Showing papers by "Università degli Studi eCampus published in 2020"

The Psychological Impact of the COVID-19 Outbreak on Health Professionals: A Cross-Sectional Study

Abstract: Background: The COVID-19 pandemic had a massive impact on health care systems, increasing the risks of psychological distress in health professionals. This study aims at assessing the prevalence of burnout and psychopathological conditions in health professionals working in a health institution in the Northern Italy, and to identify socio-demographic, work-related and psychological predictors of burnout. Methods: Health professionals working in the hospitals of the Istituto Auxologico Italiano were asked to participate to an online anonymous survey investigating socio-demographic data, COVID-19 emergency-related work and psychological factors, state anxiety, psychological distress, post-traumatic symptoms and burnout. Predictors of the three components of burnout were assessed using elastic net regression models. Results: Three hundred and thirty health professionals participated to the online survey. Two hundred and thirty-five health professionals (71.2%) had scores of state anxiety above the clinical cutoff, 88 (26.8%) had clinical levels of depression, 103 (31.3%) of anxiety, 113 (34.3%) of stress, 121 (36.7%) of post-traumatic stress. Regarding burnout, 107 (35.7%) had moderate and 105 (31.9%) severe levels of emotional exhaustion; 46 (14.0%) had moderate and 40 (12.1%) severe levels of depersonalization; 132 (40.1%) had moderate and 113 (34.3%) severe levels of reduced personal accomplishment. Predictors of all the three components of burnout were work hours, psychological comorbidities, fear of infection and perceived support by friends. Predictors of both emotional exhaustion and depersonalization were female gender, being a nurse, working in the hospital, being in contact with COVID-19 patients. Reduced personal accomplishment was also predicted by age. Conclusions: Health professionals had high levels of burnout and psychological symptoms during the COVID-19 emergency. Monitoring and timely treatment of these conditions is needed.

Dietary Habits and Psychological States during COVID-19 Home Isolation in Italian College Students: The Role of Physical Exercise.

Abstract: Social isolation has adverse effects on mental health, physical exercise, and dietary habits. This longitudinal observational study aimed to investigate the effects of mood states and exercise on nutritional choices, on 176 college students (92 males, 84 females; 23 ± 4 years old) during the COVID-19 lockdown. During 21 days, nutrition and exercise were daily monitored, and the mood states assessed. A factor analysis was used to reduce the number of nutritional variables collected. The relationships between exercise, mood and nutrition were investigated using a multivariate general linear model and a mediation model. Seven factors were found, reflecting different nutritional choices. Exercise was positively associated with fruit, vegetables and fish consumption (p = 0.004). Depression and quality of life were, directly and inversely, associated with cereals, legumes (p = 0.005; p = 0.004) and low-fat meat intake (p = 0.040; p = 0.004). Exercise mediated the effect of mood states on fruit, vegetables and fish consumption, respectively, accounting for 4.2% and 1.8% of the total variance. Poorer mood states possibly led to unhealthy dietary habits, which can themselves be linked to negative mood levels. Exercise led to healthier nutritional choices, and mediating the effects of mood states, it might represent a key measure in uncommon situations, such as home-confinement.

Coronavirus Lockdown as a Major Life Stressor: Does It Affect TMD Symptoms?

Abstract: Temporomandibular disorders are multi-factorial conditions that are caused by both physical and psychological factors. It has been well established that stress triggers or worsens TMDs. This paper looks to present early research, still unfolding, on the relationship between COVID-19 as a major life stressor and TMDs. The main aims of this study were to: investigate the presence of symptoms related to TMDs and the time of onset and the worsening of painful symptoms in relation to the changes in social life imposed by the coronavirus pandemic; and to evaluate the perception of COVID-19 as a major stressful event in subjects who report worsening of painful TMD symptoms. One hundred and eighty-two subjects answered questionnaires-Axis II of the RDC/TMD, the PSS, and specific items about coronavirus as a stressful event-during the lockdown period for COVID-19 in Italy to evaluate the presence of reported symptoms of TMD and the level of depression, somatization, and stress perceived. The results showed that 40.7% of subjects complained about TMD symptoms in the past month. Regarding the time of onset, 60.8% of them reported that facial pain started in the last three months, while 51.4% of these subjects reported that their symptoms worsened in the last month and were related to the aggravation of pain due to the coronavirus lockdown as a major life event and to the stress experienced. The results of this study seem to support the hypothesis that stress during the pandemic lockdown influenced the onset of temporomandibular joint disorders and facial pain, albeit with individual responses.

