A novel universal device "LINGUAL RING Ri.P.A.Ra" for TMDs and cranio-cervico-mandibular pains: preliminary results of a randomized control clinical trial

The aim of this study was to evaluate functionality and clinical application of a novel immediate device in the treatment of temporomandibular disorders (TMDs). To address the research purpose, authors developed and implemented a randomized control clinical trial

Interaction Between Tunnel Excavations and Historical Structures in Rome: A Fully Coupled Structural and Geotechnical Approach

In this paper we propose a 3D Finite Element (FE) approach to model the excavation of twin tunnels, accounting for the strongly non-linear soil behaviour, interacting with monumental masonry structures, carefully modelling their geometry and non-linear anisotropic mechanical behaviour. The work focuses on a specific case-study related to the ongoing construction of the line C of Rome underground

The crossing of the historical centre of Roma by the new underground line C: a study of soil-structure interaction for historical buildings

This work deals with the soil structure-interaction problems posed by the construction of the third line of Roma underground (Line C), which, in its central stretch, crosses the historical centre of the city with significant interferences with the archaeological and monumental heritage. The paper describes the methodological approach developed to evaluate the effects of tunnelling on the existing monuments and historical buildings, starting from a careful geotechnical and structural characterisation and including the development of reliable geotechnical and structural models. Experts in several disciplines were committed to this multidisciplinary work, ranging from geologists to geotechnical and structural engineers, archaeologists, and professionals working in the field of conservation and restoration of works of art and monuments. The study of the interaction between the construction activities and the built environment was carried out following procedures of increasing level of complexity, from green field analyses, in which the stiffness of the existing buildings was neglected, to full soil-structure interaction analyses, performed in both two- and three-dimensional conditions, accounting for the stiffness of existing buildings and considering possible long-term effects. The paper illustrates the main aspects of this procedure, using the example case studies of the Basilica di Massenzio and of the building of the Amministrazione Doria Pamphili

cost of walking exertional dyspnoea and fatigue in individuals with multiple sclerosis not requiring assistive devices

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Assessment of Tunneling Induced Damage on Historical Constructions Through a Fully Coupled Structural and Geotechnical Approach

The development of urban mobility implies the construction of tunnels, often interacting with valuable historical structures. It is thus necessary to develop rational and reliable procedures to estimate the potential excavation-induced damage, dealing with complex soil-structure interaction problems. Classical approaches are often characterised by relatively simple schematisations for either one or both components of the problem, as, for example, springs for the soil or equivalent plates for the structure. Such simplified assumptions prove to be appropriate for simple soil-foundation cases, while show several limitations when tackling more complex problems, as those involving the excavation in the vicinity or beneath historical masonry structure. In such cases, the need for reliable prediction of the potential damage on surface structures induced by construction activities justifies the adoption of advanced numerical approaches. These need to be based on realistic constitutive assumptions for both soils and masonry elements and require the definition of the three-dimensional geometry as well as an accurate modelling schematisation of the excavation process. In this paper a 3D Finite Element approach is proposed to model in detail the excavation of twin tunnels, accounting for the strongly non-linear soil behaviour, interacting with monumental masonry structures, carefully modelling their geometry and non-linear anisotropic mechanical behaviour. The work focuses on a specific case-study related to the ongoing construction of the line C of Rome underground

Rehabilitative treatment of patients with covid-19 infection: The p.a.r.m.a. evidence based clinical practice protocol

Background: The impact of the SARS-CoV-2 on the National Health System (NHS) required a reorganization of the various levels of care, which also involved the rehabilitation reality. Aim of the work: A clinical practice review of the literature was conducted to provide operational-rehabilitation guidelines adapt-ed to the local reality and to the recent corporate reorganization in the context of the COVID-19 emergency. Methods: A practice review of the available scientific evidence was regularly conducted from the start of the COVID-19 pandemic to periodically update the clinical practice guidelines. Articles that met the following inclusion criteria were included: studies conducted on human adult subjects with COVID-19 infection, un-dergoing rehabilitation in any hospitalization setting. Results: The results of this clinical practice update were periodically discussed with colleagues and collaborators in a multi-professional team, in order to guarantee a good clinical practice protocol, named P.A.R.M.A. Conclusions: The P.A.R.M.A. protocol is the result of a periodic review literature update, which has allowed us to take charge of patients affected by COVID-19 ac-cording to the most up-to-date clinical evidences, guaranteeing a shared and uniform treatment within a local reality in an era of health emergency. (www.actabiomedica.it)

Are old-old patients with major depression more likely to relapse than young-old patients during continuation treatment with escitalopram?

