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The presence of tumor-infiltrating lymphocytes (TILs) is associated with a favorable prognosis of primary melanoma (PM). Recently, artificial intelligence (AI)-based approach in digital pathology was proposed for the standardized assessment of TILs on hematoxylin and eosin-stained whole slide images (WSIs). Herein, the study applied a new convolution neural network (CNN) analysis of PM WSIs to automatically assess the infiltration of TILs and extract a TIL score. A CNN was trained and validated in a retrospective cohort of 307 PMs including a training set (237 WSIs, 57,758 patches) and an independent testing set (70 WSIs, 29,533 patches). An AI-based TIL density index (AI-TIL) was identified after the classification of tumor patches by the presence or absence of TILs. The proposed CNN showed high performance in recognizing TILs in PM WSIs, showing 100% specificity and sensitivity on the testing set. The AI-based TIL index correlated with conventional TIL evaluation and clinical outcome. The AI-TIL index was an independent prognostic marker associated directly with a favorable prognosis. A fully automated and standardized AI-TIL appeared to be superior to conventional methods at differentiating the PM clinical outcome. Further studies are required to develop an easy-to-use tool to assist pathologists to assess TILs in the clinical evaluation of solid tumors.
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Aprendizado Profundo , Melanoma , Humanos , Estudos Retrospectivos , Linfócitos do Interstício Tumoral/patologia , Inteligência Artificial , Prognóstico , Melanoma/patologiaRESUMO
Assessing mobility in daily life can provide significant insights into several clinical conditions, such as Chronic Obstructive Pulmonary Disease (COPD). In this paper, we present a comprehensive analysis of wearable devices' performance in gait speed estimation and explore optimal device combinations for everyday use. Using data collected from smartphones, smartwatches, and smart shoes, we evaluated the individual capabilities of each device and explored their synergistic effects when combined, thereby accommodating the preferences and possibilities of individuals for wearing different types of devices. Our study involved 20 healthy subjects performing a modified Six-Minute Walking Test (6MWT) under various conditions. The results revealed only little performance differences among devices, with the combination of smartwatches and smart shoes exhibiting superior estimation accuracy. Particularly, smartwatches captured additional health-related information and demonstrated enhanced accuracy when paired with other devices. Surprisingly, wearing all devices concurrently did not yield optimal results, suggesting a potential redundancy in feature extraction. Feature importance analysis highlighted key variables contributing to gait speed estimation, providing valuable insights for model refinement.
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Velocidade de Caminhada , Dispositivos Eletrônicos Vestíveis , Humanos , Velocidade de Caminhada/fisiologia , Masculino , Feminino , Adulto , Smartphone , Sapatos , Marcha/fisiologia , Caminhada/fisiologia , Adulto JovemRESUMO
Hypoxia, centralization of blood in pulmonary vessels, and increased cardiac output during physical exertion are the pathogenetic pathways of acute pulmonary edema observed during exposure to extraordinary environments. This study aimed to evaluate the effects of breath-hold diving at altitude, which exposes simultaneously to several of the stimuli mentioned above. To this aim, 11 healthy male experienced divers (age 18-52y) were evaluated (by Doppler echocardiography, lung echography to evaluate ultrasound lung B-lines (BL), hemoglobin saturation, arterial blood pressure, fractional NO (Nitrous Oxide) exhalation in basal condition (altitude 300m asl), at altitude (2507m asl) and after breath-hold diving at altitude. A significant increase in E/e' ratio (a Doppler-echocardiographic index of left atrial pressure) was observed at altitude, with no further change after the diving session. The number of BL significantly increased after diving at altitude as compared to basal conditions. Finally, fractional exhaled nitrous oxide was significantly reduced by altitude; no further change was observed after diving. Our results suggest that exposure to hypoxia may increase left ventricular filling pressure and, in turn, pulmonary capillary pressure. Breath-hold diving at altitude may contribute to interstitial edema (as evaluated by BL score), possibly because of physical efforts made during a diving session. The reduction of exhaled nitrous oxide at altitude confirms previous reports of nitrous oxide reduction after repeated exposure to hypoxic stimuli. This finding should be further investigated since reduced nitrous oxide production in hypoxic conditions has been reported in subjects prone to high-altitude pulmonary edema.
