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Article ; Online: Home-Based Treatment for Chronic Pain Combining Neuromodulation, Computer-Assisted Training, and Telemonitoring in Patients With Breast Cancer

Lorenzo Conti / Chiara Marzorati / Roberto Grasso / Roberta Ferrucci / Alberto Priori / Francesca Mameli / Fabiana Ruggiero / Gabriella Pravettoni

JMIR Research Protocols, Vol 12, p e

Protocol for a Rehabilitative Study

2023 Volume 49508

Abstract: BackgroundChronic pain is a disabling symptom frequently reported in patients with breast cancer with a prevalence ranging from 25% to 60%, representing a major health issue. It has negative consequences on health status, causing psychological distress ... ...

Abstract	BackgroundChronic pain is a disabling symptom frequently reported in patients with breast cancer with a prevalence ranging from 25% to 60%, representing a major health issue. It has negative consequences on health status, causing psychological distress and affecting quality of life. Furthermore, the clinical management of chronic pain is often inadequate, and many patients do not benefit from the administration of pharmacological treatments. Alternative therapeutic options have been implemented to improve the psychophysical well-being of patients, including neuromodulation and complementary interventions. ObjectiveWe aimed to investigate the effectiveness of a home care strategy combining computerized rehabilitation, transcranial direct current stimulation (tDCS), and remote telemonitoring via a web-based platform in patients with breast cancer suffering for chronic pain. MethodsA web-based structured survey aimed at monitoring chronic pain and its effect on psychological functions will be delivered to patients with breast cancer through social media and email. In total, 42 patients with breast cancer affected by chronic pain will be recruited during the medical screening visit. The patients will be randomly divided into 3 treatment groups that will carry out either tDCS only, exercise therapy only, or a combination of both over a 3-week period. All the treatments will be delivered at the patients’ home through the use of a system including a tablet, wearable inertial sensors, and a tDCS programmable medical device. Using web-based questionnaires, the perception of pain (based on the pain self-efficacy questionnaire, visual analogue scale, pain catastrophizing scale, and brief pain inventory) and psychological variables (based on the hospital and anxiety depression scale and 12-item short form survey) will be assessed at the beginning of treatment, 1 week after the start of treatment, at the end of treatment, 1 month after the start of treatment, and 3 months after the start of treatment. The system’s usability ...
Keywords	Medicine ; R ; Computer applications to medicine. Medical informatics ; R858-859.7
Subject code	616
Language	English
Publishing date	2023-11-01T00:00:00Z
Publisher	JMIR Publications
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Alternate fluency in Parkinson's disease

Roberta Ferrucci / Francesca Mameli / Fabiana Ruggiero / Mariella Reitano / Mario Miccoli / Angelo Gemignani / Ciro Conversano / Michelangelo Dini / Stefano Zago / Silvie Piacentini / Barbara Poletti / Alberto Priori / Graziella Orrù

PLoS ONE, Vol 17, Iss 3, p e

A machine learning analysis.

2022 Volume 0265803

Abstract: Objective The aim of the present study was to investigate whether patients with Parkinson's Disease (PD) had changes in their level of performance in extra-dimensional shifting by implementing a novel analysis method, utilizing the new alternate phonemic/ ...

Abstract	Objective The aim of the present study was to investigate whether patients with Parkinson's Disease (PD) had changes in their level of performance in extra-dimensional shifting by implementing a novel analysis method, utilizing the new alternate phonemic/semantic fluency test. Method We used machine learning (ML) in order to develop high accuracy classification between PD patients with high and low scores in the alternate fluency test. Results The models developed resulted to be accurate in such classification in a range between 80% and 90%. The predictor which demonstrated maximum efficiency in classifying the participants as low or high performers was the semantic fluency test. The optimal cut-off of a decision rule based on this test yielded an accuracy of 86.96%. Following the removal of the semantic fluency test from the system, the parameter which best contributed to the classification was the phonemic fluency test. The best cut-offs were identified and the decision rule yielded an overall accuracy of 80.43%. Lastly, in order to evaluate the classification accuracy based on the shifting index, the best cut-offs based on an optimal single rule yielded an overall accuracy of 83.69%. Conclusion We found that ML analysis of semantic and phonemic verbal fluency may be used to identify simple rules with high accuracy and good out of sample generalization, allowing the detection of executive deficits in patients with PD.
Keywords	Medicine ; R ; Science ; Q
Subject code	006
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The Impact of Telemedicine on Parkinson’s Care during the COVID-19 Pandemic

