Thermal regime of a highly regulated Italian river (Ticino River) and implications for aquatic communities

Thermal alteration is one of the adverse effects of flow regulation sharpened in recent years due to climate changes. In this work, we characterize the thermal regime of a highly regulated river located in Northern Italy, which is the emissary of Lake Maggiore. The thermal characteristics of the study reach are influenced by the presence of two dams and by climate warming. In the 15-year monitored period (1999-2013) a significant increase of the mean annual river temperature (i.e., +1.8°C) was indeed recorded. Minimum and maximum water temperatures were detected in correspondence of low-flow periods in February and August, respectively. During August the temperature reached a maximum of 27°C, that is a value below the upper thermal limit of tolerance for most of the aquatic taxa collected in the study area. Moreover, the local presence of seeps and the interaction with groundwater play an important ecological role by guaranteeing patches of cool water to the aquatic communities. Nevertheless, the sensitive early life stages of fish species that spawn in spring/summer may be affected by the high summer temperatures and the expected future climate warming. The wider range of temperatures preferred by alien fish species could result into a competitive disadvantage for autochthonous species. The current minimum flows established by local laws as environmental flows appeared to be able to guarantee an acceptable thermal alteration in morphologically heterogeneous reaches where river/groundwater interaction occurred, at least within the current climatic conditions.</p

Complexity index from a personalized wearable monitoring system for assessing remission in mental health

This study discusses a personalized wearable monitoring system, which provides information and communication technologies to patients with mental disorders and physicians managing such diseases. The system, hereinafter called the PSYCHE system, is mainly comprised of a comfortable t-shirt with embedded sensors, such as textile electrodes, to monitor electrocardiogram-heart rate variability (HRV) series, piezoresistive sensors for respiration activity, and triaxial accelerometers for activity recognition. Moreover, on the patient-side, the PSYCHE system uses a smartphone-based interactive platform for electronic mood agenda and clinical scale administration, whereas on the physician-side provides data visualization and support to clinical decision. The smartphone collects the physiological and behavioral data and sends the information out to a centralized server for further processing. In this study, we present experimental results gathered from ten bipolar patients, wearing the PSYCHE system, with severe symptoms who exhibited mood states among depression (DP), hypomania(HM), mixed state (MX), and euthymia (EU), i.e., the good affective balance. In analyzing more than 400 h of cardiovascular dynamics, we found that patients experiencing mood transitions from a pathological mood state (HM, DP, or MX - where depressive and hypomanic symptoms are simultaneously present) to EU can be characterized through a commonly used measure of entropy. In particular, the SampEn estimated on long-term HRV series increases according to the patients' clinical improvement. These results are in agreement with the current literature reporting on the complexity dynamics of physiological systems and provides a promising and viable support to clinical decision in order to improve the diagnosis and management of psychiatric disorders

Assessment of linear and nonlinear/complex heartbeat dynamics in subclinical depression (dysphoria)

Objective: Depression is one of the leading causes of disability worldwide. Most previous studies have focused on major depression, and studies on subclinical depression, such as those on so-called dysphoria, have been overlooked. Indeed, dysphoria is associated with a high prevalence of somatic disorders, and a reduction of quality of life and life expectancy. In current clinical practice, dysphoria is assessed using psychometric questionnaires and structured interviews only, without taking into account objective pathophysiological indices. To address this problem, in this study we investigated heartbeat linear and nonlinear dynamics to derive objective autonomic nervous system biomarkers of dysphoria. Approach: Sixty undergraduate students participated in the study: according to clinical evaluation, 24 of them were dysphoric. Extensive group-wise statistics was performed to characterize the pathological and control groups. Moreover, a recursive feature elimination algorithm based on a K-NN classifier was carried out for the automatic recognition of dysphoria at a single-subject level. Main results: The results showed that the most significant group-wise differences referred to increased heartbeat complexity (particularly for fractal dimension, sample entropy and recurrence plot analysis) with regards to the healthy controls, confirming dysfunctional nonlinear sympatho-vagal dynamics in mood disorders. Furthermore, a balanced accuracy of 79.17% was achieved in automatically distinguishing dysphoric patients from controls, with the most informative power attributed to nonlinear, spectral and polyspectral quantifiers of cardiovascular variability. Significance: This study experimentally supports the assessment of dysphoria as a defined clinical condition with specific characteristics which are different both from healthy, fully euthymic controls and from full-blown major depression

Characterizing psychological dimensions in non-pathological subjects through autonomic nervous system dynamics