Cerebellar Intermittent Theta-Burst Stimulation Combined with Vestibular Rehabilitation Improves Gait and Balance in Patients with Multiple Sclerosis: a Preliminary Double-Blind Randomized Controlled Trial.

Abstract: Difficulties in gait and balance disorders are among the most common mobility limitations in multiple sclerosis (MS), mainly due to a damage of cerebellar circuits. Moreover, the cerebellum plays a critical role in promoting new motor tasks, which is an essential function for neurorehabilitation. In this study, we investigated the effects of cerebellar intermittent theta burst stimulation (c-iTBS), a high-frequency rTMS protocol able to increase cerebellar activity, on gait and balance in a sample of 20 hospitalized participants with MS, undergoing vestibular rehabilitation (VR), an exercise-based program primarily designed to reduce vertigo and dizziness, gaze instability, and/or imbalance and falls in MS. Patients were assigned to receive either c-iTBS or sham iTBS before being treated with VR during 2 weeks. VR consisted of two types of training: gaze stability and postural stability exercises. The primary outcome measure was the change from baseline in the Tinetti Balance and Gait scale (TBG). The secondary outcome measures were changes from baseline in Berg Balance Scale (BBS), Fatigue Severity Scale (FSS), Two Minute Walking Test (2MWT), and Timed 25-ft walk test (T25FW) scales. MS patients treated with c-iTBS-VR showed a significant improvement in the TBG as compared to patients treated with sham iTBS-VR. Moreover, MS patients in the c-iTBS groups showed better performances in the vestibular-ocular reflex exercises. Combined c-iTBS and VR improves gait and balance abilities more than standard VR treatment in MS patients with a high level of disability.

Digital Biomarkers for the Early Detection of Mild Cognitive Impairment: Artificial Intelligence Meets Virtual Reality.

Abstract: Elderly people affected by Mild Cognitive Impairment (MCI) usually report a perceived decline in cognitive functions that deeply impacts their quality of life. This subtle waning, although it cannot be diagnosable as dementia, is noted by caregivers on the basis of their relative's behaviors. Crucially, if this condition is also not detected in time by clinicians, it can easily turn into dementia. Thus, early detection of MCI is strongly needed. Classical neuropsychological measures - underlying a categorical model of diagnosis - could be integrated with a dimensional assessment approach involving Virtual Reality (VR) and Artificial Intelligence (AI). VR can be used to create highly ecologically controlled simulations resembling the daily life contexts in which patients' daily instrumental activities (IADL) usually take place. Clinicians can record patients' kinematics, particularly gait, while performing IADL (Digital Biomarkers). Then, Artificial Intelligence employs Machine Learning (ML) to analyze them in combination with clinical and neuropsychological data. This integrated computational approach would enable the creation of a predictive model to identify specific patterns of cognitive and motor impairment in MCI. Therefore, this new dimensional cognitive-behavioral assessment would reveal elderly people's neural alterations and impaired cognitive functions, typical of MCI and dementia, even in early stages for more time-sensitive interventions.

Comparison among the environmental impact of solid state and fusion welding processes in joining an aluminium alloy

Abstract: The life-cycle assessment methodology was used to evaluate the environmental impact of friction stir welding of AA5754-H114 aluminium alloy sheets. Other works in literature considered the environm...

The Psychophysiological Effects of Different Tempo Music on Endurance Versus High-Intensity Performances.

