The psychological impact of prolonged disorders of consciousness on caregivers:a systematic review of quantitative studies

Objective: Systematic review of the nature, frequency and severity of psychological experiences of people who have a close relationship with a person with a prolonged disorder of consciousness. Data sources: Cochrane Library, Web of Science, PsycINFO, PubMed, Embase®, MEDLINE®, Allied and Complementary Medicine™, were searched from inceptions until December 2016 with additional hand searching of reference lists of included articles. Review methods: Studies were included that used quantitative methodologies and psychological measures to investigate experiences. The PRISMA statement was followed with inclusion criteria set a priori. A data synthesis summarized psychological constructs studied. Results: A total of 18 studies (ranging between n = 16–487 participants) met the inclusion criteria with 15 of 18 studies focused on the primary caregiver. A total of 23 standardized psychological measures were identified to assess four primary psychological constructs: Loss and grief, psychological wellbeing changes, burden and use of coping strategies. Conclusions: Small sample sizes, limited variables and reliance on observational methods affected quality. Caregivers do find ways to manage independently, but some exhibit clinically significant psychological distress that does not change over time alone and may get worse

Influence of the hydrostatic and the deviatoric components of stress on ductility of metals

Failure of ductile metals occurring as microvoids growth is known to strongly depend on the stress triaxiality parameter which is a conventional measure of the first stress invariant normalized with respect to the equivalent von Mises stress, which in turn is a conventional measure of the second stress invariant. The triaxiality parameter is usually assumed to not influence the stress-strain behavior of metals according to the von Mises plasticity. The effects of the Lode angle and of the stress triaxiality are investigated here with regard to ductile failure and to the stress-strain behavior. Experimental results and numerical predictions are compared for different metals and different specimen geometries, by investigating about various failure criteria and a procedure for the post-necking stress-strain characterization. Tensile specimens and notched plates are loaded up to failure, then finite elements simulations are verified by comparison with experimental data. The verified numerical data are then used to calculate local variables within the volume of failing specimens; the knowledge of these local variables enables to predict global and local failure conditions according to the selected failure models

Cooperative Spectrum Sensing for Beyond-5G Networks in Fading Environments

The advent of pervasive wireless systems faces several challenges due to the massive data traffic growth resulting from the interconnection of billions of new devices. This makes it essential to provide smart decision-making in identifying available spectrum resources by sensing the radio frequency environment. In this study, we aim to improve the spectrum sensing process and enhance the detection efficiency of secondary users (sensing devices) in identifying primary users (transmitting devices). We consider a scenario in which secondary users are affected by noise and fading, and employ distributed detection and data fusion to combine data from geographically distributed sensors. The results show that collaborative spectrum sensing, where multiple SUs share their sensing data, significantly enhances detection performance. By applying optimization techniques to assign optimal weight vectors to the sensors, we further increase the detection performance of the primary user, where each one is affected by different noise factors. The study reveals that detection performance improves as more users collaborate, and this improvement is validated through scenarios with varying SNR values

Emerging Neuroblastoma 3D In Vitro Models for Pre-Clinical Assessments

The potential of tumor three-dimensional (3D) in vitro models for the validation of existing or novel anti-cancer therapies has been largely recognized. During the last decade, diverse in vitro 3D cell systems have been proposed as a bridging link between two-dimensional (2D) cell cultures and in vivo animal models, both considered gold standards in pre-clinical settings. The latest awareness about the power of tailored therapies and cell-based therapies in eradicating tumor cells raises the need for versatile 3D cell culture systems through which we might rapidly understand the specificity of promising anti-cancer approaches. Yet, a faithful reproduction of the complex tumor microenvironment is demanding as it implies a suitable organization of several cell types and extracellular matrix components. The proposed 3D tumor models discussed here are expected to offer the required structural complexity while also assuring cost-effectiveness during pre-selection of the most promising therapies. As neuroblastoma is an extremely heterogenous extracranial solid tumor, translation from 2D cultures into innovative 3D in vitro systems is particularly challenging. In recent years, the number of 3D in vitro models mimicking native neuroblastoma tumors has been rapidly increasing. However, in vitro platforms that efficiently sustain patient-derived tumor cell growth, thus allowing comprehensive drug discovery studies on tailored therapies, are still lacking. In this review, the latest neuroblastoma 3D in vitro models are presented and their applicability for a more accurate prediction of therapy outcomes is discussed

Patient Perceptions of Effectiveness in Treatments for Menière's Disease: a National Survey in Italy

