The Four Factors of Mind Wandering Questionnaire: Content, Construct, and Clinical Validity.

Despite great interest in Mind Wandering, a fully validated questionnaire has been lacking. The Four Factors of Mind Wandering (4FMW) Questionnaire, presented here, meets this demand. First, 80 items were judged for content validity by two panels of experts. Those items that survived this content validity assessment were then tested using exploratory and confirmatory factor analyses on two independent samples of young adults. The 16 resulting items were shown to cluster into four factors (i.e., Failure in social interaction, Failure in interaction with objects, Unawareness, and Inattention). The 4FMW questionnaire showed good reliability, robust structure, and acceptable goodness-of-fit indices, as well as good convergent validity with another Mind Wandering questionnaire. Importantly, the 4FMW questionnaire was able to discriminate between attention-deficit/hyperactivity disorder and obsessive-compulsive disorder symptoms. The 4FMW Questionnaire is a reliable and valid instrument for assessing mind wandering in the young adult population.

Vegan Ice Cream Made from Soy Extract, Soy Kefir and Jaboticaba Peel: Antioxidant Capacity and Sensory Profile.

Considering the need for functional foods and the use of by-products of the food industry, a potentially functional ice cream was developed, using soy extract, soy kefir and dehydrated jaboticaba peel. Five ice creams were produced using soy kefir (K) and soy extract (S): (1) GS­100% S; (2) GK1-75% S/25% K; (3) GK2-50% S/50% K; (4) GK3-25% S/75% K and (5) GK-100% K; The products were evaluated by physicochemical, microbiological and sensory (check all that apply) analyses. The addition of kefir was found to increase the acidity of the products. The concentrations of total phenolic compounds in the formulations with kefir were approximately ten times higher than the GS formulation. All products presented concentrations of thermotolerant coliforms <3 NMP/g and absence of Salmonella ssp. The viability of Lactobacillus ssp., Streptococcus spp. and Bifidobacterium ssp. was higher than 10 log CFU/g during the whole storage period. The GS and GK1 formulations had the lowest scores, while GK ice cream was preferred. The formulations showed distinct sensory profiles in the CATA, and the ice cream with 100% kefir was associated with desirable attributes. The ice creams exhibited microbiological and sensory characteristics that meet the expectations of the product's target audience.

Space at home and psychological distress during the Covid-19 lockdown in Italy.

Prolonged periods of restrictions on people's freedom of movement during the first massive wave of the COVID-19 pandemic meant that most people engaged in all their daily activities at home. This suggested the need for the spatial features of the home and its occupants' perception of them to be investigated in terms of people's wellbeing. The present study was conducted on a large sample (N = 1354) drawn from different Italian regions. It examined the relationship between the "objective" and "subjective" dimensions of the home, measured in terms of objective home crowding and satisfaction with the space at home, in relation to perceived stress and the perceived risk of COVID-19 infection during the lockdown. The results showed that perceived stress is influenced by objective home crowding through the mediation of satisfaction with the space at home. These associations were more pronounced in younger generations. The negative association between satisfaction with the space at home and perceived stress was higher, the lower the perceived COVID-19 risk.

An assistive technology program for enabling five adolescents emerging from a minimally conscious state to engage in communication, occupation, and leisure opportunities.

BACKGROUND: Post-coma patients emerging from a minimally conscious state may have extensive motor disabilities and pose serious challenges to medical centers and home settings. OBJECTIVES: To promote academic performance and communication skills of post-coma individuals with traumatic brain injuries emerging from a minimally conscious state through an Assistive Technology setup. To evaluate its effects on the participants' positive participation. To generalize the learning process. To assess the intervention's clinical and social validity. METHOD: Study I included five adolescents exposed to an Assistive Technology setup enabling them with targeted adaptive behaviors. Study II involved fifty external raters in a social validation assessment. RESULTS: Data evidenced an improved performance of all the participants during the intervention, assessed through a concurrent multiple baseline design across participants. Social raters favorably scored the use of the technology. CONCLUSION: An Assistive Technology setup may be helpful to enhance the performance and positive participation of adolescents with traumatic brain injuries emerging from a minimally conscious state.

