Headache and alexithymia in children and adolescents: what Is the connection?

Background: Headache is one of the most common complaints in children and adolescents and comorbidity rates are very high and the major associated diseases are depression, anxiety, atopic disorders, sleep, and behavioral disorders. In recent years, it has been highlighted that difficulties regulating emotions such as alexithymia have also been associated with diagnosis of somatization. Methods: We carried out a mini review analyzing the relation between alexithymia and primary headache (e.g., migraine and tension type headache) in children and adolescents by synthesizing the relevant studies in the literature on PubMed, PsycINFO, and Google Scholar. Search terms were "alexithymia" combined with the "primary headache," "migraine," "tension type headache," "children," and "adolescents." Results: All analyzed studies found higher levels of alexithymia in children and adolescents with headache than control groups but there are different opinions about the relationship between headache and alexithymia. For example, some studies suggest that the association between headache and alexithymia in children may be due to an incomplete development of emotive competency or a general immature cognitive development, instead other studies found a correlation between headache symptoms, insecure attachment, and alexithymia. There seems to be also differences between children with migraine compared to those with tension type headache (TTH). Conclusion: There are some studies on adults suffering from headache or migraine and alexithymia, but there is only a moderate amount of research on pediatric age with different opinions and theories about this relationship. Further studies on children and adolescents are necessary to effectively understand this relationship and to help children to reduce headache and improve emotional consciousness

Metacognition and headache: which Is the role in childhood and adolescence?

Headache, in particular migraine, is one of the most frequent neurological symptoms in children and adolescents and it affects about 60% of children and adolescents all over the world. Headache can affect several areas of child’s functioning, such as school, physical activities, peer, and family relationship. The global and severe burden of this disease requires a multidisciplinary strategy and an effective treatment addressed all of the patient’s needs and based on cutting-edge scientific research. In recent years, research has focused on cognitive factors specifically in functions called metacognitive processes. Metacognition can be defined as the knowledge, beliefs, and cognitive processes involved in monitoring, control, and assessment of cognition. Metacognition seems to be closely related to the ability of theory of mind, the ability to infer, and reason about the mental states of other people in order to predict and explain own behavior. Recent studies found a relationship between metacognitive skills and anxiety, depression, motivation, academic performance, human social interactions, and stress symptoms. This relationship is very interesting for headache treatment, because these factors are the most commonly reported triggers in this disorder and there is a high comorbidity with anxiety and depression in children and adolescents with headache. So, headache and these comorbidities, in particular anxiety and depression, may have in common persistent and maladaptive patterns of thinking which are related to maladaptive metacognitive beliefs. Further research should assess metacognitive processes of children and adolescents with headache in order to increase their ability to control their own cognitive processes and consequently monitor factors which may trigger the attacks

Transient anomaly in fault-zone trapped waves during the preparatory phase of the 6 April 2009, Mw 6.3 L’Aquila earthquake

Fault-zone trapped waves generated by repeating earthquakes of the 2009 L’Aquila seismic sequence show a sudden, up to 100% increase of spectral amplitudes seven days before the mainshock. The jump occurs ten to twenty hours after the ML 4.1, 30 March 2009 largest foreshock. The amplitude increase is accompanied by a loss of waveform coherence in the fault-trapped wavetrain. Other geophysical and seismological parameters are known to have shown a sudden change after the 30 March foreshock. The concomitance of a consistent change in the fault-zone trapped waves leads us to interpret our observation as due to a sudden temporal variation of the velocity contrast between the fault damage zone and hosting rocks in the focal volume. Fault-zone trapped waves thus provide a refined time resolution for changes occurring near the rupture nucleation, with the indication of a strong variation in one day

Passengers information in public transport and privacy: Can anonymous tickets prevent tracking?

Abstract Modern public transportation companies often record large amounts of information. Privacy can be safeguarded by discarding nominal tickets, or introducing anonymization techniques. But is anonymity at all possible when everything is recorded? In this paper we discuss travel information management in the public transport scenario and we present a revealing case study (relative to the city of Cesena, Italy), showing that even anonymous 10-ride bus tickets may betray a user's privacy expectations. We also propose a number of recommendations for the design and management of public transport information systems, aimed at preserving the users’ privacy, while retaining the useful analysis features enabled by the e-ticketing technology

Fault-trapped waves depict continuity of the fault system responsible for the 6 April 2009 MW 6.3 L’Aquila earthquake, central Italy