Objective: The aim of this study was to investigate current treatment practices and self-reported effectiveness in Menière's disease. Materials and Methods: Members of two Italian Menière's disease support (n=170) with ≥6-month history of Menière's disease were administered an online survey about recent treatments. Vertigo episode count, work absenteeism, and limitations in family life, social life,work or travel, as included in the Social Life and Work Impact of Dizziness (SWID) Questionnaire before and after recent treatments were queried. Results: Twenty-four different treatments were reported for Menière's disease, with dietary modifications (55%), diuretics (47%), and betahistine (41%) being most common. The majority (71%) received multiple simultaneous treatments. Prior to the most recent treatments 78-89% of respondents indicated limitations in family or social life, work or traveling. After their most recent treatment, respondents reported improvements in mean vertigo episode counts (5.7±7.6 vs. 2.6 ±4.6, p<0.001), days off work per month (10.1 ±9.2 vs. 4.2 ±6.7, p<0.001), and proportions indicating limitations in any functional measure assessed (p<0.05). These findings were consistent regardless of treatment approach (all p<0.05). Intratympanic gentamicin provided the greatest reductions in vertigo count, functional limitations, and work absenteeism (all p<0.01) as well as the fewest respondents reporting post-treatment functional limitations (16-37%). Conclusions: Despite numerous treatment approaches targeting different proposed pathophysiology for Menière's disease in this cross-sectional survey, all treatments are reported as effective by patients. These findings support a prominent placebo effect in Menière's disease and highlight challenges in studying treatment outcomes; there is a critical need to better understand Menière's disease

Antibodies against specific extractable nuclear antigens (ENAs) as diagnostic and prognostic tools and inducers of a profibrotic phenotype in cultured human skin fibroblasts: are they functional?

Background: The importance of systemic sclerosis (SSc) autoantibodies for diagnosis has become recognized by their incorporation into the 2013 ACR/EULAR classification criteria. Clear prognostic and phenotypic associations with cutaneous subtype and internal organ involvement have been also described. However, little is known about the potential of autoantibodies to exert a direct pathogenic role in SSc. The aim of the study is to assess the pathogenic capacity of anti-DNA-topoisomerase I (anti-Topo-I) and anti-centromeric protein B (anti-Cenp-B) autoantibodies to induce pro-fibrotic markers in dermal fibroblasts. Methods: Dermal fibroblasts were isolated from unaffected and affected skin samples of (n = 10) limited cutaneous SSc (LcSSc) patients, from affected skin samples of diffuse cutaneous (DcSSc) patients (n = 10) and from healthy subjects (n = 20). Fibroblasts were stimulated with anti-Topo-I, anti-Cenp-B IgGs, and control IgGs in ratios 1:100 and 1:200 for 24 h. Cells were also incubated with 10% SSc anti-Topo-I+ and anti-Cenp-B+ whole serum and with 10% control serum for 24 h. Viability was assessed by MTT test, while apoptosis was assessed by flow cytometry. Activation of pro-fibrotic genes ACTA2, COL1A1, and TAGLN was evaluated by quantitative real-time PCR (qPCR), while the respective protein levels alpha-smooth-muscle actin (\u3b1-SMA), type-I-collagen (Col-I), and transgelin (SM22) were assessed by immunocytochemistry (ICC). Results: MTT showed that anti-Cenp-B/anti-Topo-I IgGs and anti-Cenp-B+/anti-Topo-I+ sera reduced viability (in a dilution-dependent manner for IgGs) for all the fibroblast populations. Apoptosis is induced in unaffected LcSSc and control fibroblasts, while affected LcSSc/DcSSc fibroblasts showed apoptosis resistance. Basal mRNA (ACTA2, COL1A1, and TAGLN) and protein (\u3b1-SMA, Col-1, and SM22) levels were higher in affected LcSSc/DcSSc fibroblasts compared to LcSSc unaffected and to control ones. Stimulation with anti-Cenp-B/anti-Topo-I IgGs and with anti-Cenp-B+/anti-Topo-I+ sera showed a better induction in unaffected LcSSc and control fibroblasts. However, a statistically significant increase of all pro-fibrotic markers is reported also in affected LcSSc/DcSSc fibroblasts upon stimulation with both IgGs and sera. Conclusions: This study suggests a pathogenic role of SSc-specific autoantibodies to directly induce pro-fibrotic activation in human dermal fibroblasts. Therefore, besides the diagnostic and prognostic use of those autoantibodies, these data might further justify the importance of immunosuppressive drugs in the early stages of the autoimmune disease, including SSc