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Altitude , Suspensão da Respiração , Mergulho , Ecocardiografia Doppler , Hipóxia , Pulmão , Humanos , Masculino , Mergulho/fisiologia , Mergulho/efeitos adversos , Adulto , Adulto Jovem , Hipóxia/fisiopatologia , Pessoa de Meia-Idade , Adolescente , Pulmão/fisiopatologia , Pulmão/diagnóstico por imagem , Pulmão/irrigação sanguínea , Edema Pulmonar/etiologia , Edema Pulmonar/fisiopatologia , Edema Pulmonar/diagnóstico por imagem , Pressão Arterial/fisiologia , Saturação de Oxigênio/fisiologia , Óxido Nítrico/metabolismo , Pressão Sanguínea/fisiologia , Hemoglobinas/análiseRESUMO
BACKGROUND: Large changes in ageing population and in retirement age are increasing the number of older people in the workforce, raising many challenges for policymakers in promoting employment opportunities and health for older workers. In this respect, longitudinal assessments of workability, well-being perception and cognitive skills over time may allow to detect factors influencing workers' health. Moreover, new available molecular markers permit the measurement of biological age and age-related changes. Most studies analysed one aspect at time (psychological, biological, labour productivity), without considering their interaction. Aims of the study are to evaluate the relationship between workability, cognitive skills, and biological age in a population of ageing workers; to conduct a cross-sectional analysis to assess the impact of occupational exposures on workability, cognitive skills, and biological age; to evaluate inter-individuals changes in a prospective analysis with a re-evaluation of each worker. METHODS: Our study plans to enrol 1000 full-time workers, aged over 50, undergoing the medical surveillance required by the current Italian Legislation. Data collection includes information about: (a) work ability and psychosocial risk factors (work ability index, HSE Management Standard-21 item, Utrecht Work Engagement Scale, World Health Organisation-Five, Well-Being Index, job satisfaction, general well-being, technostress); (b) cognitive skills (Stroop Color and Word test, Simon task, Corsi's block-tapping test, Digit span test); (c) sleep habits and psychological well-being (Pittsburgh Sleep Quality Index, Insomnia Severity Index, Ford Insomnia Response to Stress Test; Symptom Check List 90, Psychological Well-Being Index, Profile of Mood State, Beck Depression Inventory, Beck Anxiety Inventory, Perceived Stress Scale, Brief COPE); (d) biological age (telomere length, DNA methylation) for 500 workers. All workers will repeat the evaluation after one year. DISCUSSION: This study aims to increase our knowledge about interactions between work ability, cognitive ability, well-being perception and psychological status also by including molecular markers, with a longitudinal and multidisciplinary approach. By bringing better insights into the relationship between risk factors and their impact on perceived and biological health, this study also aims at identifying possible interventions and protective measures to ensure aged workers' well-being, consistent with all the eminent calls for actions promoted by key International and European labour organizations.
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Distúrbios do Início e da Manutenção do Sono , Humanos , Pessoa de Meia-Idade , Idoso , Estudos Transversais , Estudos Longitudinais , Avaliação da Capacidade de Trabalho , Envelhecimento , Local de Trabalho , CogniçãoRESUMO
BACKGROUND: The COVID-19 pandemic has increased the impact and spread of mental illness and made health services difficult to access; therefore, there is a need for remote, pervasive forms of mental health monitoring. Digital phenotyping is a new approach that uses measures extracted from spontaneous interactions with smartphones (eg, screen touches or movements) or other digital devices as markers of mental status. OBJECTIVE: This review aimed to evaluate the feasibility of using digital phenotyping for predicting relapse or exacerbation of symptoms in patients with mental disorders through a systematic review of the scientific literature. METHODS: Our research was carried out using 2 bibliographic databases (PubMed and Scopus) by searching articles published up to January 2023. By following the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines, we started from an initial pool of 1150 scientific papers and screened and extracted a final sample of 29 papers, including studies concerning clinical populations in the field of mental health, which were aimed at predicting relapse or exacerbation of symptoms. The systematic review has been registered on the web registry Open Science Framework. RESULTS: We divided the results into 4 groups according to mental disorder: schizophrenia (9/29, 31%), mood disorders (15/29, 52%), anxiety disorders (4/29, 14%), and substance use disorder (1/29, 3%). The results for the first 3 groups showed that several features (ie, mobility, location, phone use, call log, heart rate, sleep, head movements, facial and vocal characteristics, sociability, social rhythms, conversations, number of steps, screen on or screen off status, SMS text message logs, peripheral skin temperature, electrodermal activity, light exposure, and physical activity), extracted from data collected via the smartphone and wearable wristbands, can be used to create digital phenotypes that could support gold-standard assessment and could be used to predict relapse or symptom exacerbations. CONCLUSIONS: Thus, as the data were consistent for almost all the mental disorders considered (mood disorders, anxiety disorders, and schizophrenia), the feasibility of this approach was confirmed. In the future, a new model of health care management using digital devices should be integrated with the digital phenotyping approach and tailored mobile interventions (managing crises during relapse or exacerbation).