We investigate fault-trapped waves observed at a permanent broad-band station (FAGN) installed on the San Demetrio Fault, about 20 km southeast of L'Aquila. This fault has the same strike of the Paganica Fault which was responsible for the MW 6.3, 6 April 2009 earthquake. The two faults display an en-echelon pattern with a few km offset. We have found that events causing efficient trapped waves are clustered at the northwestern and southeastern bottom ends of the ruptured Paganica fault plane. The efficiency of trapped waves at FAGN, which is located about 5 km far from the ruptured fault plane, indicates that the two faults are linked at depth. This suggests that fault segments in the study area can be part of a longer and continuous fault system which controls the seismic hazard of the region. Moreover, we have found that the two earthquake clusters generating the most efficient trapped waves occur in portions of the fault system with the highest fluid pressure

The magnitude of damaging volcanic earthquakes of Mt. Etna: are the commonly used scales adequate?

On October 2002 a seismic swarm occurred on the eastern flank of Mt. Etna. One of the strongest events caused severe damage, up to EMS intensity of VIII that contrasts with its local magnitude of 4.4. The occurrence of significant damage at such small magnitude is repeatedly observed in the Mt. Etna area and is traditionally attributed to the shallow source of volcanic earthquakes. Strong-motion accelerograms and broad-band seismograms recorded during the swarm demonstrate that there is a more cogent cause for the severe damage, i.e. an anomalously strong low-frequency (0.1 < f < 1 Hz) radiation deviating from the conventional Brune (1970) spectral scaling. Therefore, these earthquakes cause unexpectedly large ground displacements and long ( 20 sec) durations of shaking. The integration of digital accelerograms recorded on October 2002 yields a maximum peak ground displacement as large as 1.8 cm at a distances of 18 km, out of the largest damage zone. Based on the sharp local attenuation of ground motion amplitudes observed during the Mt. Etna earthquakes, we infer that displacements near the epicentres can have attained 10 cm. So large displacements are consistent with the maximum observed damage. Moreover, the frequency cutoff below 1.25 Hz in the Wood-Anderson response attenuates the peak-to-peak amplitudes used to assess local magnitudes. This instrumental deamplification at low frequency yields underestimated values of local magnitude that are not representative of the real ground shaking. Since a prompt, correct magnitude (and potential damage) assessment is crucial for efficient Civil Protection actions, a procedure is proposed which, in near-real-time, can be successful in identifying potentially damaging earthquakes of Mt. Etna through the computation of response spectra. The procedure provides a magnitude value that is derived on a statistical basis from the Housner (1952) spectral intensity computed in the low-frequency band. This parameter is a suitable near-real-time indicator of large earthquake-induced building shaking and could also be applied for a preliminary determination of the epicentral macroseismic intensity of volcanic events of Mt. Etna through consolidated relationships established for tectonic earthquakes in Italy

Disentangling the initiation from the response in joint attention: an eye-tracking study in toddlers with autism spectrum disorders

Joint attention (JA), whose deficit is an early risk marker for autism spectrum disorder (ASD), has two dimensions: (1) responding to JA and (2) initiating JA. Eye-tracking technology has largely been used to investigate responding JA, but rarely to study initiating JA especially in young children with ASD. The aim of this study was to describe the differences in the visual patterns of toddlers with ASD and those with typical development (TD) during both responding JA and initiating JA tasks. Eye-tracking technology was used to monitor the gaze of 17 children with ASD and 15 age-matched children with TD during the presentation of short video sequences involving one responding JA and two initiating JA tasks (initiating JA-1 and initiating JA-2). Gaze accuracy, transitions and fixations were analyzed. No differences were found in the responding JA task between children with ASD and those with TD, whereas, in the initiating JA tasks, different patterns of fixation and transitions were shown between the groups. These results suggest that children with ASD and those with TD show different visual patterns when they are expected to initiate joint attention but not when they respond to joint attention. We hypothesized that differences in transitions and fixations are linked to ASD impairments in visual disengagement from face, in global scanning of the scene and in the ability to anticipate object's action

Sympathetic arousal in children with oppositional defiant disorder and its relation to emotional dysregulation

