Therapeutic educational workshops for caregivers of patients with severe acquired brain injury.

Abstract: Severe acquired brain injury (sABI) leads to a wide range of functional limitations in cognitive, moto and behavioural abilities. These changes impact the patient's family in terms of the feeling of emotional and physical health, social life and financial condition. Caregivers are often intensely involved in the patient's management exposing them to negative effects of caregiving including stress, mood disorders and decreased quality of life. Implementing forms of active involvement of caregivers in the rehabilitative program could be useful. Thus, in the present study, therapeutic educational workshops (TEWs) for caregivers during the post-acute intensive hospitalization were organized during the post-acute intensive hospitalization of patients with sABI. The caregivers were asked to participate in the workshops to actively involve them in the patient's care and neurorehabilitation program. Each workshop session provided indications regarding the management of the patient with aphasia, neglect, behavioural and swallowing disorders. A questionnaire of 22 items has been designed in order to represent possible indicators of usefulness and effectiveness of the TEWs. The primary aim of this study was to develop a reliable and valid questionnaire able to assess the caregivers' satisfaction with the modalities of carrying out the TEW as a novel activity during the post-acute hospitalization of patients with sABI. The second aim was to assess the caregivers' satisfaction with the utility of the TEW as a tool to enhance their skills in the management of patients' disabilities. 100 caregivers of patients with sABI who attended at least one TEW session and completed the questionnaire were included in the analysis. In conclusion the administered questionnaire has proven to be a valid and reliable tool to evaluate sABI caregivers' satisfaction with TEW. Moreover, caregivers were satisfied with the organization of the TEW and with their usefulness in the management of the patients with sABI.

Cytoskeleton disruption by the metabolic inhibitor 3-bromopyruvate: implications in cancer therapy.

The small molecule 3-bromopyruvate (3BP), is an anticancer molecule that acts by hindering glycolysis and mitochondrial function leading to energy depletion and consequently, to cell death. In this work we have focused on understanding how the glycolytic inhibition affects cancer cell structural features. We showed that 3BP leads to a drastic decrease in the levels of ß-actin and α-tubulin followed by disorganization and shrinkage of the cytoskeleton in breast cancer cells. 3BP inhibits cell migration and colony formation independently of the activity of metalloproteinases. To disclose if these structural alterations occurred prior to 3BP toxic effect, non-toxic concentrations of 3BP were used and we could observe that 3BP was able to inhibit energy production and induce loss of ß-actin and α-tubulin proteins. This was accompanied with alterations in cytoskeleton organization and an increase in E-cadherin levels which may indicate a decrease in cancer cells aggressiveness. In this study we demonstrate that 3BP glycolytic inhibition of breast cancer cells is accompanied by cytoskeleton disruption and consequently loss of migration ability, suggesting that 3BP can potentially be explored for metastatic breast cancer therapy.

Correlation between Quality of Life and severity of Parkinson's Disease by assessing an optimal cut-off point on the Parkinson's Disease questionnaire (PDQ-39) as related to the Hoehn & Yahr (H&Y) scale.

Purpose: Strong evidence shows that symptoms in individuals with Parkinson's Disease (PD) restrict both their independence and social participation, leading to a low Quality of Life (QoL). Conversely, a reduced QoL has a negative impact on symptoms. The aim is to evaluate the correlation between QoL and severity of PD by assessing the presence of an optimal cut-off point on the Parkinson's disease questionnaire (PDQ-39) as related to the Hoehn &Yahr (H&Y) scale in a cohort of Italian adults with PD. Methods: A multicenter, cross-sectional study was performed. This study was conducted on a cohort of consecutive individuals. All participants were evaluated with the PDQ-39, and the severity of PD was recorded according to the H&Y scale by a neurologist. Receiver op-erating characteristic (ROC) curves and coordinates, visually inspected, were used to find cut-off points with optimal sensitivity and specificity. These were in turn used to determine the optimal PDQ-39 cut-off score for identifying disease severity according to H&Y stages. Results: 513 individuals were included in the study. The ROC curve analysis showed that QoL worsened with an increase in disease severity and age. Moreover, QoL was worse in females. Conclusions: The results of this study allowed for the correlation of QoL and disease severity in a cohort of individuals with PD. With this cut-off point, it is now possible to make a determination of QoL of an individual with PD at a certain stage of the disease, in a specific age range, and of a particular gender.

What if sharing music as a language is the key to meeting halfway? Absolute pitch, pitch discrimination and Autism Spectrum Disorder.