Simultaneous Application of Mixotrophic Culture and Magnetic Fields as a Strategy to Improve Spirulina sp. LEB 18 Phycocyanin Synthesis.

Spirulina is a filamentous microalga which is considered a promising alternative source of essential nutrients and active biomolecules. High production cost and the space required to install a photobioreactor are two of the greatest challenges in the industrial application of microalga-based products. Thus, this study aimed to improve Spirulina sp. LEB 18 biomass and phycocyanin content by combining the application of mixotrophic culture and magnetic fields (MF). Zarrouk medium was modified with 1 and 3 g/L liquid molasses and the application of 30 mT for 1·h/d was investigated. Mixotrophic culture with 1 g/L molasses showed the highest biomass concentration (1.62 g/L), carbohydrate content (25.6%), and lipid contents (8.7%) after 15 days. Although the combination of 30 mT and 1 g/L liquid molasses decreased biomass production (1.44 g/L), there was increase in protein yield (76.9%) and protein productivity (73.8 mg/L·d). The proposed method increased phycocyanin production by 145% and its purity from 0.584 in the control culture to 0.627. Data described by this study show that the combination of mixotrophic culture and MF application is a promising alternative to increase microalga protein and phycocyanin production.

The impact of age and familiarity with the environment on categorical and coordinate spatial relation representations.

Retrieving spatial information is a crucial everyday ability that is affected by age-related changes. Previous research has shown that this change is mediated by familiarity with an environment. The present research uses a series of landmark location tasks to extend and deepen our understanding of the role of aging in spatial mental representations of more or less familiar environments, also disentangling the contribution of coordinate and categorical spatial relations. The study tested the following hypotheses: (1) younger adults only have an advantage over the elderly in less familiar environments; (2) the advantage for categorical over coordinate spatial relations is mainly found for less familiar environments; and finally; (3) interactions between age, familiarity, and spatial relations might reveal that the effects of age and familiarity take different trajectories for coordinate and categorical spatial relations. Results confirmed that: (1) young people outperform the elderly only in less familiar environments; (2) there is a reduction in the difference between coordinate and categorical accuracy with increasing familiarity with the environment; while (3) the interaction between age and level of familiarity did not significantly differentiate coordinate from categorical spatial relations. In conclusion, the present study provides new evidence for the role of familiarity with geographical areas and its impact on the representation of categorical and coordinate relations, with practical implications for the assessment of topographical disorientation in aging.

Studying Individual Differences in Spatial Cognition Through Differential Item Functioning Analysis.

Background: In the field of spatial cognition, the study of individual differences represents a typical research topic. Gender and age have been prominently investigated. A promising statistical technique used to identify the different responses to items in relation to different group memberships is the Differential Item Functioning Analysis (DIF). The aim of the present study was to investigate the DIF of the Landmark positioning on a Map (LPM) task, across age groups (young and elderly) and gender, in a sample of 400 healthy human participants. Methods: LPM is a hometown map completion test based on well-known and familiar landmarks used to assess allocentric mental representations. DIF was assessed on LPM items two times: on categorical (i.e., positions) and coordinate (i.e., distances) scores, separately. Results: When positions and distances were difficult to assess with respect to the intended reference point, the probability to endorse the items seemed to get worse for the elderly compared to the younger participants. Instead other features of landmarks (high pleasantness, restorativeness) seemed to improve the elderly performance. A gender-related improvement of probability to endorse distance estimation of some landmarks, favoring women, emerged, probably associated with their repeated experiences with those landmarks. Overall, the complexity of the task seemed to have a differential impact on young and elderly people while gender-oriented activities and places seemed to have a differential impact on men and women. Conclusions: For the first time DIF was applied to a spatial mental representation task, based on the schematic sketch maps of the participants. The application of DIF to the study of individual differences in spatial cognition should become a systematic routine to early detect differential items, improving knowledge, as well as experimental control, on individual differences.