Abstract: The use of music during training represents a special paradigm for trainers to stimulate people undertaking different types of exercise. However, the relationship between the tempo of music and perception of effort during different metabolic demands is still unclear. Therefore, the aim of this research was to determine whether high intensity exercise is more sensitive to the beneficial effects of music than endurance exercise. This study assessed 19 active women (age 26.4 ± 2.6 years) during endurance (walking for 10' at 6.5 km/h on a treadmill) and high intensity (80% on 1-RM) exercise under four different randomly assigned conditions: no music (NM), with music at 90-110 bpm (LOW), with music at 130-150 bpm (MED), and with music at 170-190 bpm (HIGH). During each trial, heart rate (HR) and the rating of perceived exertion (RPE) were assessed. Repeated analysis of variance measures was used to detect any differences between the four conditions during high intensity and low intensity exercise. RPE showed more substantial changes during the endurance exercises (11%), than during high intensity exercise (6.5%), between HIGH and NM conditions. The metabolic demand during the walking exercise increased between NM and HIGH bpm conditions. This study indicates the benefits of music under stress conditions as well as during endurance and high intensity training. The results demonstrate that the beneficial effects of music are more likely to be seen in endurance exercise. Consequently, music may be considered an important tool to stimulate people engaging in low intensity physical exercise.

Isoinertial Eccentric-Overload Training in Young Soccer Players: Effects on Strength, Sprint, Change of Direction, Agility and Soccer Shooting Precision

Abstract: The isoinertial training method owes its efficacy to an accommodated resistance and optimal individualized eccentric overload. The aim of this study was to assess the effects of a 6-week isoinertial eccentric-overload training program - using a flywheel inertial device during the execution of specific soccer exercises - on explosive and reactive strength, sprint ability, change of direction (COD) performance and soccer shooting precision. Thirty-four junior soccer players were randomly assigned to a plyometric training group (PT) (n = 16, aged 13.36 ± 0.80), which underwent a six-week traditional soccer training program, and a flywheel eccentric overload group (FEO) (n = 18, aged 13.21 ± 1.21), which received additional training consisting of two inertial eccentric-overload training sessions per week. Pre and post intervention tests were carried out to assess explosive and reactive strength, sprint ability, COD ability, agility using the Y-agility test (YT) and soccer shooting precision. The FEO showed significantly higher values than the PT in squat jump height (SJh) (p = 0.01), drop jump height (DJh) (p = 0.003), 7 repeated hop test heights (p = 0.001), the Illinois test (ILL) (p = 0.001), and the Loughborough Soccer Shooting Test (SHOT) (p = 0.02). Finally, the FEO showed significant between-group differences in DJh (p = 0.007), ILL (p = 0.0002), YT (p = 0.002), a linear sprint test (SPRINT) (p = 0.001), and SHOT (p = 0.003). These results confirmed the positive effect of isoinertial training. The use of an isoinertial device to overload multidirectional movements in specific sport conditions leads to greater performance improvements than conventional soccer training. The absence of knowledge of the eccentric overload applied by the isoinertial device, which is different in any exercise repetition, may stimulate the athlete's neural adaptations, improving their soccer skills and in particular their soccer shooting precision.

Cortico-cortical connectivity: the road from basic neurophysiological interactions to therapeutic applications

Abstract: Transcranial magnetic stimulation (TMS) based methods are emerging as a unique approach to evaluate in real-time brain electrical activity in healthy and pathological conditions. By applying TMS pulses in two different bran areas within a short temporal frame of few milliseconds, it is possible to investigate their physiological interactions. These paradigms, collectively termed dual-site TMS, have been inspired by Professor John Rothwell's work, based on the idea that applying a conditioning stimulus over a cortical area may activate putative pathways projecting onto a second target area, thus providing a unique opportunity to test the causal effects between interconnected brain areas. This review highlights the most important features of dual-coil TMS protocols, mainly pioneered in Professor John Rothwell's lab. In the first part, I reviewed development of dual-site TMS protocols leading to the discovery of a distributed system of short-latency interactions within the human parieto-frontal network, likely mediated by direct anatomical pathways. In the second part, the physiological role of these dual-site TMS evoked pathways is considered, describing how these functional interactions are not fixed but vary depending on the brain activation, the condition and on the precise time window in which they are explored. Then, I reviewed recent advances showing that the repeated coupling of interconnected neuronal populations, by means of dual-coil TMS, is able to induce spike-time-dependent plasticity and to determine selective potentiation of physiological connectivity between two human brain regions. Finally, the therapeutic implications of these novel discoveries are discussed, pointing to multi-site TMS as a novel tool to identify early features of synaptic dysfunctions, to monitor disease progression and potentially to provide novel therapeutic approaches by reshaping plasticity in different neurological and psychiatric conditions.