The objective assessment of psychological traits of healthy subjects and psychiatric patients has been growing interest in clinical and bioengineering research fields during the last decade. Several experimental evidences strongly suggest that a link between Autonomic Nervous System (ANS) dynamics and specific dimensions such as anxiety, social phobia, stress, and emotional regulation might exist. Nevertheless, an extensive investigation on a wide range of psycho-cognitive scales and ANS non-invasive markers gathered from standard and non-linear analysis still needs to be addressed. In this study, we analyzed the discerning and correlation capabilities of a comprehensive set of ANS features and psycho-cognitive scales in 29 non-pathological subjects monitored during resting conditions. In particular, the state of the art of standard and non-linear analysis was performed on Heart Rate Variability, InterBreath Interval series, and InterBeat Respiration series, which were considered as monovariate and multivariate measurements. Experimental results show that each ANS feature is linked to specific psychological traits. Moreover, non-linear analysis outperforms the psychological assessment with respect to standard analysis. Considering that the current clinical practice relies only on subjective scores from interviews and questionnaires, this study provides objective tools for the assessment of psychological dimensions

Real vs. immersive-virtual emotional experience: Analysis of psycho-physiological patterns in a free exploration of an art museum

[EN] Virtual reality is a powerful tool in human behaviour research. However, few studies compare its capacity to evoke the same emotional responses as in real scenarios. This study investigates psycho-physiological patterns evoked during the free exploration of an art museum and the museum virtualized through a 3D immersive virtual environment (IVE). An exploratory study involving 60 participants was performed, recording electroencephalographic and electrocardiographic signals using wearable devices. The real vs. virtual psychological comparison was performed using self-assessment emotional response tests, whereas the physiological comparison was performed through Support Vector Machine algorithms, endowed with an effective feature selection procedure for a set of state-of-the-art metrics quantifying cardiovascular and brain linear and nonlinear dynamics. We included an initial calibration phase, using standardized 2D and 360 degrees emotional stimuli, to increase the accuracy of the model. The self-assessments of the physical and virtual museum support the use of IVEs in emotion research. The 2-class (high/low) system accuracy was 71.52% and 77.08% along the arousal and valence dimension, respectively, in the physical museum, and 75.00% and 71.08% in the virtual museum. The previously presented 360 degrees stimuli contributed to increasing the accuracy in the virtual museum. Also, the real vs. virtual classifier accuracy was 95.27%, using only EEG mean phase coherency features, which demonstrates the high involvement of brain synchronization in emotional virtual reality processes. These findings provide an important contribution at a methodological level and to scientific knowledge, which will effectively guide future emotion elicitation and recognition systems using virtual reality.This work was supported by Ministerio de Economia y Competitividad de Espana (URL: http://www.mineco.gob.es/; Project TIN201345736-R and DPI2016-77396-R); Direccion General de Trafico, Ministerio Del Interior de Espana (URL: http://www.dgt.es/es/; Project SPIP2017-02220); and the Institut Valencia d'Art Modern (URL: https://www.ivam.es/).The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Marín-Morales, J.; Higuera-Trujillo, JL.; Greco, A.; Guixeres, J.; Llinares Millán, MDC.; Gentili, C.; Scilingo, EP.... (2019). Real vs. immersive-virtual emotional experience: Analysis of psycho-physiological patterns in a free exploration of an art museum. 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Towards ecological flows: status of the benthic macroinvertebrate community during summer low-flow periods in a regulated lowland river

Climate change along with the increasing exploitation of water resources exacerbates low-flow periods, causing detrimental effects on riverine communities. The main mitigation measure currently adopted to counteract hydrological alterations induced by off-stream diversion is the release of minimum flows (MFs), even if within the European Union Water Framework Directive an upgrade towards ecological flows is urgently required to achieve good ecological status (GES). In this study, we investigated the temporal evolution of the benthic macroinvertebrate community in an Italian-regulated lowland river (Ticino River) to clarify the ecological effects of summer low flows, and we evaluated the current MFs in the perspective of meeting GES standard. Biomonitoring was carried out for four consecutive years (2019-2022), in a river site immediately below a large off-stream diversion. The four study years were characterized by different streamflow patterns, thus allowing us to compare the temporal trajectories of the community under different flow conditions. Moreover, the interruption of the low-flow periods due to overflow spilled by the upstream dam gave us the opportunity to assess the effects of experimental flow peaks. Contrary to the expectation, the macroinvertebrate assemblage kept almost unvaried across the years, showing great resistance and resilience to hydrological changes. Even in extraordinarily dry 2022, the community composition varied only slightly, with a reduction of mayflies and an increase of mollusks. However, a deterioration of the ecological status below GES standard was recorded that summer, indicating the need for an upgrading of the current MFs. This upgrade would include experimental flow peaks in critical periods, which act as intermediate disturbances, enhancing community richness, diversity, and overall quality, as well as compliance with a threshold of an index specifically developed for the hydrological pressure