Adjuvant radiotherapy treatment for soft tissue sarcoma of extremities and trunk. A retrospective mono-institutional analysis.

Soft tissue sarcomas (STS) are uncommon, heterogeneous malignant tumors of mesodermal origin. Other than conservative surgery (CS), neoadjuvant or adjuvant radiotherapy (RT) is recommended when the risk of local recurrence is high. The aim of this study is to present our Institutional experience in adjuvant RT for treatment of STS of extremities and trunk (with either brachytherapy (BRT), external beam RT (EBRT), or both) and to provide an insight of toxicity and oncological outcomes for each RT modality. According to the RT treatment approach, patients were divided into three categories: 1) BRT alone; 2) EBRT alone; 3) combined BRT+EBRT. Differences among the three groups were assessed by the Chi-squared test. Patients' follow-up was performed every 6 months for the first two years after the end of RT and then once a year. Data from 90 patients were analyzed. The overall 3-year distant relapse-free survival (DRFS), progression-free survival (PFS), and overall survival (OS) were 84%, 80%, and 97%, respectively. Acute erythema was the most frequent side effect, although severe grade 3 toxicity was present in 5 patients. Chronic toxicity of any grade was reported in 14 patients. The incidence of chronic toxicity did not show any association with treatment modality. Multivariate analysis suggested a significant correlation between acute toxicity and tumor size, RT modality, and RT dose. In conclusion, good local control and toxicity profile were observed, despite negative patients' selection at baseline. Further investigation on wider series is warranted in order to define the optimal combination with systemic therapy.

High Supervised Resistance Training in Elderly Women: The Role of Supervision Ratio.

The objective of this study was to compare the effects of very high supervision (VHS-RT) versus high supervision (HS-RT) ratio resistance training (RT) on irisin, brain-derived neurotrophic factor (BNDF), muscle strength, functional capacity, and body composition in elderly women. Participants performed daily undulating periodized RT over 16 weeks with two different supervision ratios: VHS-RT at 1:2 (supervisor/subject) or HS-RT at 1:5. Serum was used to analyze brain derived neurotropic factor (BDNF) and irisin by enzyme-linked immunosorbent assay (ELISA). Body composition was evaluated by dual-energy X-ray absorptiometry, while functional capacity was evaluated using the Six-minute walk test, and Timed Up and Go (TUG). One- repetition maximum (1RM) was determined for bench press and 45° leg press exercises. For both groups, no differences between baseline and post-training were identified for irisin and lean mass (p > 0.05). Both groups improved bench press 1-RM, 45° leg press 1-RM, and TUG (p < 0.05). The VHS-RT group displayed higher effect sizes for 1-RM tests. Moreover, only VHS-RT group reduced body fat and body fat percentage (p < 0.05). In contrast, the HS-RT increased BDNF (p < 0.01). In this sense, RT enhances muscle strength and functional capacity in elderly women independent of supervision ratio. A greater supervision ratio during RT may induce more improvements in muscle strength, and body composition than lower supervision ratio during RT.

How to separate coordinate and categorical spatial relation components in integrated spatial representations: A new methodology for analysing sketch maps.

Spatial relations between landmarks can be represented by means of categories and coordinates. In the present research, this paradigm was applied to sketch maps based on information acquired in goal-directed behaviour of exploration of a university campus area. The first aim was to investigate whether categorical and coordinate information can be considered conceptually independent in sketch maps. The second aim was to assess which kind of distance measure served better to represent coordinate information in the present case study, and finally to assess the factorial structure of coordinate and categorical data. Analytic methodology as well as statistical analysis were found to confirm that separating coordinate and categorical components was formally as well as empirically appropriate. A series of confirmatory factor analyses showed the best fit for the model with two correlated components, as well as an acceptable reliability of measures emerged. The two components were moderately correlated. Moreover, the adoption of Manhattan distance seemed to be the most effective method to represent coordinate spatial relations in spatial sketch maps of areas acquired through navigation.