<p>Abstract</p> <p>Background</p> <p>Escitalopram has shown efficacy and tolerability in the prevention of relapse in elderly patients with major depressive disorder (MDD). This <it>post-hoc </it>analysis compared time to relapse for <it>young-old </it>patients (n = 197) to that for <it>old-old </it>patients (n = 108).</p> <p>Method</p> <p>Relapse prevention: after 12-weeks open-label treatment, remitters (MADRS ≤12) were randomised to double-blind treatment with escitalopram or placebo and followed over 24-weeks. Patients were outpatients with MDD from 46 European centers aged ≥75 years (<it>old-old</it>) or 65-74 years of age (<it>young-old</it>), treated with escitalopram 10-20mg/day. Efficacy was assessed using the Montgomery Åsberg Depression Rating Scale (MADRS).</p> <p>Results</p> <p>After open-label escitalopram treatment, a similar proportion of <it>young-old </it>patients (78%) and <it>old-old </it>patients (72%) achieved remission. In the analysis of time to relapse based on the Cox model (proportional hazards regression), with treatment and age group as covariates, the hazard ratio was 4.4 for placebo <it>versus </it>escitalopram (χ²-test, df = 1, χ²= 22.5, p < 0.001), whereas the effect of age was not significant, with a hazard ratio of 1.2 for <it>old-old </it>versus <it>young-old </it>(χ²-test, df = 1, χ²= 0.41, p = 0.520). Escitalopram was well tolerated in both age groups with adverse events reported by 53.1% of <it>young-old </it>patients and 58.3% of <it>old-old </it>patients. There was no significant difference in withdrawal rates due to AEs between age groups (χ²-test, χ²= 1.669, df = 1, p = 0.196).</p> <p>Conclusions</p> <p><it>Young-old </it>and <it>old-old </it>patients with MDD had comparable rates of remission after open-label escitalopram, and both age groups had much lower rates of relapse on escitalopram than on placebo.</p

Efficacy and acceptability of selective serotonin reuptake inhibitors for the treatment of depression in Parkinson's disease: a systematic review and meta-analysis of randomized controlled trials

<p>Abstract</p> <p>Background</p> <p>Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed antidepressants for the treatment of depression in patients with Parkinson's Disease (PD) but data on their efficacy are controversial.</p> <p>Methods</p> <p>We conducted a systematic review and meta-analysis of randomized controlled trials to investigate the efficacy and acceptability of SSRIs in the treatment of depression in PD.</p> <p>Results</p> <p>Ten studies were included. In the comparison between SSRIs and Placebo (n = 6 studies), the combined risk ratio (random effects) was 1.08 (95% confidence interval: 0.77 - 1.55, p = 0.67). In the comparison between SSRIs and Tricyclic Antidepressants (TCAs) (n = 3 studies) the combined risk ratio was 0.75 (0.39 - 1.42, p = 0.37). An acceptability analysis showed that SSRIs were generally well tolerated.</p> <p>Conclusions</p> <p>These results suggest that there is insufficient evidence to reject the null hypothesis of no differences in efficacy between SSRIs and placebo in the treatment of depression in PD. Due to the limited number of studies and the small sample sizes a type II error (false negative) cannot be excluded. The comparison between SSRIs and TCAs is based on only three studies and further trials with more pragmatic design are needed.</p

Bupropion Increases Selection of High Effort Activity in Rats Tested on a Progressive Ratio/Chow Feeding Choice Procedure: Implications for Treatment of Effort-Related Motivational Symptoms

Background: Depression and related disorders are characterized by deficits in behavioral activation, exertion of effort, and other psychomotor/motivational dysfunctions. Depressed patients show alterations in effort-related decision making and a bias towards selection of low effort activities. It has been suggested that animal tests of effort-related decision making could be useful as models of motivational dysfunctions seen in psychopathology. Methods: Because clinical studies have suggested that inhibition of catecholamine uptake may be a useful strategy for treatment of effort-related motivational symptoms, the present research assessed the ability of bupropion to increase work output in rats responding on a test of effort-related decision-making (ie, a progressive ratio/chow feeding choice task). With this task, rats can choose between working for a preferred food (high-carbohydrate pellets) by lever pressing on a progressive ratio schedule vs obtaining a less preferred laboratory chow that is freely available in the chamber. Results: Bupropion (10.0–40.0 mg/kg intraperitoneal) significantly increased all measures of progressive ratio lever pressing, but decreased chow intake. These effects were greatest in animals with low baseline levels of work output on the progressive ratio schedule. Because accumbens dopamine is implicated in effort-related processes, the effects of bupropion on markers of accumbens dopamine transmission were examined. Bupropion elevated extracellular dopamine levels in accumbens core as measured by microdialysis and increased phosphorylated dopamine and cyclic-AMP related phosphoprotein 32 kDaltons (pDARPP-32) immunoreactivity in a manner consistent with D1 and D2 receptor stimulation. Conclusion: The ability of bupropion to increase exertion of effort in instrumental behavior may have implications for the pathophysiology and treatment of effort-related motivational symptoms in humans