Fabiana Ruggiero / Linda Lombi / Maria Takeko Molisso / Giorgio Fiore / Eleonora Zirone / Roberta Ferrucci / Elena Pirola / Marco Locatelli / Sergio Barbieri / Francesca Mameli

Healthcare, Vol 10, Iss 1065, p

An Italian Online Survey

2022 Volume 1065

Abstract: Traditionally, medical care and research in Parkinson’s disease (PD) have been conducted through in-person visit. The recent Coronavirus Disease 2019 (COVID-19) pandemic has profoundly impacted the delivery of in-person clinical care. We conducted an ... ...

Abstract	Traditionally, medical care and research in Parkinson’s disease (PD) have been conducted through in-person visit. The recent Coronavirus Disease 2019 (COVID-19) pandemic has profoundly impacted the delivery of in-person clinical care. We conducted an online survey to investigate the impact of COVID-19 on access to telehealth care, interviewing both PD patients and neurologists. Survey responses were collected from 1 March to 31 May 2021 through an anonymous, self-reported questionnaire, on the ‘Qualtrics’ platform. In total, 197 patients and 42 neurologists completed the survey. In our sample, 37.56% of PD patients and 88.10% of neurologists reported having used alternatives to in-person visits, while 13.70% of PD patients and 40.48% of neurologists used telemedicine. Data showed that respondents were generally satisfied with the use of telemedicine during the COVID-19 pandemic. The relational dimension between patient and neurologist seems to be the factor that most positively affected the telemedicine experience, contributing greatly to a more patient-centred care. Current findings suggest the need to improve the access to telehealth services for patients with PD. The technology has the potential to improve the care of frail patients, especially when availability of face-to-face visits is limited.
Keywords	survey ; Parkinson’s disease ; COVID-19 ; telehealth ; telemedicine ; E-health ; Medicine ; R
Subject code	310
Language	English
Publishing date	2022-06-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Alternate fluency in Parkinson’s disease

PLoS ONE, Vol 17, Iss

A machine learning analysis

2022 Volume 3

Abstract: Objective The aim of the present study was to investigate whether patients with Parkinson’s Disease (PD) had changes in their level of performance in extra-dimensional shifting by implementing a novel analysis method, utilizing the new alternate phonemic/ ...

Abstract	Objective The aim of the present study was to investigate whether patients with Parkinson’s Disease (PD) had changes in their level of performance in extra-dimensional shifting by implementing a novel analysis method, utilizing the new alternate phonemic/semantic fluency test. Method We used machine learning (ML) in order to develop high accuracy classification between PD patients with high and low scores in the alternate fluency test. Results The models developed resulted to be accurate in such classification in a range between 80% and 90%. The predictor which demonstrated maximum efficiency in classifying the participants as low or high performers was the semantic fluency test. The optimal cut-off of a decision rule based on this test yielded an accuracy of 86.96%. Following the removal of the semantic fluency test from the system, the parameter which best contributed to the classification was the phonemic fluency test. The best cut-offs were identified and the decision rule yielded an overall accuracy of 80.43%. Lastly, in order to evaluate the classification accuracy based on the shifting index, the best cut-offs based on an optimal single rule yielded an overall accuracy of 83.69%. Conclusion We found that ML analysis of semantic and phonemic verbal fluency may be used to identify simple rules with high accuracy and good out of sample generalization, allowing the detection of executive deficits in patients with PD.
Keywords	Medicine ; R ; Science ; Q
Subject code	006
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Psychological Impact During the First Outbreak of COVID-19 in Italy