A protocol for a multicentre, parallel-group, pragmatic randomised controlled trial to evaluate the NEVERMIND system in preventing and treating depression in patients with severe somatic conditions

Background Depressive symptoms are common in individuals suffering from severe somatic conditions. There is a lack of interventions and evidence-based interventions aiming to reduce depressive symptoms in patients with severe somatic conditions. The aim of the NEVERMIND project is to address these issues and provide evidence by testing the NEVERMIND system, designed to reduce and prevent depressive symptoms in comparison to treatment as usual. Methods The NEVERMIND study is a parallel-groups, pragmatic randomised controlled trial to assess the effectiveness of the NEVERMIND system in reducing depressive symptoms among individuals with severe somatic conditions. The NEVERMIND system comprises a smart shirt and a user interface, in the form of a mobile application. The system is a real-time decision support system, aiming to predict the severity and onset of depressive symptoms by modelling the well-being condition of patients based on physiological data, body movement, and the recurrence of social interactions. The study includes 330 patients who have a diagnosis of myocardial infarction, breast cancer, prostate cancer, kidney failure, or lower limb amputation. Participants are randomised in blocks of ten to either the NEVERMIND intervention or treatment as usual as the control group. Clinical interviews and structured questionnaires are administered at baseline, at 12 weeks, and 24 weeks to assess whether the NEVERMIND system is superior to treatment as usual. The endpoint of primary interest is Beck Depression Inventory II (BDI-II) at 12 weeks defined as (i) the severity of depressive symptoms as measured by the BDI-II. Secondary outcomes include prevention of the onset of depressive symptoms, changes in quality of life, perceived stigma, and self-efficacy. Discussion There is a lack of evidence-based interventions aiming to reduce and prevent depressive symptoms in patients with severe somatic conditions. If the NEVERMIND system is effective, it will provide healthcare systems with a novel and innovative method to attend to depressive symptoms in patients with severe somatic conditions. Trial registration DRKS00013391. Registered 23 November 2017

The NEVERMIND e-health system in the treatment of depressive symptoms among patients with severe somatic conditions: A multicentre, pragmatic randomised controlled trial

Background This study assessed the effectiveness of the NEVERMIND e-health system, consisting of a smart shirt and a mobile application with lifestyle behavioural advice, mindfulness-based therapy, and cognitive behavioural therapy, in reducing depressive symptoms among patients diagnosed with severe somatic conditions. Our hypothesis was that the system would significantly decrease the level of depressive symptoms in the intervention group compared to the control group. Methods This pragmatic, randomised controlled trial included 425 patients diagnosed with myocardial infarction, breast cancer, prostate cancer, kidney failure, or lower limb amputation. Participants were recruited from hospitals in Turin and Pisa (Italy), and Lisbon (Portugal), and were randomly assigned to either the NEVERMIND intervention or to the control group. Clinical interviews and structured questionnaires were administered at baseline, 12 weeks, and 24 weeks. The primary outcome was depressive symptoms at 12 weeks measured by the Beck Depression Inventory II (BDI-II). Intention-to-treat analyses included 425 participants, while the per-protocol analyses included 333 participants. This trial is registered in the German Clinical Trials Register, DRKS00013391. Findings Patients were recruited between Dec 4, 2017, and Dec 31, 2019, with 213 assigned to the intervention and 212 to the control group. The sample had a mean age of 59·41 years (SD=10·70), with 44·24% women. Those who used the NEVERMIND system had statistically significant lower depressive symptoms at the 12-week follow-up (mean difference=-3·03, p<0·001; 95% CI -4·45 to -1·62) compared with controls, with a clinically relevant effect size (Cohen's d=0·39). Interpretation The results of this study show that the NEVERMIND system is superior to standard care in reducing and preventing depressive symptoms among patients with the studied somatic conditions. Funding The NEVERMIND project received funding from the European Union's Horizon 2020 Research and Innovation Programme under grant agreement No. 689691