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Transtornos Mentais , Pandemias , Humanos , Transtornos Mentais/diagnóstico , Saúde Mental , Transtornos do Humor , Recidiva , SmartphoneRESUMO
We describe the development and preliminary evaluation of an innovative low-cost wearable device for gait analysis. We have developed a sensorized sock equipped with 32 piezoresistive textile-based sensors integrated in the heel and metatarsal areas for the detection of signals associated with the contact pressures generated during walking phases. To build the sock, we applied a sensing patch on a commercially available sock. The sensing patch is a stretchable circuit based on the resistive matrix method, in which conductive stripes, based on conductive inks, are coupled with piezoresistive fabrics to form sensing elements. In our sensorized sock, we introduced many relevant improvements to overcome the limitations of the classical resistive matrix method. We preliminary evaluated the sensorized sock on five healthy subjects by performing a total of 80 walking tasks at different speeds for a known distance. Comparison of step count and step-to-step frequency versus reference measurements showed a high correlation between the estimated measure and the real one.
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Análise da Marcha , Dispositivos Eletrônicos Vestíveis , Humanos , Tecnologia , Têxteis , CaminhadaRESUMO
Aging is associated not only with the reduction of psychophysical and sensory capacities but also with different types of neurodegenerative disorders up to dementia manifestations. Aging in health and self-sufficiency is strictly dependent on the prevention and correction of factors that may determine reduction of psychophysical capacities (e.g., cardiovascular, locomotor and neurodegenerative ones). To reach this goal, due to the dynamics of social and family changes and to the aging of the population, health professionals can be supported by technologies which provide noninvasive monitoring of physiologic parameters and rely on telemedicine, both instruments of support and care for better aging in the home setting. The authors, starting from the initial idea of a personalized monitoring of different psychophysical variables, defined a pilot study to assess the role of a 12-month individually tailored lifestyle counseling on parameters of mild cognitive impairment in a group of elderly subjects. Data derived from the applied approach appeared promising and may open the road to the possible implementation of individual counseling, based on multiparametric non-obtrusive technologies which take into consideration both psychological and physical aspects, to be followed in the home environment.
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Disfunção Cognitiva , Envelhecimento Saudável , Telemedicina , Idoso , Humanos , Estilo de Vida , Projetos PilotoRESUMO
We investigated changes of slow-wave activity and sleep slow oscillations in the night following procedural learning boosted by reinforcement learning, and how these changes correlate with behavioural output. In the Task session, participants had to reach a visual target adapting cursor's movements to compensate an angular deviation introduced experimentally, while in the Control session no deviation was applied. The task was repeated at 13:00â hours, 17:00â hours and 23:00â hours before sleep, and at 08:00â hours after sleep. The deviation angle was set at 15° (13:00â hours and 17:00â hours) and increased to 45° (reinforcement) at 23:00â hours and 08:00â hours. Both for Task and Control nights, high-density electroencephalogram sleep recordings were carried out (23:30-19:30â hours). The Task night as compared with the Control night showed increases of: (a) slow-wave activity (absolute power) over the whole scalp; (b) slow-wave activity (relative power) in left centro-parietal areas; (c) sleep slow oscillations rate in sensorimotor and premotor areas; (d) amplitude of pre-down and up states in premotor regions, left sensorimotor and right parietal regions; (e) sigma crowning the up state in right parietal regions. After Task night, we found an improvement of task performance showing correlations with sleep slow oscillations rate in right premotor, sensorimotor and parietal regions. These findings suggest a key role of sleep slow oscillations in procedural memories consolidation. The diverse components of sleep slow oscillations selectively reflect the network activations related to the reinforced learning of a procedural visuomotor task. Indeed, areas specifically involved in the task stand out as those with a significant association between sleep slow oscillations rate and overnight improvement in task performance.