Roberta Ferrucci / Alberto Averna / Daniela Marino / Maria Rita Reitano / Fabiana Ruggiero / Francesca Mameli / Michelangelo Dini / Barbara Poletti / Sergio Barbieri / Alberto Priori / Gabriella Pravettoni

Frontiers in Psychiatry, Vol

2020 Volume 11

Abstract: The first outbreak of COVID-19 in Italy was confirmed on February 21, 2020. Subsequently, COVID-19 turned into a global pandemic, causing a global health emergency, triggering an unprecedented event in the modern era. This study assessed the immediate ... ...

Abstract	The first outbreak of COVID-19 in Italy was confirmed on February 21, 2020. Subsequently, COVID-19 turned into a global pandemic, causing a global health emergency, triggering an unprecedented event in the modern era. This study assessed the immediate psychological impact of the COVID-19 epidemic on emotional health and well-being.An ad hoc questionnaire was designed for online completion to expedite data collection during the COVID-19 outbreak. People were invited to participate in the study via social media and email from 4 to 18 March 2020. The entire survey comprised of 21 questions, covering a wide range of factors, such as demographics, disease knowledge, psychological impact, daily life activities, and psychological precautionary measures. The main outcome measure was psychological impact. This was measured based on intensity and prevalence of self-reported feelings of anxiety, fear, sadness, anger, and concern during the epidemic.In total, 10,025 respondents completed the online survey. Of these, about 73% were females, and 100% of the sample possessed good knowledge of the disease. The greatest prevalence of high psychological impact was reported in the <34 years' age group and in north Italy. Additionally, the psychological impact influenced important daily life activities, such as sexuality and nutrition.Our study provides information about the immediate psychological (emotional feelings) responses of Italy's general population to the COVID-19 epidemic. The survey covers several factors that can influence mental health; our results help gauge the psychological burden on the community and offer ways to minimize the impact.
Keywords	anxiety ; fear ; sexuality ; psychological distress ; COVID-19 ; Psychiatry ; RC435-571 ; covid19
Subject code	306
Language	English
Publishing date	2020-11-01T00:00:00Z
Publisher	Frontiers Media S.A.
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: A Systematic Review and Provisional Metanalysis on Psychopathologic Burden on Health Care Workers of Coronavirus Outbreaks

Federica Galli / Gino Pozzi / Fabiana Ruggiero / Francesca Mameli / Marco Cavicchioli / Sergio Barbieri / Maria Paola Canevini / Alberto Priori / Gabriella Pravettoni / Gabriele Sani / Roberta Ferrucci

Frontiers in Psychiatry, Vol

2020 Volume 11

Abstract: BackgroundThe new coronavirus (SARS-CoV-2) shows several similarities with previous outbreaks of Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS). Aim of this systematic review and meta-analysis is to provide evidence ... ...