Recycling of reclaimed fibers from end-of-life tires in hot mix asphalt

Abstract: Nowadays, the disposal of end-of-life tires (ELT) is worldwide one of the major concerns for the environment as well as for public health. Crumb rubber and steel wires, the main by-products (in terms of weight) deriving from the ELT processing, can be recycled in several ways. However, the textile fiber, representing about 10% of the waste by weight, is typically not reused and ends up in landfills or incinerators. The present paper deals with the use of reclaimed fibers from ELT in hot mix asphalt (HMA), with the aim to improve its performance. The study included the preliminary characterization of the fiber through microscope observation and Fourier trans form infrared (FTIR) spectroscopy and then the investigation of the mechanical properties of HMA containing ELT fibers, in comparison with an ordinary HMA with no fibers. In particular, indirect tensile strength (ITS), indirect tensile stiffness modulus (ITSM), semi-circular bending (SCB), three point bending (3PB) and indirect tensile fatigue (ITF) tests were carried out. The results showed that the use of ELT fibers does not reflect in a significant improvement in terms of strength and stiffness properties. However, the ELT fibers determine a noticeable increase of the HMA resistance to fatigue, probably related to the ability of the fibers in sewing the micro-crack edges and contrasting the macro-crack opening.

Evaluation of the reliability and validity of the Italian version of the schema mode inventory for eating disorders: short form for adults with dysfunctional eating behaviors

Abstract: To examine the psychometric properties and the factorial structure of the Italian version of the schema mode inventory for eating disorders—short form (SMI-ED-SF) for adults with dysfunctional eating patterns. 649 participants (72.1% females) completed the 64-item Italian version of the SMI-ED-SF and the eating disorder examination questionnaire (EDE-Q) for measuring eating disorder symptoms. Psychometric testing included confirmatory factor analysis (CFA) and internal consistency. Multivariate analysis of covariance (MANCOVA) was also run to test statistical differences between the EDE-Q subscales on the SMI-ED-SF modes, while controlling for possible confounding variables. Factorial analysis confirmed the 16-factors structure for the SMI-ED-SF [S–Bχ2 (1832) = 3324.799; p < .001; RMSEA = 0.045; 90% CI 0.043–0.048; CFI = 0.880; SRMR = 0.066; χ2/df = 1.81; < 3]. Internal consistency was acceptable in all scales, with Cronbach’s Alpha coefficients ranging from 0.635 to 0.873. The SMI-ED-SF represents a reliable and valid alternative to the long-form SMI-ED for assessment and conceptualization of schema modes in Italian adults with disordered eating habits. Its use is recommended for clinical and research purposes. Level V, descriptive study.

Effects of Palmitoylethanolamide Combined with Luteoline on Frontal Lobe Functions, High Frequency Oscillations, and GABAergic Transmission in Patients with Frontotemporal Dementia.

