Caregiver Tele-Assistance for Reduction of Emotional Distress During the COVID-19 Pandemic. Psychological Support to Caregivers of People with Dementia: The Italian Experience.

BACKGROUND: COVID-19 pandemic worsened vulnerability of patients with dementia (PWD). This new reality associated with government restriction and isolation worsened stress burden and psychological frailties in PWD caregivers. OBJECTIVE: To give tele-psychological support to caregivers and evaluate the effect of this intervention by quantifying stress burden and quality of life during the first COVID-19 lockdown. METHODS: 50 caregivers were divided into two groups: "Caregiver-focused group" (Cg) and "Patient-focused group" (Pg). Both groups received telephone contact every 2 weeks over a 28-week period, but the content of the call was different: in Cg, caregivers answered questions about the state of the PWD but also explored their own emotional state, stress burden, and quality of life. In Pg instead, telephone contacts were focused only on the PWD, and no evaluation regarding the caregiver mood or state of stress was made. Psychometric scales were administered to evaluate COVID-19 impact, stress burden, and quality of life. RESULTS: Considering the time of intervention, from baseline (W0) to W28, Zarit Burden Interview and Quality of Life-caregiver questionnaires remained unchanged in Cg as compared with baseline (p > 0.05), whereas they worsened significantly in Pg (p < 0.01), showing increased stress over time and decreased quality of life in this group. Moreover, Impact on Event Scale values improved over the weeks in Cg (p = 0.015), while they remained unchanged in Pg (p = 0.483). CONCLUSION: Caregivers who received telephone support about their mood and stress burden did not worsen their psychological state during the time of intervention, as did instead those who did not get such support.

Use of Machine Learning to Identify Children with Autism and Their Motor Abnormalities.

In the present work, we have undertaken a proof-of-concept study to determine whether a simple upper-limb movement could be useful to accurately classify low-functioning children with autism spectrum disorder (ASD) aged 2-4. To answer this question, we developed a supervised machine-learning method to correctly discriminate 15 preschool children with ASD from 15 typically developing children by means of kinematic analysis of a simple reach-to-drop task. Our method reached a maximum classification accuracy of 96.7% with seven features related to the goal-oriented part of the movement. These preliminary findings offer insight into a possible motor signature of ASD that may be potentially useful in identifying a well-defined subset of patients, reducing the clinical heterogeneity within the broad behavioral phenotype.

A special case of lower back pain in a 3-year-old girl.

We describe the case of a 3-year-old girl with a 15-day clinical history of lower back pain. We diagnosed a spondylodiscitis of vertebral bodies L5-S1 caused by Salmonella species group B that totally recovered with appropriate antibiotic therapy. Spondylodiscitis in children is a rare condition and Salmonella infection is one of the rarest aetiology. A high index of suspicion is needed for prompt diagnosis to ensure better long-term outcome. Microbiological diagnosis is essential for the appropriate choice of antibiotic treatment.

Eye-hand coordination in children with high functioning autism and Asperger's disorder using a gap-overlap paradigm.

We investigated eye-hand coordination in children with autism spectrum disorders (ASD) in comparison with age-matched normally developing peers. The eye-hand correlation was measured by putting fixation latencies in relation with pointing and key pressing responses in visual detection tasks where a gap-overlap paradigm was used and compared to fixation latencies in absence of manual response. ASD patients showed less efficient eye-hand coordination, which was particularly evident when pointing towards a target was being fixated. The data of normally developing participants confirmed that manual gap effects are more likely for more complex hand movements. An important discrepancy was discovered in participants with ASD: beside normal eye gap effects, they showed no concurrent hand gap effects when pointing to targets. This result has been interpreted as a further sign of inefficient eye-hand coordination in this patient population.

Reach and throw movement analysis with support vector machines in early diagnosis of autism.

Movement disturbances play an intrinsic part in autism. Upper limb movements like reach-and-throw seem to be helpful in early identification of children affected by autism. Nevertheless few works investigate the application of classifying methods to upper limb movements. In this study we used a machine learning approach Support Vector Machine (SVM) for identifying peculiar features in reach-and-throw movements. 10 pre-scholar age children with autism and 10 control subjects performing the same exercises were analyzed. The SVM algorithm proved to be able to separate the two groups: accuracy of 100% was achieved with a soft margin algorithm, and accuracy of 92.5% with a more conservative one. These results were obtained with a radial basis function kernel, suggesting that a non-linear analysis is possibly required.

Gastrointestinal lesions in parvovirus B19 infection.

A 13-year-old girl with persistent fever, pharyngitis, acute anaemia, peripheral blood and bone marrow positive for parvovirus B19 DNA.Microscopic findings of gastrointestinal biopsy showed diffuse vacuolar alteration of the cytoplasma of duodenal enterocytes and virological analysis demonstrated the presence of parvovirus in lymphocytes of the duodenal wall's epithelial layer.In unexplained gastrointestinal pathologies, the role of parvovirus B19 infection should be investigated.