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Córtex Cerebral/fisiopatologia , Eletroencefalografia/métodos , Aprendizagem/fisiologia , Sono/fisiologia , Adulto , Feminino , Voluntários Saudáveis , Humanos , Masculino , Adulto JovemRESUMO
The aim of this study is to ascertain whether the simultaneous measurement of hemoglobin O2 saturation (StO2 ) and dimension of venous leg ulcers (VLU) by near infrared spectroscopy (NIRS) imaging can predict the healing course with protocols employing a conventional treatment alone or in combination with hyperbaric oxygen therapy (HBOT). NIRS 2D images of wound region were obtained in 81 patients with hard-to-heal VLU that had been assigned, in a randomized controlled clinical trial, to the following protocols: 30 HBOT sessions, adjunctive to the conventional therapy, either twice daily over 3 weeks (group A) or once daily over 6 weeks (group B), and conventional therapy without HBOT (group C). Seventy-three patients completed the study with a total of 511 NIRS images being analyzed. At the end of treatment, wound area was significantly smaller in all three groups. However, at the 3-week mark the wound area reduction tended to be less evident in group A than in the other groups. This trend continued up to the 6-week end-point when a significantly greater area reduction was found with group B (65.5%) and group C (56.8%) compared to group A (29.7%) (P < .01). Furthermore, a higher incidence of complete healing was noted with group B (20%) than with group A (4.5%) and group C (3.8%). When using a final wound reduction in excess of 40% to distinguish healing from nonhealing ulcers, it was found that only the former present NIRS StO2 values abating over the study period both at center and edge of lesions. In conclusion, NIRS analysis of StO2 and wound area can predict the healing course of VLU. Adjunctive HBOT significantly facilitates VLU healing compared to the conventional treatment alone. This positive action, however, becomes manifest only with a longer and less intensive treatment schedule.
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Bandagens Compressivas , Hemoglobinas/metabolismo , Oxigenoterapia Hiperbárica/métodos , Espectroscopia de Luz Próxima ao Infravermelho/métodos , Úlcera Varicosa/terapia , Cicatrização/fisiologia , Idoso , Biomarcadores/sangue , Feminino , Humanos , Masculino , Consumo de Oxigênio , Resultado do Tratamento , Úlcera Varicosa/sangueRESUMO
Continuous heart monitoring is essential for early detection and diagnosis of cardiovascular diseases, which are key factors for the evaluation of health status in the general population. Therefore, in the future, it will be increasingly important to develop unobtrusive and transparent cardiac monitoring technologies for the population. The possible approaches are the development of wearable technologies or the integration of sensors in daily-life objects. We developed a smart bed for monitoring cardiorespiratory functions during the night or in the case of continuous monitoring of bedridden patients. The mattress includes three accelerometers for the estimation of the ballistocardiogram (BCG). BCG signal is generated due to the vibrational activity of the body in response to the cardiac ejection of blood. BCG is a promising technique but is usually replaced by electrocardiogram due to the difficulty involved in detecting and processing the BCG signals. In this work, we describe a new algorithm for heart parameter extraction from the BCG signal, based on a moving auto-correlation sliding-window. We tested our method on a group of volunteers with the simultaneous co-registration of electrocardiogram (ECG) using a single-lead configuration. Comparisons with ECG reference signals indicated that the algorithm performed satisfactorily. The results presented demonstrate that valuable cardiac information can be obtained from the BCG signal extracted by low cost sensors integrated in the mattress. Thus, a continuous unobtrusive heart-monitoring through a smart bed is now feasible.
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Acelerometria/instrumentação , Balistocardiografia , Frequência Cardíaca , Processamento de Sinais Assistido por Computador , Eletrocardiografia , Coração , HumanosRESUMO
A neoprene wetsuit is widely used to reduce thermal dispersion during diving. Recent observations have pointed out that elastic recoil of the wetsuit might have significant compressive effects, able to affect water and electrolyte homeostasis during both dry and immersed conditions. The aim of this study was to evaluate the possible cardiovascular and respiratory effects of the neoprene wetsuit in dry conditions in a sample of experienced divers. Twenty-four (24) healthy divers were evaluated by Doppler-echocardiography and by spirometry in basal conditions and while wearing a full neoprene wetsuit. During wetsuit conditions, we observed a significant decrease in heart rate (-5%; p ⟨ 0.05) and cardiac output (-12%; p ⟨ 0.05), and a significant increase in total peripheral resistances (15%; p ⟨ 0.05). Moreover, a significant reduction of right ventricular early diastolic filling was observed (-15%; p ⟨ 0.05). As concerns pulmonary function, a significant reduction of vital capacity (-2%; p ⟨ 0.001) and expiratory reserve volume (-25%; p ⟨ 0.001), and a significant increase of inspiratory capacity (9%; p ⟨ 0.001) and tidal volume (25%; p ⟨ 0.05) were observed. These data support the hypothesis that neoprene elastic recoil, possibly due to a compression exerted on chest, might affect systemic circulation (decreasing cardiac output and impairing right ventricular filling) and respiratory function.