Abstract	BackgroundThe new coronavirus (SARS-CoV-2) shows several similarities with previous outbreaks of Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS). Aim of this systematic review and meta-analysis is to provide evidence of the psychopathologic burden on health care workers (HCWs) of the first two deadly coronavirus outbreaks to get lessons for managing the current burden of COVID-19 outbreak.MethodAccording to Cochrane Collaboration guidelines and the PRISMA Statement, the study quantified the effects of frontline work on mental health of HCWs. Major databases — Pubmed, Scopus, Embase, Medline, and Web of Science — were searched for observational and case-control studies evaluating mental health indexes reported by front-line work. This study computed the percentage of sample that reported clinically significant levels of psychiatric symptoms. Cohen’s d was used for comparing mental health outcomes of health care workers directly involved in addressing pandemic emergency with a control group that was not directly exposed to such conditions. Pooled effect sizes (dw) were estimated whenever at least three independent studies yielded data. Heterogeneity of findings and bias of publication were estimated as well.FindingsFifteen studies have been selected for a total of 7,393 HCWs. From 9.6% to 51% of HCWs reported symptoms of Post-Traumatic Stress Disorder (PTSD) and from 20% to 75% reported psychiatric symptoms, with a prevalence of anxiety and depression. From one to the three years after outbreak, from 2% to 19% reported PTSD symptoms and from 5% to 90% psychiatric symptoms. Interestingly, HWCs who were directly involved in pandemic emergency showed significantly higher depressive and anxious symptoms (dw = .66 (.46–.85); p <.001) than ones who were not directly exposed. Similarly, the direct involvement significantly affected the severity of PTSD symptoms (dw = .30 (.21–.39); p <.001).ConclusionHealth care professionals in general and most of all frontline workers showed an association with a likely risk of developing psychiatric disorders following outbreaks and for at least three years later. Mental health interventions for professionals exposed to COVID-19 need to be immediately implemented. Further studies are warranted to investigate long-term consequences carefully, and to look for mediating and buffering factors as well. The role of clinical psychologists and psychiatrists in delivering adequate interventions is critically important.
Keywords	Post-Traumatic Stress Disorder ; anxiety ; depression ; psychological distress ; “health care worker” ; Psychiatry ; RC435-571 ; covid19
Subject code	150
Language	English
Publishing date	2020-10-01T00:00:00Z
Publisher	Frontiers Media S.A.
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The risk of abuse of legal firearms by old and young individuals with acquired cognitive impairments

Carlo Alfredo Clerici / Valeria Pirro / Laura Veneroni / Francesca Mameli / Angelo de' Micheli

Italian Journal of Public Health, Vol 8, Iss

a review of the literature

2011 Volume 4

Abstract: Background : Risk assessment in relation to firearms and cognitive impairments is complex, and no guidelines exist regarding the appropriate management of people with dementia who may own or have access to a firearm. In Italy, approximately 4.8 million ... ...

Abstract	Background : Risk assessment in relation to firearms and cognitive impairments is complex, and no guidelines exist regarding the appropriate management of people with dementia who may own or have access to a firearm. In Italy, approximately 4.8 million people either own a firearm or use one for recreational, sporting or professional reasons. Recent studies report that firearms were used in 35.7% of suicides committed by people over 65 years old and that 5% of all suicides were committed by over 65-year-olds using firearms. As for the figures related to homicides committed with firearms by people over 65, these represented 31.8% of all homicides committed with firearms. Results : The aim of the present study was to conduct a critical review of the procedures currently used in relation to the use of firearms by elderly people. We conducted a review of the international scientific literature published over the last 20 years on the phenomenon of firearms abuse by elderly people and its prevention, drawn from the Medline and PsychINFO online databases. We considered all studies published in journals and books from 1990 to 2010 using the following keywords: violence, firearms, suicide, homicide, dementia and cognitive impairments, and searching for quantitative studies, case reports and literature reviews. Conclusions : Family physicians and specialists (geriatricians, neuropsychiatrists, clinical psychologists) can act as an indispensable observatory of the related risks in people who own firearms, but their role should be supported by suitable training on the procedures used to assess and report on any such risks.
Keywords	Firearms ; suicide ; homicide ; dementia ; older adults ; Public aspects of medicine ; RA1-1270 ; Medicine ; R ; DOAJ:Public Health ; DOAJ:Health Sciences
Subject code	360
Language	English
Publishing date	2011-12-01T00:00:00Z
Publisher	Prex spa
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The importance of spirituality in supportive care

Giuseppina Messina / Stefania Anania / Claudia Bonomo / Laura Veneroni / Antonietta Andreoli / Francesca Mameli / Chiara Ortolina / Paola De Fabritiis / Maria Gaffuri / Francesco Imbesi / Egidio Moja

International Journal of Yoga, Vol 4, Iss 1, Pp 33-

2011 Volume 38

Abstract: Background: It has been shown that the pineal gland plays a fundamental role in mediating either the spiritual perception or the anticancer immunity by stimulating the endogenous production of anticancer cytokine interleukin (IL)-2. Objective: The ... ...