The differential effect of normal and pathological aging on egocentric and allocentric spatial memory in navigational and reaching space.

BACKGROUND: Topographical disorientation (TD) refers to a particular condition which determines the loss of spatial orientation, both in new and familiar environments. TD and spatial memory impairments occur relatively early as effect of cognitive decline in aging, even in prodromal stages of dementia, namely mild cognitive impairment (MCI). AIMS: (a) To show that components linked to the recall of familiar spatial knowledge are relatively spared with respect to the learning of unfamiliar ones in normal aging, while they are not in MCI, and (b) to investigate gender differences for their impact on egocentric and allocentric frames of reference. METHOD: Forty young participants (YC), 40 healthy elderly participants (HE), 40 elderly participants with subjective memory complaints (SMC), and 40 elderly with probable MCI were administered with egocentric and allocentric familiar tasks, based on the map of their hometown, and with egocentric and allocentric unfamiliar tasks, based on new material to be learned. A series of general linear models were used to analyze data. RESULTS: No group differences were found on egocentric task based on familiar information. MCI performed worse than the other groups on allocentric tasks based on familiar information (YC = HE = SMC > MCI). Significant differences emerged between groups on egocentric and allocentric tasks based on unfamiliar spatial information (YC > HE = SMC > MCI). A gender difference was found, favoring men on allocentric unfamiliar task. CONCLUSION: Familiarity of spatial memory traces can represent a protective factor for retrospective components of TD in normal aging. Conversely, using newly learned information for assessment may lead to overestimating TD severity.

Virtual Reality as a Technological-Aided Solution to Support Communication in Persons With Neurodegenerative Diseases and Acquired Brain Injury During COVID-19 Pandemic.

The COVID-19 poses an ongoing threat to lives around the world and challenges the existing public health and medical service delivery. The lockdown or quarantine measures adopted to prevent the spread of COVID-19 has caused the interruption in ongoing care and access to medical care including to patients with existing neurological conditions. Besides the passivity, isolation, and withdrawal, patients with neurodegenerative diseases experience difficulties in communication due to a limited access to leisure opportunities and interaction with friends and relatives. The communication difficulties may exacerbate the burden on the caregivers. Therefore, assistive-technologies may be a useful strategy in mitigating challenges associated with remote communication. The current paper presents an overview of the use of assistive technologies using virtual reality and virtual body ownership in providing communication opportunities to isolated patients, during COVID-19, with neurological diseases and moderate-to-severe communication difficulties. We postulate that the assistive technologies-based intervention may improve social interactions in patients with neurodegenerative diseases and acquired brain injury-thereby reducing isolation and improving their quality of life and mental well-being.

Memory for familiar locations: The impact of age, education and cognitive efficiency on two neuropsychological allocentric tasks.

This research aims to reconsider and support the use of spatial tasks based on familiar geographical information in the neuropsychological assessment of topographical (dis)orientation. Performance on two spatial tasks based on familiar information -l andmark positioning on a map and map of Italy - were compared in two studies assessing allocentric orientation among young and healthy elderly with different levels of education (Study 1) and elderly with and without probable cognitive impairment (Study 2). Results from Study 1 showed that the map of Italy task was affected by education, while the landmark positioning on a map was not. Results of Study 2 showed that both tasks were sensitive to different levels of cognitive functioning in a sample of community-dwelling seniors. Overall, spatial tasks based on mental representation of the hometown environment may be an important supplement in the assessment of allocentric topographical disorientation, discriminating typical from atypical aging.

Visuospatial/executive abilities and mood affect the reliability of a subjective memory complaints measure.