Abstract: Background: Frontotemporal dementia (FTD) is a presenile neurodegenerative disease for which there is no effective pharmacological treatment. Recently, a link has been proposed between neuroinflammation and FTD. Objective: Here, we aim to investigate the effects of palmitoylethanolamide (PEA) combined with luteoline (PEA-LUT), an endocannabinoid with anti-inflammatory and neuroprotective effects, on behavior, cognition, and cortical activity in a sample of FTD patients. Methods: Seventeen patients with a diagnosis of probable FTD were enrolled. Cognitive and neurophysiological evaluations were performed at baseline and after 4 weeks of PEA-LUT 700 mg×2/day. Cognitive effects were assessed by Neuropsychiatric Inventory (NPI), Mini-Mental State Examination, Frontal Assessment Battery (FAB), Screening for Aphasia in Neurodegeneration, Activities of Daily Living-Instrumental Activities of Daily Living, and Frontotemporal Lobar Degeneration-modified Clinical Dementia Rating scale. To investigate in vivo neurophysiological effects of PEA-LUT, we used repetitive and paired-pulse transcranial magnetic stimulation (TMS) protocols assessing LTP-like cortical plasticity, short-interval intracortical inhibition, long-interval intracortical inhibition (LICI), and short-latency afferent inhibition. Moreover, we used TMS combined with EEG to evaluate the effects on frontal lobe cortical oscillatory activity. Results: Treatment with PEA-LUT was associated with an improvement in NPI and FAB scores. Neurophysiological evaluation showed a restoration of LICI, in particular at ISI 100 ms, suggesting a modulation of GABA(B) activity. TMS-EEG showed a remarkable increase of TMS-evoked frontal lobe activity and of high-frequency oscillations in the beta/gamma range. Conclusion: PEA-LUT could reduce behavioral disturbances and improve frontal lobe functions in FTD patients through the modulation of cortical oscillatory activity and GABA(B)ergic transmission. Keywords: Brain inflammation; EEG; GABA activity; behavioral symptoms; executive functions; frontotemporal dementia; transcranial magnetic stimulation.

Business cycle modeling between financial crises and black swans: Ornstein-Uhlenbeck stochastic process vs Kaldor deterministic chaotic model.

Abstract: Business cycles are oscillations in the economy because of recessions and expansions. In this paper we investigate the oscillation of the gross domestic product as a result of its relations with the other main macroeconomic variables such as capital, consumption, and investment. There is a long-standing debate about chaos and non-linear dynamics in economy and even the usefulness of those concepts has been questioned. Stochastic modeling has proven to be able to simulate reality fairly well. However, a stochastic behavior implies that reality is about exogenous randomness, while a chaotic behavior means that reality is deterministic and non-linearities are endogenous. Here we compare an Ornstein–Uhlenbeck stochastic process with a Kaldor–Kalecki deterministic chaotic model to understand which one fits better real data. We show that our chaotic model is able to represent reality as well as the stochastic model taken into consideration. Furthermore, our model may reproduce an extreme event (black swans).

Rethinking the Role of Affect in Risk Judgment: What We Have Learned From COVID-19 During the First Week of Quarantine in Italy

Abstract: Due to COVID-19 spreading in Italy, on March 11 the Prime Minister of Italy declared a lockdown and imposed severe restrictive measures impacting citizens' freedom at several levels. People were required to stay at home and go out only to satisfy basic needs. Several risk models have postulated a link among online searching behavior, affect, anxiety, and complaints by individuals toward government restrictions (GR), which emerged as also related to an increased perception of knowledge toward risk. However, to date, no study has addressed how these key risk-related aspects (i.e., affect, anxiety, perceived knowledge on risk, and risk dimensions) can act jointly to orient online health information-seeking behavior, and people's complaints toward GR imposed during the lockdown. This study investigated the mechanisms underlying online health information-seeking behavior and people's complaints toward the government's restrictions during a COVID-19 emergency in the Italian population. Drawing from the health belief model (HBM), which postulates a link between sociodemographic variables, risk, and affect dimensions in emergency, we assumed risk factors as predictors of affect and anxiety, which, in turn, were posited as mediators between risk dimensions, online health information-seeking behavior, and complaints toward GR. Participants (1,031) were involved during the first week of the quarantine (March 11-18) and completed an online survey composed of (i) an adapted version of the Italian Risk Perception Questionnaire; (ii) the Italian Positive (PA) and Negative Affect (NA) Schedule (PANAS-10); (iii) the State Anxiety Scale (STAI-Y1); (iv) ad hoc personal knowledge measure about novel coronavirus; (v) ad hoc item measuring information search behavior regarding the novel coronavirus; (vi) ad hoc measure of the complains regarding GR; and (vii) sociodemographic questions. General linear models and structural equation modeling (SEM) were carried out to test the model. Sociodemographic and cognitive factors predicted the participants' affect and anxiety, which, in turn, motivated and fully mediated both information search behavior and complaint toward GR. This research can offer useful suggestions for policy-makers during the COVID-19 emergency, and it advanced the knowledge on the risk-emotion link in emergency situations.