Abstract	Background: It has been shown that the pineal gland plays a fundamental role in mediating either the spiritual perception or the anticancer immunity by stimulating the endogenous production of anticancer cytokine interleukin (IL)-2. Objective: The present study was performed to evaluate the impact of a spiritual approach consisting of Kriya Yoga program alone or in association with melatonin (MLT) or low-dose IL-2 plus MLT on the survival time in a group of metastatic cancer patients with life expectancy less than 1 year. Materials and Methods: A case-control study was carried out in 240 patients (M/F: 146/94; median age: 62 years, range: 34-71, suffering from non-small-cell lung cancer or gastrointestinal tumors) who were subdivided into 6 groups of 40 patients, treated with supportive care alone as a control group, supportive care plus Yoga, MLT alone, MLT plus Yoga, inteleukin-2 plus MLT, or IL-2 plus MLT plus Yoga. Results: The best results in terms of increased survival time were obtained by the association between neuroimmunotherapy with MLT plus IL-2 and Yoga program (2 years), which was significantly longer with respect to that achieved by supportive care alone, Yoga alone, or IL-2 plus MLT alone (1 year). Conclusions: This study would suggest that a spiritual therapeutic approach may improve the survival time of untreatable metastatic solid tumor patients.
Keywords	Cancer; spirituality; yoga ; Public aspects of medicine ; RA1-1270 ; Medicine ; R
Subject code	616
Language	English
Publishing date	2011-01-01T00:00:00Z
Publisher	Medknow Publications
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Brain switches utilitarian behavior

Manuela Fumagalli / Maurizio Vergari / Patrizio Pasqualetti / Sara Marceglia / Francesca Mameli / Roberta Ferrucci / Simona Mrakic-Sposta / Stefano Zago / Giuseppe Sartori / Gabriella Pravettoni / Sergio Barbieri / Stefano Cappa / Alberto Priori

PLoS ONE, Vol 5, Iss 1, p e

does gender make the difference?

2010 Volume 8865

Abstract: Decision often implies a utilitarian choice based on personal gain, even at the expense of damaging others. Despite the social implications of utilitarian behavior, its neurophysiological bases remain largely unknown. To assess how the human brain ... ...

Abstract	Decision often implies a utilitarian choice based on personal gain, even at the expense of damaging others. Despite the social implications of utilitarian behavior, its neurophysiological bases remain largely unknown. To assess how the human brain controls utilitarian behavior, we delivered transcranial direct current stimulation (tDCS) over the ventral prefrontal cortex (VPC) and over the occipital cortex (OC) in 78 healthy subjects. Utilitarian judgment was assessed with the moral judgment task before and after tDCS. At baseline, females provided fewer utilitarian answers than males for personal moral dilemmas (p = .007). In males, VPC-tDCS failed to induce changes and in both genders OC-tDCS left utilitarian judgments unchanged. In females, cathodal VPC-tDCS tended to decrease whereas anodal VPC-tDCS significantly increased utilitarian responses (p = .005). In males and females, reaction times for utilitarian responses significantly decreased after cathodal (p<.001) but not after anodal (p = .735) VPC-tDCS. We conclude that ventral prefrontal tDCS interferes with utilitarian decisions, influencing the evaluation of the advantages and disadvantages of each option in both sexes, but does so more strongly in females. Whereas cathodal tDCS alters the time for utilitarian reasoning in both sexes, anodal stimulation interferes more incisively in women, modifying utilitarian reasoning and the possible consequent actions. The gender-related tDCS-induced changes suggest that the VPC differentially controls utilitarian reasoning in females and in males. The gender-specific functional organization of the brain areas involved in utilitarian behavior could be a correlate of the moral and social behavioral differences between the two sexes.
Keywords	Medicine ; R ; Science ; Q
Subject code	170
Language	English
Publishing date	2010-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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