Fatigue assessment by energy approach during tensile tests on AISI 304 steel

Estimation of the fatigue limit for steel ductile materials using non-destructive methods is a topic of great interest to researchers today. In recent years, the method adopted has implemented infrared sensors to detect the surface temperature and correlate it with the fatigue limit. In previous paper, a new energy approach was proposed to investigate the fatigue limit during tensile test. The numerical procedure proposed by Chrysochoos is adopted to clean infrared images and applied to analyse the surface heat sources during tensile test. AISI 304 specimens with rectangular cross-sections are tested. Moreover fatigue tests at increasing loads were carried out on steel by a stepwise succession, applied to the same specimen, for applying the thermographic method. The predictions of the fatigue limit, obtained by the analysis of the energy evolution during the static tests, were compared with the predictions obtained applying the thermographic method during fatigue tests

A Monitoring Framework with Integrated Sensing Technologies for Enhanced Food Safety and Traceability

A novel and low-cost framework for food traceability, composed by commercial and proprietary sensing devices, for the remote monitoring of air, water, soil parameters and herbicide contamination during the farming process, has been developed and verified in real crop environments. It offers an integrated approach to food traceability with embedded systems supervision, approaching the problem to testify the quality of the food product. Moreover, it fills the gap of missing low-cost systems for monitoring cropping environments and pesticides contamination, satisfying the wide interest of regulatory agencies and final customers for a sustainable farming. The novelty of the proposed monitoring framework lies in the realization and the adoption of a fully automated prototype for in situ glyphosate detection. This device consists of a custom-made and automated fluidic system which, leveraging on the Molecularly Imprinted Polymer (MIP) sensing technology, permits to detect unwanted glyphosate contamination. The custom electronic mainboard, called ElectroSense, exhibits both the potentiostatic read-out of the sensor and the fluidic control to accomplish continuous unattended measurements. The complementary monitored parameters from commercial sensing devices are: temperature, relative humidity, atmospheric pressure, volumetric water content, electrical conductivity of the soil, pH of the irrigation water, total Volatile Organic Compounds (VOCs) and equivalent CO (Formula presented.). The framework has been validated during the olive farming activity in an Italian company, proving its efficacy for food traceability. Finally, the system has been adopted in a different crop field where pesticides treatments are practiced. This has been done in order to prove its capability to perform first level detection of pesticide treatments. Good correlation results between chemical sensors signals and pesticides treatments are highlighted

Stress ossidativo nei pazienti con diagnosi di sindrome delle apnee ostruttive notturne

La Sindrome delle Apnee Ostruttive Notturne (OSAS) è una patologia caratterizzata da alterazioni metaboliche e da un elevato rischio di sviluppo di patologie cardiovascolari. Lo scopo dello studio è stato quello di identificare dei markers precoci predittivi di rischio cardiovascolare con la valutazione dello stress ossidativo misurato attraverso esami di laboratorio in soggetti normali e pazienti con diagnosi di sindrome delle apnee ostruttive notturne. È stato effettuato uno studio prospettico per confrontare i risultati di laboratorio ottenuti dalla valutazione dei biomarkers dello stress ossidativo in 20 pazienti adulti con OSAS e 20 soggetti sani. Le tecniche di analisi utilizzate avevano l’obiettivo di identificare e quantificare i danni dei radicali liberi attraverso la misurazione di anti-ossidanti e pro-ossidanti in modo da valutare l’equilibrio ossidativo presente nei due gruppi di studio. I due gruppi di pazienti sono risultati omogeni per sesso, età ed indice di massa corporea (p < 0,05). Una differenza statisticamente significativa è stata individuata tra i livelli di indice di apnea-ipopnea valutata alla polisonnografia e di isoprostani, produzione di proteine di ossidazione e proteine non legate al ferro nei due gruppi in esame. Nessuna differenza significativa è stata trovata nel livello dei tioli tra i soggetti sani e i pazienti con sindrome delle apnee ostruttive. I tioli, a differenza degli altri markers, sono molecole anti-ossidanti, i restanti sono invece espressione di danno ossidativo. I risultati dello studio indicano che i biomarkers potrebbero essere utilizzati come indici di ostruzione delle vie aeree superiori (VAS) e come marcatori precoci di ipossiemia causando processi flogistici ricorrenti e danno locale da radicali liberi a carico delle VAS