BACKGROUND: Absolute pitch is the ability to identify a given note in the absence of a reference note. The prevalence of absolute pitch in autism is between 5% and 11% and autism involves notably enhanced abilities in pitch discrimination. OBJECTIVES: To summarize the evidence about the role and the meaning of these special skills in autism. METHODS: Systematic electronic database searches were conducted using Pubmed, Scopus, Psycinfo, and Web of Science. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRI-SMA) guideline was followed, and, after thorough screening by two independent reviewers, 17 articles remained eligible for inclusion in this study. RESULTS: We have two different groups of results. Eight case-control studies discuss pitch discrimination and autism. The second group included four case reports about autistic individuals with absolute pitch and five case-control studies. These results strongly suggest that music elicits special attention for children with autism, and taken together, this evidence supports a major frequency of AP in autistic children. CONCLUSION: Based on this evidence, future perspectives could include studies aiming to detect absolute pitch at an early age and to use this special skill to stimulate joint attention, as well as socio-communicative skills.

Development and validation of a test for the assessment of knowledge learned by healthcare students during an online course on COVID-19: cross-sectional study.

ABSTRACT: Many Italian universities during the COVID-19 pandemic had numerous students attending hospital wards. The training of health care students was necessary to prepare for good practices in implementing knowledge about COVID-19 and minimizing contagion among students who carried out the internship. In February 2020, a course aiming to guide health personnel so that they can appropriately address the health emergency posed by the new coronavirus was created, making use of the scientific evidence currently available as well as official sources of information and updates. The aim of this study was the development and validation of a useful tool to evaluate the progress in knowledge regarding COVID-19 of students in degree courses for the health care professions. The reliability of the test was assessed using Cronbach's alpha (α) coefficient, while the responsiveness of the test between T0 and T1 was measured with a student t test. The standard error of measurement was used to calculate the minimal detectable change of the tool. The test is made up of 31 items with four multiple-choice answers, one of which is correct. Fifteen bachelor's degree courses at the Sapienza University of Rome were enrolled, for a total population of 1,017 students from different course years. The test showed good internal consistency, with Cronbach's α values of 0.82. The item-total analysis also showed good results, with homogeneous α values from 0.80 to 0.82 for each item. The student t test showed a difference of 3.59 between T0 and T1 (p < 0.001). The minimal detectable change was 0.47. The test is a useful tool for assessing progress in skills regarding COVID-19 for students from bachelor's degree courses in the health professions. It allows the improvement and acquisition of skills as well as a qualitative analysis of the organization of internship degree courses.

Frustration and inhomogeneous environments in relaxation of open chains with Ising-type interactions.

Frustration can contribute to very slow relaxation times in large open chains, as in spin glasses and in biopolymers. However, frustration may not be sufficient to produce broken ergodicity in finite systems. Here we employ a system-plus-reservoir approach to investigate how strongly inhomogeneous environments and frustration compete in the relaxation of finite open chains. We find a sufficient condition for our inhomogeneous environments to break ergodicity. We use the microscopic model to derive a Markovian quantum master equation for a generic chain with ultrastrong intrachain couplings. We show that this microscopic model avoids a spurious broken ergodicity we find in the phenomenological model. We work out an explicit example of broken ergodicity due to the inhomogeneous environment of an unfrustrated spin chain as far as simulating a recent experiment on protein denaturation (where environment inhomogeneity is especially relevant). We finally show that an inhomogeneous environment can mitigate the effects of frustration-induced degeneracies.

Validation of the Pediatric Evaluation of Disability Inventory in an Italian Population with Autism Spectrum Disorder: a Cross-Sectional Study.

OBJECTIVES: To measure psychometric properties of the Italian version of the Pediatric Evaluation of Disability Inventory (PEDI-I) in a population with Autism Spectrum Disorder (ASD). METHODS: The PEDI-I was administered to different children with ASD. The internal consistency was examined by using Cronbach's Alpha, while the intraclass correlation coefficient (ICC) was used to investigate both inter-observer and intra-observer reproducibility. Its concurrent validity was evaluated with the Italian version of the Barthel Index. RESULTS: The PEDI-I was administered to 60 children with a diagnosis of ASD. Cronbach's Alpha showed statistically significant values (.885-.965). Inter-observer and intra-observer investigations confirm the reproducibility of the scale with a range of high and very high parameters. The Pearson Correlation Coefficient with the Barthel Index showed significant data for all PEDI-I subscales with a p<0.01. CONCLUSIONS: The PEDI-I showed good psychometric properties and it is possible to confirm its validity and reliability in ASD population. However, for better understanding of how PEDI-I works in clinical practice, further researches are recommended.

Occupational Therapy's efficacy in children with Asperger's syndrome: a systematic review of randomized controlled trials.