Data Science in Unveiling COVID-19 Pathogenesis and Diagnosis: Evolutionary Origin to Drug Repurposing

Abstract: MOTIVATION: The outbreak of novel severe acute respiratory syndrome coronavirus (SARS-CoV-2, also known as COVID-19) in Wuhan has attracted worldwide attention. SARS-CoV-2 causes severe inflammation, which can be fatal. Consequently, there has been a massive and rapid growth in research aimed at throwing light on the mechanisms of infection and the progression of the disease. With regard to this data science is playing a pivotal role in in silico analysis to gain insights into SARS-CoV-2 and the outbreak of COVID-19 in order to forecast, diagnose and come up with a drug to tackle the virus. The availability of large multiomics, radiological, bio-molecular and medical datasets requires the development of novel exploratory and predictive models, or the customisation of existing ones in order to fit the current problem. The high number of approaches generates the need for surveys to guide data scientists and medical practitioners in selecting the right tools to manage their clinical data. RESULTS: Focusing on data science methodologies, we conduct a detailed study on the state-of-the-art of works tackling the current pandemic scenario. We consider various current COVID-19 data analytic domains such as phylogenetic analysis, SARS-CoV-2 genome identification, protein structure prediction, host-viral protein interactomics, clinical imaging, epidemiological research and drug discovery. We highlight data types and instances, their generation pipelines and the data science models currently in use. The current study should give a detailed sketch of the road map towards handling COVID-19 like situations by leveraging data science experts in choosing the right tools. We also summarise our review focusing on prime challenges and possible future research directions. CONTACT: hguzzi@unicz.it, sroy01@cus.ac.in.

Psychological, Behavioral, and Interpersonal Effects and Clinical Implications for Health Systems of the Coronavirus (COVID-19) Pandemic: A Call for Research

Abstract: The novel coronavirus disease (COVID-19) emerged at the end of 2019 and was classified as a pandemic by the World Health Organization (WHO) on March 11, 2020. Both the COVID-19 emergency and the extraordinary measures to contain it have negatively affected the life of billions of people and have threatened individuals and nations. One of the main goals of clinical and health psychology during this pandemic is to investigate the behavioral, cognitive, emotional, and psychobiological responses to the COVID-19 emergency as well as to the preventive measures that have been imposed by governments to limit the contagion, such as social isolation. Psychological research has the responsibility to deliver sound empirical evidence to inform public health policies and to support and advise governments and policymakers in their introduction of sustainable, feasible, and cost-efficient prevention and intervention guidelines. Hence, the goal of this call for research is to stimulate theoretical discussions and empirical investigations on the bio-psycho-social impacts of COVID-19 for individuals, groups, and nations. We invite contributions that address the challenges that the COVID-19 emergency has imposed on couples, families, and social systems. In addition, we call for studies that assess the specific effects of the COVID-19 pandemic on highly vulnerable populations such as children, adolescents, pregnant women, patients suffering from chronic and life-threatening conditions, healthcare workers, and elderly citizens. Papers focusing on the impact of emotion regulation and coping strategies are encouraged. Original research, data reports, study protocols, single case reports and community case studies, theoretical perspectives, and viewpoints are invited to help improve our understanding of the COVID-19 pandemic.

Health-related quality of life (HRQoL) after stroke: Positive relationship between lower extremity and balance recovery

