a good comprehension of questions put to them, use of strategy, description of procedures; and final checking but a certain clumsiness in the hand–eye co-ordination test and a tendency to use one hand only. Students coming from technical high schools showed a less immediate grasp of questions put to them, sometimes requiring their repetition, disorganised behaviour in blind-fold tests, insufficient use of strategies and little checking but notable ability in hand–eye co-ordination tests and dextrous simultaneous use of both hands. These results were then correlated with the result of the aptitude test. In conclusion, a notable correspondence between student selection based on the aptitude test and the experimental manual dexterity test was verified. This correspondence outlines that manual dexterity is not only a ‘manual’ but a ‘mental’ ability.