This systematic review of randomized controlled trials (RCTs) aims at evaluating the efficacy of Occupational therapy (OT) interventions in Asperger's syndrome (AS) pediatric patients. We conducted a systematic review according to PRISMA guidelines. The screening of the literature was carried out on PUBMED, SCOPUS, WEB OF SCIENCE and OT SEEKER databases, TO December 2018. We selected three RCTs having the common objective to evaluate whether children with AS can improve their social skills thanks to OT treatments. The interventions targeted by the three selected studies were: LEGO therapy, Social Use of Language Programme, Let's Face It! software and Parent Training combined with the administration of risperidone. All the studies showed that the intervention groups improved their overall social ability.This review shows that OT interventions can help concretely AS children in overcoming their social issues. Nevertheless, more RCTs are needed to better understand the OT's benefits and limitations in AS patients.

The effect of physiotherapy on fatigue and physical functioning in chronic fatigue syndrome patients: A systematic review.

OBJECTIVE: The objectives of this work were to fill the gap in the scientific literature and to evaluate the results of physical therapy treatments in individuals affected by chronic fatigue syndrome, considering only studies that employed a randomized controlled trial. METHODS: A systematic review was carried out according to PRISMA guidelines. Three bibliographic databases were searched: MEDLINE, Cochrane Library, and PEDro. The minimum prerequisites for papers to be included in the systematic review were that they had to (a) employ a randomized controlled trial; (b) be published in English; and (c) be published during the last ten years (2007-2017). The studies were evaluated according to Jadad score. RESULTS: Four studies were included. This systematic review suggests that a treatment that is more effective than all the others cannot be defined. This conclusion is related to the low number of investigated studies; therefore, the collected results cannot be generalized. CONCLUSION: Chronic fatigue syndrome is not yet a well-understood pathology, and the physical mechanisms that influence the outcomes still need more study. Rehabilitation programs that promote physiotherapy techniques such as exercise, mobilization, and body awareness (e.g., MRT and GET) are the most effective in reducing medium and long-term fatigue severity in CFS patients.

Work on a quantum dipole by a single-photon pulse.

Energy transfer from a quantized field to a quantized dipole is investigated. We find that a single photon can transfer energy to a two-level dipole by inducing a dynamic Stark shift, going beyond the well-known absorption and emission processes. A quantum thermodynamical perspective allows us to unravel these two energy transfer mechanisms and to identify the former as a generalized work and the latter as a generalized heat. We show two necessary conditions for the generalized work transfer by a single photon to occur, namely, off-resonance and finite linewidth of the pulse. We also show that the generalized work performed by a single-photon pulse equals the reactive (dispersive) contribution of the work performed by a semiclassical pulse in the low-excitation regime.

Tiger-Moths in Savannas in Eastern Amazon: First Assessment of Diversity and Seasonal Aspects.

Biodiversity knowledge on insects is urgently needed due to the ever growing demand for food and the consequent deforestation process and loss of natural habitats in many understudied tropical regions. In this paper, we describe the outcome of a biodiversity research on tiger moths performed for the first time in a poorly studied Amazonian landscape-the savanna. We sampled tiger moths monthly with UV automatic light traps for 12 consecutive months in two sampling points in an area of savanna in eastern Amazon, and we compared our results to previously available data for eastern Amazon. We found a total of 91 species of which 80 were identified to species level. The most species-rich subtribes were Phaegopterina and Euchromiina with 32 species each. Species richness and abundance did not differ among sampling sites, but in general the species richness was higher during the dry season while abundance was higher during the wet season. This seasonal diversity pattern differs from the most common patterns recorded for savannas in other parts of the world. The species composition also changed in wet and dry seasons and correlated significantly with temperature and relative humidity. Our results suggest that the alpha diversity of the Amazonian savannas in our sampling area is lower than that in nearby rain forests and similar to that in agriculturally disturbed areas surrounded by rain forests. However, the species composition differed considerably from natural and disturbed areas. These results highlight the need of basic biodiversity surveys of insects in Amazonian savannas.

Dynamic Stark shift induced by a single photon packet.

The dynamic Stark shift results from the interaction of an atom with the electromagnetic field. We show how a propagating single-photon wave packet can induce a time-dependent dynamical Stark shift on a two-level system (TLS). A non-perturbative fully quantum treatment is employed, where the quantum dynamics of both the field and the TLS are analyzed. We also provide the means to experimentally access such time-dependent frequency by measuring the interference pattern in the electromagnetic field inside a 1D waveguide. The effect we evidence here may find applications in the autonomous quantum control of quantum systems without classical external fields, which can be useful for quantum information processing as well as for quantum thermodynamical tasks.

Non-Markovianity induced by a single-photon wave packet in a one-dimensional waveguide.