Abstract: Background: Stroke survivors have poor long-term quality of life (QoL), especially in the dimensions of mobility and daily activities. Objectives: We aimed to investigate how clinical variables influence QoL during subacute stroke rehabilitation. Methods: We assessed the evolution of the health-related QoL (HRQoL), the balance skills, the sensory-motor functions, and the ability in the activity of daily living in 25 hospitalized patients (60.6 ± 11.14 years old; 32% female) during a period of 2 months of stroke rehabilitation. We used the Stroke-Specific Quality of Life scale (SSQoL) to assess the HRQoL; the Berg Balance Scale to assess gait and balance functions; the Fugl-Meyer Assessment scale for sensory-motor functions of upper (UE) and lower limb (LE); and the Barthel Index for activity of daily living. All data have been investigated with the repeated-measures analysis of variance before and after normalization. Multiple Regression Analysis (MRA) has been performed on the normalized data and between the normalized data and the demographic characteristics (Gender; Age; Lesion side). Results: A significant improvement was found in all the assessed scales during the time of observation. MRA shows a positive regression between HRQoL and the motor recovery of LE and between HRQoL and the balance skills in 60 days from the stroke (MR = 0.88; respectively: p = 0.004 and p = 0.02). Conclusions: Our result shows that LE motor recovery impacts the QoL more than motor recovery of UE after 60 days of neurorehabilitation. This finding is strengthened by a positive regression between balance skills and QoL.

The Predictive Role of Executive Functions and Psychological Factors on Chronic Pain after Orthopaedic Surgery: A Longitudinal Cohort Study

Abstract: Prevention and treatment of chronic post-surgical pain should be based on the early identification of patients at risk. The presence of a deficit in executive functions, along with the presence of psychological risk factors, could impair the use of appropriate pain coping strategies and might facilitate the transition to chronic post-surgical pain. A longitudinal cohort study was implemented. Patients listed for orthopaedic surgery were enrolled. Variables measured before surgery were pain intensity, the sensory, affective, cognitive and mixed components of pain, state and trait variables associated with the psychological status of the patient, fear of movement, pain catastrophizing, visual attention and cognitive flexibility. Pain intensity and the components of pain were re-evaluated after surgery and after three months. A linear mixed model was used to assess the predictors of pain intensity, and a multivariate linear mixed model was used to assess the predictors of the pain components. 167 patients were enrolled. Controlling for sex, age, pain duration and surgical procedure, catastrophizing and visual attention were predictors of pain intensity at follow-up. The sensory component of pain was predicted by state anxiety, healthcare-related fears, pain catastrophizing and visual attention. Anxiety and catastrophizing were predictors of the affective and evaluative components of pain. The mixed component of pain was predicted by state anxiety, healthcare-related fears and pain catastrophizing. Executive functions, along with psychological risk factors, shape the course of post-surgical pain. The efficacy of preventive and rehabilitation treatment could be possibly enhanced if these factors are treated.

Effects of Cerebellar Theta Burst Stimulation on Contralateral Motor Cortex Excitability in Patients with Alzheimer's Disease.

Abstract: Although the cerebellum is not among the most renowned brain structures affected in Alzheimer`s disease (AD), recent evidence suggest that it undergoes degenerative changes during the course of the disease. A main neurophysiological feature of AD patients is the remarkable impairment of long term potentiation (LTP)-like cortical plasticity assessed in the primary motor cortex (M1) using theta burst stimulation (TBS) protocols. In healthy conditions, continuous (cTBS) and intermittent TBS (iTBS) of the cerebellum induce respectively long term depression (LTD)-like and LTP-like after effects in the contralateral M1. Here we aimed at examining the effects of cerebellar TBS on contralateral M1 excitability in a sample of 15 AD patients and 12 healthy age matched controls (HS). Motor evoked potentials (MEPs) were obtained in the contralateral M1 before and after cerebellar cTBS and iTBS protocols. As compared to HS, AD patients showed an impairment of LTP-like cortical plasticity mechanisms following cerebellar iTBS. No difference was observed for the cTBS protocol, in which both populations exhibited the expected LTD-like after effect. This study shows that mechanisms of cerebellar-cortical plasticity are impaired in AD. Given its role in high order cognitive functions, new potential therapeutic strategies could be built up in the future to modulate neural activity in the cerebellum in AD.

miR-146a Plasma Levels Are Not Altered in Alzheimer's Disease but Correlate With Age and Illness Severity.

