The Impact of Alexithymia on Treatment Response in Psychiatric Disorders: A Systematic Review

Treatment of psychiatric disorders relies heavily on a trial and error approach, often prolonging the time required to obtain symptomatic improvements. The identification of reliable predictors of treatment response is instrumental to enact an individualized approach. Alexithymia represents a personality trait reflecting an intrinsic difficulty in recognizing the emotional components of subjective experiences. Thus, its modulating role on treatment outcome has gathered substantial attention during the past years. In the present paper, we aimed at exploring the available evidence for Alexithymia role in influencing the treatment outcome on a wide range of psychiatric conditions by means of a systematic review

The bistable system: an archetypal model for complex systems

Bistable systems often play the role of archetypal models to understand the dynamical behavior of complex systems. Examples range from microphysics to macrophysics, bìology, chemistry and also econophysics. Moreover the statistical mechanics is essential to study the physical properties of complex systems and to investigate stochastic systems in which the microscopic degrees of freedom behave collectively over large scales. We investigate the nonlinear relaxation in a bistable system in classical and quantum systems. (i) As a first classical system, the role of the multiplicative and additive noise in the mean life time of the metastable state of an asymmetric bistable system is investigated. Thìs model is useful to describe the dynamical behavior of an out of equilibrium Ising spin system. Nonmonotonic behavior of the average lifetime as a function of both additive and multiplicative noise source intensities ìs found. (ii) The role of a non-Gaussian Lévy noise on the nonlinear dynamics of: a) a partide moving in a metastable system, b) an ecosystem composed by two competing species interacting with the surrounding environment, and c) a short overdamped Iosephson junction is investigated. a) By using the backward fractional Fokker-Planck equation we investigate the barrier crossing event and the nonlinear relaxation time for a metastable system; b) In the ecosystem, the role of two non-Gaussian noise sources in the exclusion and coexistence regimes is analyzed. Quasiperiodic oscillations and stochastic resonance phenomenon in the dynamics of the competing specìes are found: c) In the short overdamped Iosepbson, the mean escape time of the junction is investigated considering Gaussian, Cauchy- Lorentz and Lévy-Smìrnov probability distributions of the noise signals. In these conditions we find resonant activation and the first evidence of noise enhanced stability in a metastable system in the presence of Lévy noise. For Cauchy- Lorentz noise source, trapping phenomena and power law dependence on the noise intensity are observed. (iii) Finally the dynamics of a quantum particle subject to an asymmetric bistable potential and interacting with a thermal reservoir is investigated. We obtain the time evolution of the population distributions in the position eigenstates of the particle, for dìfferent values of the coupling strength with the thermal bath. The calculation is carried out by using the Feynman-Vernon functional under the discrete variable representation

TRANSIENT DYNAMICS AND ASYMPTOTIC POPULATIONS IN A DRIVEN METASTABLE QUANTUM SYSTEM

The transient dynamics of a periodically driven metastable quantum system, interacting with a heat bath, is investigated. The time evolution of the populations, within the framework of the Feynman–Vernon influ- ence functional and in the discrete variable representation, is analyzed by varying the parameters of the external driving. The results display strong non-monotonic behaviour of the populations with respect to the driving frequency

Effect of Low-frequency Noise on Adiabatic Passage in a Superconducting Nanocircuit

Recent experiments have demonstrated coherent phenomena in three-level systems based on superconducting nanocircuits. This opens the possibility to detect Stimulated Raman Adiabatic Passage (STIRAP) in artificial atoms. Low-fequency noise (often 1/f) is one of the main sources of decoherence in these systems, and we study its effect on the transfer e±ciency. We propose a way to analyze low frequency fluctuations in terms of fictitious correlated fluctuations of external parameters. We discuss a specific implementation, namely the Quantronium setup of a Cooper-pair box, showing that optimizing the trade-off between efficient coupling and protection against noise may allow us to observe coherent population transfer in this nanodevice

THE BISTABLE POTENTIAL: AN ARCHETYPE FOR CLASSICAL AND QUANTUM SYSTEMS

In this work we analyze the transient dynamics of three different classical and quantum systems. First, we consider a classical Brownian particle moving in an asymmetric bistable potential, subject to a multiplicative and additive noise source. We investigate the role of these two noise sources on the life time of the metastable state. A nonmonotonic behavior of the lifetime as a function of both additive and multiplicative noise intensities is found, revealing the phenomenon of noise enhanced stability. Afterward, by using a Lotka–Volterra model, the dynamics of two competing species in the presence of Lévy noise sources is analyzed. Quasiperiodic oscillations and stochastic resonance phenomenon in the dynamics of the competing species are found. Finally the dynamics of a quantum particle subject to an asymmetric bistable potential and interacting with a thermal reservoir is investigated. We use the Caldeira–Leggett model and the approach of the Feynman–Vernon functional in discrete variable representation. We obtain the time evolution of the population distributions in energy eigenstates of the particle, for different values of the coupling strength with the thermal bath

Lithium and its effects: does dose matter?