BACKGROUND: Inconsistent results are reported so far in the literature on the relationship between subjective memory complaints (SMC) and objective memory performance. Mixed findings triggered the need to investigate whether other potential mediating variables, such as mood and non-memory domains, affect the relationship between SMC and memory performance. AIMS: The present study aimed to contribute in clarifying the relation between subjective and objective memory considering the potential role of mood and visuospatial/executive functions. METHODS: Six hundred and sixty Italian community-dwelling adults (52-91 years old) were enrolled. Italian version of Montreal Cognitive Assessment Test (MoCA), Geriatric Depression Scale and Subjective Memory Complaints Questionnaire (SMCQ) were administered. Four subsamples were composed according to the following criteria: (a) participants with high visuospatial/executive function (VSE) score at MoCA and high mood; (b) participants with high VSE score and low mood; (c) participants with low VSE score and high mood and; (d) participants with low VSE score and low mood. RESULTS: Preliminarily, two confirmatory factor analysis have set the one-factor structure of SMCQ as the best fitting model. Diagnostic accuracy of the SMCQ in discriminating high and low memory score was assessed. ROC analyses confirmed that a low score in executive tasks was associated with poor reliability of the SMCQ. On the contrary, well-preserved executive functions and high mood levels ensured a good reliability of SMCQ in detecting memory problems. DISCUSSION AND CONCLUSIONS: Although mood is a key mediator in the relationship between subjective and objective memory, preserving executive functions is essential for ensuring the accuracy of memory self-appraisal in adulthood and elderly.

Validating Driver Behavior and Attitude Measure for Older Italian Drivers and Investigating Their Link to Rare Collision Events.

The present study aimed to: (a) validate the factor structures of three scales assessing driving behavior, attitudes toward traffic safety (ATTS) and self-regulation in driving, in a sample of Italian older adults, through confirmatory factor analyses and (b) to determine the effectiveness of these measures in predicting the likelihood and the frequency of collision involvements in the following year. A 28-item driver behavior questionnaire (DBQ), a 16-item ATTS, a 21-item extended driving mobility questionnaire (DMQ-A) were administered to 369 active Italian drivers, aged between 60 and 91 years. Results showed a four-factor structure for the DBQ, a five-factor structure for the ATTS and a two-factor structure for the Extended DMQ-A, as the best fitting models. Hurdle model analysis of count data with extra-zeros showed that all factors of DBQ predicted the likelihood of road collisions. Risky behavior, except for aggressive violations, self-regulation and attitudes toward traffic rules were associated with the frequency of collision involvement. The aforementioned three scales seemed to be a useful and concise suite of instruments assessing risky as well as protective factors of driving behavior in elderly.

Assistive technology for promoting adaptive skills of children with cerebral palsy: ten cases evaluation.

Objectives: To extend the use of assistive technology for promoting adaptive skills of children with cerebral palsy. To assess its effects on positive participation of ten participants involved. To carry out a social validation recruiting parents, physiotherapists and support teachers as external raters. Method: A multiple probe design was implemented for Studies I and II. Study I involved five participants exposed to a combined program aimed at enhancing choice process of preferred items and locomotion fluency. Study II involved five further children for a combined intervention finalized at ensuring them with literacy access and ambulation responses. Study III recruited 60 external raters for a social validation assessment. Results: All participants improved their performance, although differences among children occurred. Indices of positive participation increased as well. Social raters favorably scored the use of both technology and programs. Conclusion: Assistive technology-based programs were effective for promoting independence of children with cerebral palsy. Implications for Rehabilitation A basic form of assistive technology such as a microswitch-based program may be useful and helpful for supporting adaptive skills of children with cerebral palsy and different levels of functioning. The same program may improve the participants' indices of positive participation and constructive engagement with beneficial effects on their quality of life. The positive social rating provided by external experts sensitive to the matter may recommend a favorable acceptance and implementation of the program in daily settings.

Impact of image guidance on toxicity and tumour outcome in moderately hypofractionated external-beam radiotherapy for prostate cancer.