Abstract: miR-146a is a microRNA (miRNA) involved in neuroinflammation and aging; alterations in its expression were described in Alzheimer's disease (AD). However, most of the studies conducted so far on this miRNA included a limited number of participants and produced contradictory results. We compared miR-146a levels in plasma from 33 AD patients vs. 28 age-matched non-affected controls (CTRL) through quantitative real-time polymerase chain reaction (qRT-PCR). No difference between the case and the control group was evidenced, but a correlation was detected between miR-146a levels and subjects' age (p < 0.001) as well as between miR-146a levels and patients' Mini-Mental State Examination (MMSE) scores (p = 0.011), in an enlarged group of 51 AD patients and 45 CTRL supporting a role for this miRNA in aging processes and disease progression.

Recurrence quantification analysis of heart rate variability during continuous incremental exercise test in obese subjects

Abstract: The present paper concerns a new description of changing in metabolism during incremental exercises test that permit an individually tailored program of exercises for obese subjects. We analyzed heart rate variability from RR interval time series (tachogram) with an alternative approach, the recurrence quantification analysis, that allows a description of a time series in terms of its dynamic structure and is able to identify the phase transitions. A transition in cardiac signal dynamics was detected and it perfectly reflects the aerobic threshold, as identified by gas exchange during an incremental exercise test, revealing the coupling from the respiratory system toward the heart. Moreover, our analysis shows that, in the recurrence plot of RR interval, it is possible to identify a specific pattern that allows to identify phase transitions between different dynamic regimes. The perfect match of the occurrence of the phase transitions with changes observed in the VO2 consumption, the gold standard approach to estimate thresholds, strongly supports the possibility of using our analysis of RR interval to detect metabolic threshold. In conclusion, we propose a novel nonlinear data analysis method that allows for an easy and personalized detection of thresholds both from professional and even from low-cost wearable devices, without the need of expensive gas analyzers.

On the Italian public accounts' sustainability: A wavelet approach

Abstract: In this paper we analyse the relationship between public primary deficit and debt for Italian sustainability over the 1862–2013 years. Our empirical strategy uses the wavelet analysis. The evidence confirms the absence of fiscal sustainability in the long‐run for Italy, reinforcing the need for a rebalancing of the public accounts.

Genetic determinants of circulating VEGF levels in major depressive disorder and electroconvulsive therapy response.

Abstract: Alterations in peripheral vascular endothelial growth factor (VEGF) levels were observed in major depressive disorder and relative treatments and were shown to be influenced by genetic variants. The study objective was to explore, at a genome-wide level, possible interplaying effects between the genetic background and major depressive disorder in regulating VEGF levels. Moreover, we aimed to investigate the association between these variants and response to electroconvulsive therapy. A genome-wide association study was carried out both on controls and patients with major depressive disorder (n = 145; n = 121) in correlation with serum VEGF levels determined by ELISA. Five SNPs not included in SNP arrays were additionally genotyped. Seventy-one patients with treatment-resistant depression underwent electroconvulsive therapy and were evaluated as responders/nonresponders. An association between VEGF levels and a locus in 6p21.1, downstream the VEGF gene, was evidenced both in controls (best SNP: FDR-corrected p = 2.4 × 10-5 ) and in patients with major depressive disorder (best SNP: FDR-corrected p = 2.6 × 10-3 ). The alleles associated with lower VEGF concentrations in patients were also associated with nonresponse to electroconvulsive therapy (p = .01). These results confirm a role of SNPs in 6p21.1 locus as major influencers of circulating VEGF levels also in patients affected by major depressive disorder and indicate a possible implication in response to electroconvulsive therapy.

Recurrence quantification analysis on a Kaldorian business cycle model

Abstract: Business cycles denote oscillations in economy as a result of downturns and expansions. The macroeconomic variable under our investigation is income as derived by the dynamic interaction with capital, consumption and investment. In this paper, a Kaldorian business cycle model is used to simulate real dynamics so that nonlinear techniques such as recurrence quantification analysis, Poincare Plot and related quantifiers can be applied. Analysis of chaos brings evidences on fractal dimension and entropy measures for both real data and model’s simulations. The final goal is to discover whether real and simulated business cycle dynamics have similar characteristics and validate the model as a suitable tool to simulate reality.