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Mergulho/fisiologia , Hemodinâmica/fisiologia , Neopreno , Roupa de Proteção/efeitos adversos , Capacidade Pulmonar Total/fisiologia , Adulto , Débito Cardíaco/fisiologia , Ecocardiografia Doppler , Elasticidade , Volume de Reserva Expiratória/fisiologia , Feminino , Frequência Cardíaca/fisiologia , Humanos , Capacidade Inspiratória/fisiologia , Masculino , Pessoa de Meia-Idade , Pressão , Espirometria , Volume de Ventilação Pulmonar/fisiologia , Resistência Vascular/fisiologia , Função Ventricular Direita/fisiologia , Capacidade Vital/fisiologiaRESUMO
Herpes zoster arises from reactivation of the varicella-zoster virus (VZV), causing varicella in children. As reactivation occurs when cell-mediated immunity (CMI) declines, and there is evidence that re-exposure to VZV boosts CMI, mass varicella immunization might increase the zoster burden, at least for some decades. Fear of this natural zoster boom is the main reason for the paralysis of varicella immunization in Europe. We apply optimal control to a realistically parametrized age-structured model for VZV transmission and reactivation to investigate whether feasible varicella immunization paths that are optimal in controlling both varicella and zoster exist. We analyse the optimality system numerically focusing on the role of the cost functional, of the relative zoster-varicella cost and of the planning horizon length. We show that optimal programmes will mostly be unfeasible for public health owing to their complex temporal profiles. This complexity is the consequence of the intrinsically antagonistic nature of varicella immunization programmes when aiming to control both varicella and zoster. However, we show that gradually increasing-hence feasible-vaccination schedules can perform better than routine programmes with constant vaccine uptake. Finally, we show the optimal profiles of feasible programmes targeting mitigation of the post-immunization natural zoster boom with priority.
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Varicela/prevenção & controle , Herpes Zoster/prevenção & controle , Herpesvirus Humano 3/imunologia , Vacinação em Massa , Adolescente , Adulto , Varicela/virologia , Criança , Pré-Escolar , Europa (Continente) , Herpes Zoster/virologia , Humanos , Pessoa de Meia-Idade , Modelos Teóricos , Adulto JovemRESUMO
We review current models of consciousness in the context of wakefulness and sleep. We show that recent results on Slow Wave Sleep, including our own works, naturally fit within consciousness models. In particular, Sleep Slow Oscillations, namely low-frequency (<1Hz) oscillations, contain electrophysiological properties (up and down states) able to elicit and quench neural integration during Slow Wave Sleep. The physiological unconsciousness related to the Sleep Slow Oscillation derives from the interplay between spontaneous or evoked wake-like activities (up states) and half-a-second's electrical silences (down states). Sleep Slow Oscillation induces unconsciousness via the formation of parallel and segregated neural activities.