Background: Emotional dysregulation (ED) is a trans-nosographical condition characterized by mood instability, severe irritability, aggression, temper outburst, and hyper-arousal. Pathophysiology of emotional dysregulation and its potential biomarkers are an emerging field of interest. A Child Behaviour Checklist (CBCL) profile, defined as Dysregulation Profile (DP), has been correlated to ED in youth. We examined the association between the CBCL-DP and indices of sympathetic arousal in children with Oppositional Defiant Disorder (ODD) and healthy controls. Method: The current study sought to compare the arousal level measured via electrodermal activity in response to emotional stimuli in three non-overlapping groups of children: (1) ODD+CBCL-DP (n = 28), (2) ODD without CBCL-DP (n = 35), and (3) typically developing controls (n = 25). Results: Analyses revealed a distinct electrodermal activity profile in the three groups. Specifically, children with ODD+CBCL-DP presented higher levels of sympathetic arousal for anger and sadness stimuli compared to the other two groups. Limitations: The relatively small sample and the lack of assessing causality limit the generalizability of this study which results need to be replicated in larger, different samples. Conclusion: The CBCL-DP was associated to higher levels of arousal for negative emotions, consistently with previous reports in individuals with depression and anxiety. Further work may identify potential longitudinal relationships between this profile and clinical outcomes

CRISPR/Cas9 genome-wide screening identifies KEAP1 as a sorafenib, lenvatinib, and regorafenib sensitivity gene in hepatocellular carcinoma.

Sorafenib is the first-line drug used for patients with advanced hepatocellular carcinoma (HCC). However, acquired sorafenib resistance in cancer patients limits its efficacy. Here, we performed the first genome-wide CRISPR/Cas9-based screening on sorafenib-treated HCC cells to identify essential genes for non-mutational mechanisms related to acquired sorafenib resistance and/or sensitivity in HCC cells. KEAP1 was identified as the top candidate gene by Model-based Analysis of Genome-wide CRISPR/Cas9 Knockout (MAGeCK). KEAP1 disrupted HCC cells were less sensitive than wild-type cells in short- and long-term sorafenib treatments. Compared to wild-type cells, KEAP1-disrupted cells showed lower basal and sorafenib-induced reactive oxygen species (ROS) levels and were more resistant to oxidative stress-induced cell death. The absence of KEAP1 led to increased activity of Nrf2, a key transcription factor controlling antioxidant responses, as further evidenced by increased expression of Nrf2-controlled genes including NQO1, GPX2 and TXNRD1, which were positively associated with chemoresistance. In addition, KEAP1 disruption counteracted the reduction of cell viability and the elevation of ROS caused by lenvatinib, a drug that recently showed clinical efficacy as a first-line treatment for unresectable HCC. Finally, Keap1 disruption also increased the resistance of cells to regorafenib, a recently approved drug to treat HCC as a second line therapy. Taken together, our data indicate that deregulation of the KEAP1/Nrf2 pathway following KEAP1 inactivation contributes to sorafenib, lenvatinib, and regorafenib resistance in human HCC cells through up-regulation of Nrf2 downstream genes and decreased ROS levels

Evaluation of altered functional connections in male children with autism spectrum disorders on multiple-site data optimized with machine learning

No univocal and reliable brain-based biomarkers have been detected to date in Autism Spectrum Disorders (ASD). Neuroimaging studies have consistently revealed alterations in brain structure and function of individuals with ASD; however, it remains difficult to ascertain the extent and localization of affected brain networks. In this context, the application of Machine Learning (ML) classification methods to neuroimaging data has the potential to contribute to a better distinction between subjects with ASD and typical development controls (TD). This study is focused on the analysis of resting-state fMRI data of individuals with ASD and matched TD, available within the ABIDE collection. To reduce the multiple sources of heterogeneity that impact on understanding the neural underpinnings of autistic condition, we selected a subgroup of 190 subjects (102 with ASD and 88 TD) according to the following criteria: male children (age range: 6.5–13 years); rs-fMRI data acquired with open eyes; data from the University sites that provided the largest number of scans (KKI, NYU, UCLA, UM). Connectivity values were evaluated as the linear correlation between pairs of time series of brain areas; then, a Linear kernel Support Vector Machine (L-SVM) classification, with an inter-site cross-validation scheme, was carried out. A permutation test was conducted to identify over-connectivity and under-connectivity alterations in the ASD group. The mean L-SVM classification performance, in terms of the area under the ROC curve (AUC), was 0.75 ± 0.05. The highest performance was obtained using data from KKI, NYU and UCLA sites in training and data from UM as testing set (AUC = 0.83). Specifically, stronger functional connectivity (FC) in ASD with respect to TD involve (p &lt; 0.001) the angular gyrus with the precuneus in the right (R) hemisphere, and the R frontal operculum cortex with the pars opercularis of the left (L) inferior frontal gyrus. Weaker connections in ASD group with respect to TD are the intra-hemispheric R temporal fusiform cortex with the R hippocampus, and the L supramarginal gyrus with L planum polare. The results indicate that both under-and over-FC occurred in a selected cohort of ASD children relative to TD controls, and that these functional alterations are spread in different brain networks