Background: Decades of clinical research have demonstrated the efficacy of lithium in treating acute episodes (both manic and depressive), as well as in preventing recurrences of bipolar disorder (BD). Specific to lithium is its antisuicidal effect, which appears to extend beyond its mood-stabilizing properties. Lithium's clinical effectiveness is, to some extent, counterbalanced by its safety and tolerability profile. Indeed, monitoring of lithium levels is required by its narrow therapeutic index. There is consensus that adequate serum levels should be above 0.6 mEq/L to achieve clinical effectiveness. However, few data support the choice of this threshold, and increasing evidence suggests that lithium might have clinical and molecular effects at much lower concentrations. Content: This narrative review is aimed at: (1) reviewing and critically interpreting the clinical evidence supporting the use of the 0.6 mEq/L threshold, (2) reporting a narrative synthesis of the evidence supporting the notion that lithium might be effective in much lower doses. Among these are epidemiological studies of lithium in water, evidence on the antisuicidal, anti-aggressive, and neuroprotective effects, including efficacy in preventing cognitive impairment progression, Alzheimer's disease (AD), and amyotrophic lateral sclerosis (ALS), of lithium; and (3) revieweing biological data supporting clinically viable uses of lithium at low levels with the delineation of a mechanistic hypothesis surrounding its purported mechanism of action. The study selection was based on the authors' preference, reflecting the varied and extensive expertise on the review subject, further enriched with an extensive pearl-growing strategy for relevant reviews and book sections. Conclusions: Clinical and molecular effects of lithium are numerous, and its effects also appear to have a certain degree of specificity related to the dose administered. In sum, the clinical effects of lithium are maximal for mood stabilisation at concentrations higher than 0.6 mEq/l. However, lower levels may be sufficient for preventing depressive recurrences in older populations of patients, and microdoses could be effective in decreasing suicide risk, especially in patients with BD. Conversely, lithium's ability to counteract cognitive decline appears to be exerted at subtherapeutic doses, possibly corresponding to its molecular neuroprotective effects. Indeed, lithium may reduce inflammation and induce neuroprotection even at doses several folds lower than those commonly used in clinical settings. Nevertheless, findings surrounding its purported mechanism of action are missing, and more research is needed to investigate the molecular targets of low-dose lithium adequately

Twenty-Year Follow-Up of Excimer Laser Photorefractive Keratectomy: A Retrospective Observational Study

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Pharmacokinetic Markers of Clinical Outcomes in Severe Mental Illness: A Systematic Review

The term severe mental illness (SMI) encompasses those psychiatric disorders exerting the highest clinical burden and socio-economic impact on the affected individuals and their communities. Pharmacogenomic (PGx) approaches hold great promise in personalizing treatment selection and clinical outcomes, possibly reducing the burden of SMI. Here, we sought to review the literature in the field, focusing on PGx testing and particularly on pharmacokinetic markers. We performed a systematic review on PUBMED/Medline, Web of Science, and Scopus. The last search was performed on the 17 September 2022, and further augmented with a comprehensive pearl-growing strategy. In total, 1979 records were screened, and after duplicate removal, 587 unique records were screened by at least 2 independent reviewers. Ultimately, forty-two articles were included in the qualitative analysis, eleven randomized controlled trials and thirty-one nonrandomized studies. The observed lack of standardization in PGx tests, population selection, and tested outcomes limit the overall interpretation of the available evidence. A growing body of evidence suggests that PGx testing might be cost-effective in specific settings and may modestly improve clinical outcomes. More efforts need to be directed toward improving PGx standardization, knowledge for all stakeholders, and clinical practice guidelines for screening recommendations

Assessment of blood perfusion quality in laparoscopic colorectal surgery by means of Machine Learning

An innovative algorithm to automatically assess blood perfusion quality of the intestinal sector in laparoscopic colorectal surgery is proposed. Traditionally, the uniformity of the brightness in indocyanine green-based fluorescence consists only in a qualitative, empirical evaluation, which heavily relies on the surgeon's subjective assessment. As such, this leads to assessments that are strongly experience-dependent. To overcome this limitation, the proposed algorithm assesses the level and uniformity of indocyanine green used during laparoscopic surgery. The algorithm adopts a Feed Forward Neural Network receiving as input a feature vector based on the histogram of the green band of the input image. It is used to (i) acquire information related to perfusion during laparoscopic colorectal surgery, and (ii) support the surgeon in assessing objectively the outcome of the procedure. In particular, the algorithm provides an output that classifies the perfusion as adequate or inadequate. The algorithm was validated on videos captured during surgical procedures carried out at the University Hospital Federico II in Naples, Italy. The obtained results show a classification accuracy equal to [Formula: see text], with a repeatability of [Formula: see text]. Finally, the real-time operation of the proposed algorithm was tested by analyzing the video streaming captured directly from an endoscope available in the OR

Pharmacological Treatment of Bipolar Depression: A Review of Observational Studies

The persistence of depressive morbidity is frequent in bipolar disorder, and the pharmacological management of this symptomatology often lacks effectiveness. This systematic review aimed to summarize the results of the naturalistic observational studies on the pharmacological treatment of bipolar depression published through April 2022. The certainty of evidence was evaluated according to the GRADE approach. In sum, 16 studies on anticonvulsants, 20 on atypical antipsychotics, 2 on lithium, 28 on antidepressants, and 9 on other compounds were found. Lamotrigine, quetiapine, aripiprazole, and ketamine were the most investigated compounds. Overall, the results support the recommendations regarding the effectiveness of lamotrigine and quetiapine. In contrast to the current recommendations, aripiprazole was shown to be effective and generally well tolerated. Additionally, SSRIs were shown to be effective, but, since they were associated with a possibly higher switch risk, they should be used as an adjunctive therapy to mood stabilizers. Lithium was only studied in two trials but was shown to be effective, although the serum concentrations levels were not associated with clinical response. Finally, ketamine showed divergent response rates with a low certainty of evidence and, so far, unclear long-term effects. Heterogeneity in diagnosis, sample sizes, study designs, reporting of bias, and side effects limited the possibility of a head-to-head comparison