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Ondas Encefálicas , Estado de Consciência , Fases do Sono , Animais , Encéfalo/fisiologia , HumanosAssuntos
Aprendizado de Máquina , Neoplasias Cutâneas , Algoritmos , Humanos , Internet , Masculino , PeleRESUMO
During non-REM sleep the largest EEG response evoked by sensory stimulation is the K-complex (eKC), composed of an initial positive bump (P200) followed by a bistable cortical response: a giant negative deflection (N550) and a large positive one (P900), respectively reflecting down states and up states of < 1 Hz oscillations.Sensory-modality-independent topology of N550 and P900, with maximal detection rate on fronto-central areas, has been consistently reported, suggesting that sensory inputs arise to the cortex avoiding specific primary sensory areas. However, these studies neglected latencies of all KC components as a function of electrode sites.Our aim is to identify, component by component, which topological/dynamical properties of eKCs depend on stimulus modality and which are mainly related to local cortical properties. We measured temporal and morphological features of acoustic, tactile and visual eKCs to disentangle specific sensory excitatory activities from aspecific responses due to local proneness to bistability, measured by means of the N550 descending steepness (synchronization in falling into down state).While confirming the sensory-modality independence of N550 and P900 topology with maximal detection rate in fronto-central areas, four main original results emerge from this study: (i) the topology of P200 latency depends on the sensory modality with earliest waves in the stimulation-related primary sensory areas; (ii) P200 rapidly travels as a cortical excitation; (iii) P200-like excitations when KCs are not evoked are detected over the scalp with significantly smaller amplitudes in fronto-central areas, compared to eKC P200s; and (iv) N550 latency mirrors its mean local steepness which is a function of topological proneness to bistability.From these results we can describe the emergence N550/P900 complex as the interplay between a waxing P200 cortical travel and higher fronto-central proneness to bistability.In conclusion, eKCs exhibit a physiological dichotomy: P200 acts as a traveling cortical excitation whose function is to induce the bistable cortical response (N550/P900), which in turn is crucial for maintaining sleep and unconsciousness.
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Relógios Biológicos/fisiologia , Mapeamento Encefálico/métodos , Córtex Cerebral/fisiologia , Potenciais Evocados/fisiologia , Rede Nervosa/fisiologia , Sensação , Fases do Sono/fisiologia , Adulto , Eletroencefalografia/métodos , Feminino , Humanos , Masculino , Adulto JovemRESUMO
Background: Persons with specific phobias typically generalize the dangerousness of the phobic animal to all members of its species, possibly as a result of malfunctioning brain circuitry normally providing quick and dirty identification of evolutionary-relevant stimuli. An objective assessment of which perceptual features make an animal more or less scary to phobic and non-phobic people would help overcome the limitations of the few studies available so far, based on self-reports. Objective: To achieve this aim, we built an augmented reality setting where volunteers with different levels of fear of spiders were asked to make holographic spiders that look either dangerous or harmless. To reach this goal, a computerized interface allowed participants to modify the spider's perceptual features (hairiness, body/leg size, and locomotion) in real time. Results: On average, the dangerous spiders were made hairy, thick, and moving according to spider-like locomotion; coherently, the harmless spiders were made hairless, slim, and moving according to a butterfly-like locomotion. However, these averaged preferences could not fully describe the complex relationship between perceptual preferences with each other and with arachnophobia symptoms. An example of a key finding revealed by cluster analysis is the similarity in perceptual preferences among participants with little or no fear of spiders, whereas participants with more arachnophobia symptoms expressed more varying preferences. Conclusion: Perceptual preferences toward the spider's features were behaviorally assessed through an observational study, objectively confirming a generalization effect characterizing spider-fearful participants. These results advance our knowledge of phobic preferences and could be used to improve the acceptability of exposure therapies.
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The COVID-19 pandemic experience has highlighted the importance of developing general control principles to inform future pandemic preparedness based on the tension between the different control options, ranging from elimination to mitigation, and related costs. Similarly, during the COVID-19 pandemic, social distancing has been confirmed to be the critical response tool until vaccines become available. Open-loop optimal control of a transmission model for COVID-19 in one of its most aggressive outbreaks is used to identify the best social distancing policies aimed at balancing the direct epidemiological costs of a threatening epidemic with its indirect (i.e., societal level) costs arising from enduring control measures. In particular, we analyse how optimal social distancing varies according to three key policy factors, namely, the degree of prioritization of indirect costs, the adherence to control measures, and the timeliness of intervention. As the prioritization of indirect costs increases, (i) the corresponding optimal distancing policy suddenly switches from elimination to suppression and, finally, to mitigation; (ii) the "effective" mitigation region-where hospitals' overwhelming is prevented-is dramatically narrow and shows multiple control waves; and (iii) a delicate balance emerges, whereby low adherence and lack of timeliness inevitably force ineffective mitigation as the only accessible policy option. The present results show the importance of open-loop optimal control, which is traditionally absent in public health preparedness, for studying the suppression-mitigation trade-off and supplying robust preparedness guidelines.