Sensitivity to object viewpoint and action instructions during search for targets in the lower visual field.

We contrasted visual search for targets presented in prototypical views and targets presented in nonprototypical views, when targets were defined by their names and when they were defined by the action that would normally be performed on them. The likelihood of the first fixation falling on the target was increased for prototypical-view targets falling in the lower visual field. When targets were defined by actions, the durations of fixations were reduced for targets in the lower field. The results are consistent with eye movements in search being affected by representations within the dorsal visual stream, where there is strong representation of the lower visual field. These representations are sensitive to the familiarity or the affordance offered by objects in prototypical views, and they are influenced by action-based templates for targets.

A case of furuncular myiasis associated with systemic inflammation.

Cutaneous myiasis is a common travel-associated dermatosis caused by fly larvae. We report an unusual case of furuncular myiasis caused by Dermatobia hominis that was associated with signs of systemic inflammation. In this case study, morphological and novel molecular approaches were used to identify and characterize the larvae responsible for human infestation.

The representation of unseen objects in visual neglect: effects of view and object identity.

We provide evidence for long-term priming based on view-specific representations of neglected stimuli. A patient with visual neglect, M.P., was asked to search for a target presented amongst other objects on a table. Subsequently recognition memory was tested for items that were identified and for items missed in search. Items that were missed were rejected more slowly than novel items in the recognition memory task, providing evidence for implicit processing (Experiment 1). Implicit memory for missed items was both item-specific (Experiment 2) and view-specific (Experiment 3), and it was eliminated when there were intervening activities lasting about 1 hour (Experiment 4). There was also an implicit memory for distractors in the search task, which was item- but not view-specific (Experiments 2 and 3) and it lasted for at least an hour, even with other intervening activities (Experiment 4). The data suggest that the representations of neglected stimuli may differ qualitatively from those of nonneglected items, with representations of neglected objects being both view-specific and vulnerable across extended retention intervals. The results support the argument that attention is needed in order to encode object representations that are robust to view transformations and temporal decay or interference.

Cross-modal visuo-tactile matching in a patient with a semantic disorder.

This study is concerned with the nature of object representations coded within and between vision and touch, assessed through a study of perceptual matching abilities in a patient with impaired semantic knowledge for objects: JP. Prior work with JP has indicated that she has a category-specific deficit that is particularly severe for tools (see the Case report and Humphreys, G. W., Vernier, M. -P., & Riddoch, M. J. A semantic deficit for tools, in preparation). Here, we test whether, despite this semantic deficit, JP can perform object matching under various conditions. We demonstrate that JP could perform matching across sensory modalities (between touch and vision) when objects appeared in the same view, but this did not generalise across views. In addition, JP was able to match from 3D felt representations to 2D visual representations provided the stimuli were real (previously familiar) objects. The data support the idea that matching between touch and vision can be based on common view-specific, perceptual representations, sensitive to the familiarity of individual objects.

Visuomotor cuing through tool use in unilateral visual neglect.

In the present study, the authors examined the effect of tool use in a patient, MP, with neglect of peripersonal space. They found that target detection improved when the patient searched with his arm outstretched, when both visual and motor cues were present. Motor cues (arm outstretched but hidden from view) and visual cues alone (shining a torch on the objects) were less effective. In a final experiment, the authors reported that MP established a better memory for the objects that were searched for when a combined visual and motor cue was present. The authors argue that search was improved by combined visuomotor cuing, which was effective when the action could affect the objects present. Visuomotor cuing also led to stronger memories for searched locations, which reduced any tendency to reexamine positions that had been searched previously. The data are discussed in terms of the interaction between perception and action.

A brief and unobtrusive instrument to detect simulation and exaggeration in patients with whiplash syndrome.

The objective of this study was to develop and test a brief and unobtrusive instrument to detect exaggeration and simulation in whiplash syndrome. The instrument consists of eight scenarios with ten response options that have to be ordered according to how easy a behavior is to perform. Twenty-five simulating and 25 non-simulating patients with whiplash syndrome of grades 2 and 3 according to the Quebec Task Force classification as well as 25 simulating and 25 non-simulating controls completed the instrument. In a cross-validation study 20 controls and 20 patients participated. Malingering and exaggeration scores were determined for each subject and patient. The scores were summed up and compared across malingering and exaggerating subjects and controls and cut-off values were determined to classify the patients. T-tests and a discriminant analysis were used to determine classification accuracy. The instrument correctly identified 94% of the simulators and 84% of the exaggerators in both samples. This brief and unobtrusive instrument can detect exaggeration and simulation in whiplash syndrome.