The concept of non-Markovianity (NM) in quantum dynamics is still an open debate. Understanding how to generate and measure NM in specific models may aid in this quest. In quantum optics, an engineered electromagnetic environment coupled to a single atom can induce NM. The most common scenario of structured electromagnetic environment is an optical cavity, composed by a pair of mirrors. Here, we show how to generate and measure NM on a two-level system coupled to a one-dimensional waveguide with no mirrors required. The origin of the non-Markovian behavior lies in the initial state of the field, prepared as a single-photon packet. NM is shown to depend on two experimentally controllable parameters, namely, the linewidth of the packet and its central frequency. We relate the presence of NM to quantum interference. We also show how the two output channels of the waveguide provide distinct signatures of NM, both experimentally accessible.

Heat transport between two pure-dephasing reservoirs.

A pure-dephasing reservoir acting on an individual quantum system induces loss of coherence without energy exchange. When acting on composite quantum systems, dephasing reservoirs can lead to a radically different behavior. Transport of heat between two pure-dephasing Markovian reservoirs is predicted in this work. They are connected through a chain of coupled sites. The baths are kept in thermal equilibrium at distinct temperatures. Quantum coherence between sites is generated in the steady-state regime and results in the underlying mechanism sustaining the effect. A quantum model for the reservoirs is a necessary condition for the existence of stationary heat transport. A microscopic derivation of the non-unitary system-bath interaction is employed, valid for arbitrary inter-site coupling regime. The model assumes that each site-reservoir coupling is local.

Fabry-Perot interferometer with quantum mirrors: nonlinear light transport and rectification.

Optical transport represents a natural route towards fast communications, and it is currently used in large scale data transfer. The progressive miniaturization of devices for information processing calls for the microscopic tailoring of light transport and confinement at length scales appropriate for upcoming technologies. With this goal in mind, we present a theoretical analysis of a one-dimensional Fabry-Perot interferometer built with two highly saturable nonlinear mirrors: a pair of two-level systems. Our approach captures nonlinear and nonreciprocal effects of light transport that were not reported previously. Remarkably, we show that such an elementary device can operate as a microscopic integrated optical rectifier.

Optimal rectification in the ultrastrong coupling regime.

We study the effect of ultrastrong coupling on the transport of heat. In particular, we present a condition for optimal rectification, i.e., flow of heat in one direction and complete isolation in the opposite direction. We show that the strong-coupling formalism is necessary for correctly describing heat flow in a wide range of parameters, including moderate to low couplings. We present a situation in which the strong-coupling formalism predicts optimal rectification whereas the phenomenological approach predicts no heat flow in any direction, for the same parameter values.

Evaluation of genotyping methods and the relative cost of pharmacogenomics.

Recently, several methods to assess the quality of cost-effectiveness, cost-utility and cost-benefit in the pharmacogenomic field have become available. A relevant example is the National Institute for Health and Clinical Excellence (NICE). NICE forms a diverse clinical Advisory committee, which stimulates Pharma and Academic communities to produce a robust set of data, including the design and data source, for economic models of personalized healthcare. Personalized medicine includes genomic tests of each patients and their disease into their clinical treatments, so as minimize toxicity and maximize benefits. It is well known that Pharmacogenomics (PG) tests, performed before drug treatment, lower overall medical costs and provide higher quality of life and longer life expectancy. In this issue relative costs of genotyping methods and platforms, were evaluated by "manually cured criteria" due to lack of specific guidelines. Finally, with the progress made in this scenario over the next five years, health decision-making may able to accelerating the translation of genetic technologies into routine clinical laboratory.

Laboratory evolution of adenylyl cyclase independent learning in Drosophila and missing heritability.

Gene interactions are acknowledged to be a likely source of missing heritability in large-scale genetic studies of complex neurological phenotypes. However, involvement of rare variants, de novo mutations, genetic lesions that are not easily detected with commonly used methods and epigenetic factors also are possible explanations. We used a laboratory evolution study to investigate the modulatory effects of background genetic variation on the phenotypic effect size of a null mutation with known impact on olfactory learning. To accomplish this, we first established a population that contained variation at just 23 loci and used selection to evolve suppression of the learning defect seen with null mutations in the rutabaga adenylyl cyclase. We thus biased the system to favor relatively simplified outcomes by choosing a Mendelian trait and by restricting the genetic variation segregating in the population. This experimental design also assures that the causal effects are among the known 23 segregating loci. We observe a robust response to selection that requires the presence of the 23 variants. Analyses of the underlying genotypes showed that interactions between more than two loci are likely to be involved in explaining the selection response, with implications for the missing heritability problem.