To report toxicity and efficacy outcome of moderately hypofractionated image-guided external-beam radiotherapy in a large series of patients treated for prostate cancer (PCa). Between 10/2006 and 12/2015, 572 T1-T3N0M0 PCa patients received 70.2 Gy in 26 fractions at 2.7 Gy/fraction: 344 patients (60%) with three-dimensional conformal radiotherapy (3D-CRT) and 228 (40%) with intensity-modulated radiotherapy (IMRT). Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer criteria and Houston definition (nadir + 2) were used for toxicity and biochemical failure evaluation, respectively. Median age was 74 years (interquartile range 69-77). Compared with 3D-CRT, in IMRT group more high-risk patients (29% vs 18%; P = 0.002) and more high-volume target (75% vs 60%; P < 0.001) were included. Acute gastro-intestinal (GI) toxicity G > 1 were registered in 8% and in 11% IMRT and 3D-CRT patients, respectively, whereas late GI G > 1 were observed in 2% and 16% IMRT and 3D-CRT patients, respectively. Acute genito-urinary (GU) toxicity G > 1 were registered in 26% and 40% IMRT and 3D-CRT patients, respectively, whereas late GU G > 1 occurred in 5% IMRT and 15% 3D-CRT patients. Multivariate proportional hazard Cox models confirmed significantly greater risk of late toxicity with 3D-CRT compared to IMRT for GU > 1 (P = 0.004) and for GI > 1 (P < 0.001). With a median 4-year follow-up, overall survival (OS), clinical progression-free survival (cPFS) and biochemical PFS (bPFS) for the whole series were 91%, 92% and 91%, respectively. cPFS and bPFS were significantly different by risk groups. Multivariate Cox models for bPFS and cPFS showed no difference between irradiation techniques and a significant impact of risk group and initial PSA. Moderately hypofractionated radiotherapy is a viable treatment option for localized PCa with excellent tumour control and satisfactory toxicity profile. IMRT seems associated with a reduction in toxicity, whereas tumour control was equal between IMRT and 3D-CRT patients and depended mainly on the risk category.

Topographical disorientation in aging. Familiarity with the environment does matter.

Topographical disorientation (TD) refers to navigational impairment as an effect of aging or brain damage. Decreases in navigational performance with aging are more due to deficits in the ability to mentally represent space in an object-centered (allocentric) than in a self-centered (egocentric) format. Familiarity/remoteness of spatial memory traces can represent a protective factor for TD in aging. Conversely, using newly learned information for assessment may lead to overestimating TD severity as it combines two contributing factors: heading (allocentric) disorientation and anterograde agnosia. A supplementary evaluation of TD with aging according to ecological spatial tasks is recommended. The core tasks should focus on landmark positioning, both on a blind map (allocentric) and along a route (egocentric) of the hometown so as to disentangle spatial memory for familiar/remote information from decline due to recent encoding of information.

Spatial reorientation decline in aging: the combination of geometry and landmarks.

OBJECTIVES: The study is focused on the assessment of reorientation skills in a sample of community-dwelling elderly people, manipulating landmarks and geometric (layout) information. METHOD: A neuropsychological assessment was administered to 286 elderly participants, divided into six groups (healthy controls, HC; four subgroups of participants with mild cognitive impairment, MCI; participants with probable dementia, Prob_D) and tested with the Virtual Reorientation Test (VReoT). VReoT manipulated different spatial cues: geometry and landmarks (proximal and distal). RESULT: Compared with HC, participants with MCI and Prob_D showed to be impaired in tasks involving geometry, landmarks and a combination of them. Both single and multiple domain impairment in MCI had an impact on reorientation performance. Moreover, VReoT was marginally able to discriminate between amnesic and non-amnesic MCI. The occurrence of getting lost events seemed to be associated to learning of geometric information. CONCLUSION: The associative strength between landmark and target plays an important role in affecting spatial orientation performance of cognitively impaired participants. Geometry significantly supports landmark information and becomes helpful with the increase of cognitive impairment which is linked to a decrement in landmark encoding. VReoT seems to represent a reliable evaluation supplement for spatial orientation deficits in prodromal stages of dementia.