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COVID-19 , Distanciamento Físico , Humanos , Pandemias/prevenção & controle , COVID-19/epidemiologia , COVID-19/prevenção & controle , Saúde Pública , Surtos de DoençasRESUMO
Introduction: Cognitive functions play a crucial role in individual's life since they represent the mental abilities necessary to perform any activity. During working life, having healthy cognitive functioning is essential for the proper performance of work, but it is especially crucial for preserving cognitive abilities and thus ensuring healthy cognitive aging after retirement. The aim of this paper was to systematically review the scientific literature related to the effects of work on cognitive functions to assess which work-related factors most adversely affect them. Method: We queried the PubMed and Scopus electronic databases, in February 2023, according to the PRISMA guidelines (PROSPERO ID number = CRD42023439172), and articles were included if they met all the inclusion criteria and survived a quality assessment. From an initial pool of 61,781 papers, we retained a final sample of 64 articles, which were divided into 5 categories based on work-related factors: shift work (n = 39), sedentary work (n = 7), occupational stress (n = 12), prolonged working hours (n = 3), and expertise (n = 3). Results: The results showed that shift work, occupational stress, and, probably, prolonged working hours have detrimental effects on cognitive functioning; instead, results related to sedentary work and expertise on cognitive functions are inconclusive and extremely miscellaneous. Discussion: Therefore, workplace health and well-being promotion should consider reducing or rescheduling night shift, the creation of less demanding and more resourceful work environments and the use of micro-breaks to preserve workers' cognitive functioning both before and after retirement. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023439172, identifier CRD42023439172.
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The positive effects of meditation on human wellbeing are indisputable, ranging from emotion regulation improvement to stress reduction and present-moment awareness enhancement. Changes in brain activity regulate and support these phenomena. However, the heterogeneity of meditation practices and their cultural background, as well as their poor categorization limit the generalization of results to all types of meditation. Here, we took advantage of a collaboration with the very singular and precious community of the Monks and Geshes of the Tibetan University of Sera-Jey in India to study the neural correlates of the two main types of meditation recognized in Tibetan Buddhism, namely concentrative and analytical meditation. Twenty-three meditators with different levels of expertise underwent to an ecological (i.e., within the monastery) EEG acquisition consisting of an analytical and/or concentrative meditation session at "their best," and with the only constraint of performing a 5-min-long baseline at the beginning of the session. Time-varying power-spectral-density estimates of each session were compared against the baseline (i.e., within session) and between conditions (i.e., analytical vs. concentrative). Our results showed that concentrative meditation elicited more numerous and marked changes in the EEG power compared to analytical meditation, and mainly in the form of an increase in the theta, alpha and beta frequency ranges. Moreover, the full immersion in the Monastery life allowed to share the results and discuss their interpretation with the best scholars of the Monastic University, ensuring the identification of the most expert meditators, as well as to highlight better the differences between the different types of meditation practiced by each of them.
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Objective: This observational study investigates workability and its associations with cognitive functioning, sleep quality and technostress among an older working population, also shedding light on potential differences between two occupational categories with different work schedules. Methods: Workers aged over 50, employed in different working sectors (banking/finance, chemical and metal-mechanic industry) were administered a self- report questionnaire including Work Ability Index (WAI), cognitive tests (Stroop Color Task, Corsi Blocks, Digit Span), sleep quality questionnaires (Pittsburgh Sleep Quality Index-PSQI; Insomnia Severity Index-ISI; Ford Insomnia Response to Stress Test-FIRST) and technostress scale. Linear regression models evaluated associations among variables, interaction effects investigated potential moderators. Results: A total of 468 aged workers categorized as white (WCWs; N = 289, 62%) or blue collars (BCWs; N = 179, 38%) were enrolled; most BCWs (N = 104; 58%) were night shift workers. WCWs reported higher workability, cognitive functioning, sleep quality and lower technostress (except for invasion and privacy subscales) than BCWs. Associations between cognitive functioning and workability were statistically significant only for BCWs [slopes equal to 0.2 (0.33), 0.8 (0.34), -0.02 (0.001) for Memory Span Corsi, Block Span Digit and Interference Speed respectively]; additionally, sleep quality significantly moderated this association (p = 0.007). Higher levels of technostress were associated with lower workability, and this relationship was stronger for BCWs. Conclusion: The aging of the workforce has important implications for occupational health and safety. Our findings suggest potential interventions and protective measures to promote older workers' wellbeing; blue-collar workers particularly should benefit from tailored intervention to sustain workability and prevent technostress, considering the role of healthy sleep habits promotion.