8 research outputs found
The Application of tDCS to Treat Pain and Psychocognitive Symptoms in Cancer Patients: A Scoping Review
No full textBackground: The use of transcranial direct current stimulation (tDCS) to modulate pain, psychological aspects, and cognitive functions has increased in recent years. The present scoping review aims to investigate the use of tDCS in cancer patients and its significant impact on psychocognitive and pain related symptoms. Methods: From the earliest available date to June 2023, a comprehensive search was conducted in three electronic scientific databases-PubMed, Scopus, and Embase-and other supplementary sources. Ten relevant studies were identified and included, comprising single case studies, randomized controlled trials, pilot studies, and one retrospective study. PRISMA guidelines for scoping reviews were followed. Results: These studies investigated the use of tDCS to improve pain and psychocognitive aspects in patients with various types of cancer, including breast, oral, bladder, lung, pancreatic, head and neck cancer, hepatocellular carcinoma, and meningioma. Overall, the results suggest that tDCS has shown efficacy in relieving pain, reducing anxiety and depression, and improving cognitive function in cancer patients. Conclusion: Due to the limited number and high heterogeneity of the existing literature in this field, more investigation and the establishment of standardized protocols would be required to obtain more conclusive evidence
Testing the evolutionary link between submillimetre galaxies and quasars: CO observations of QSOs at z~2
No full textWe have used the IRAM Plateau de Bure millimetre interferometer and the UKIRT 1–5 μm Imager Spectrometer (UIST) to test the connection between the major phases of spheroid growth and nuclear accretion by mapping CO emission in nine submillimetre-detected QSOs at z= 1.7–2.6 with black hole (BH) masses derived from near-infrared spectroscopy. When combined with one QSO obtained from the literature, we present sensitive CO(3–2) or CO(2–1) observations of 10 submillimetre-detected QSOs selected at the epoch of peak activity in both QSOs and submillimetre (submm) galaxies (SMGs). CO is detected in 5/6 very optically luminous (MB∼−28) submm-detected QSOs with BH masses MBH≃ 109–1010 M⊙, confirming the presence of large gas reservoirs of Mgas≃ 3.4 × 1010 M⊙. Our BH masses and dynamical mass constraints on the host spheroids suggest, at face value, that these optically luminous QSOs at z= 2 lie about an order of magnitude above the local BH–spheroid relation, MBH/Msph, although this result is dependent on the size and inclination of the CO-emitting region. However, we find that their BH masses are ∼30 times too large and their surface density is ∼300 times too small to be related to typical SMGs in an evolutionary sequence. Conversely, we measure weaker CO emission in four fainter (MB∼−25) submm-detected QSOs with properties, BH masses (MBH≃ 5 × 108 M⊙), and surface densities similar to SMGs. These QSOs appear to lie near the local MBH/Msph relation, making them plausible ‘transition objects’ in the proposed evolutionary sequence linking QSOs to the formation of massive young galaxies and BHs at high redshift. We show that SMGs have a higher incidence of bimodal CO line profiles than seen in our QSO sample, which we interpret as an effect of their relative inclinations, with the QSOs seen more face-on. Finally, we find that the gas masses of the four fainter submm-detected QSOs imply that their star formation episodes could be sustained for ∼10 Myr, and are consistent with representing a phase in the formation of massive galaxies which overlaps a preceding SMG starburst phase, before subsequently evolving into a population of present-day massive ellipticals
The awakening of BL Lacertae: observations by Fermi, Swift and the GASP-WEBT
No full textSince the launch of the Fermi satellite, BL Lacertae has been moderately active at ?-rays and optical frequencies until 2011 May, when the source started a series of strong flares. The exceptional optical sampling achieved by the GLAST–AGILE Support Program of the Whole Earth Blazar Telescope in collaboration with the Steward Observatory allows us to perform a detailed comparison with the daily γ-ray observations by Fermi. Discrete correlation analysis between the optical and γ-ray emission reveals correlation with a time lag of 0 ± 1 d, which suggests cospatiality of the corresponding jet emitting regions. A better definition of the time lag is hindered by the daily gaps in the sampling of the extremely fast flux variations. In general, optical flares present more structure and develop on longer time-scales than corresponding γ-ray flares. Observations at X-rays and at millimetre wavelengths reveal a common trend, which suggests that the region producing the mm and X-ray radiation is located downstream from the optical and γ-ray-emitting zone in the jet. The mean optical degree of polarization slightly decreases over the considered period and in general it is higher when the flux is lower. The optical electric vector polarization angle (EVPA) shows a preferred orientation of about 15°, nearly aligned with the radio core EVPA and mean jet direction. Oscillations around it increase during the 2011–2012 outburst. We investigate the effects of a geometrical interpretation of the long-term flux variability on the polarization. A helical magnetic field model predicts an evolution of the mean polarization that is in reasonable agreement with the observations. These can be fully explained by introducing slight variations in the compression factor in a transverse shock waves model
Neuropsychological Assessment in Non-Central Nervous System Cancer Patients: A Systematic Review of Cognitive Screening and Assessment Within Oncology Practice
No full textBackground: Early cancer detection and innovative treatments have prolonged the lifespan of cancer patients, leading to long-term consequences, including cancer-related cognitive impairment (CRCI), affecting the patients’ quality of life. In 2011, the International Cancer and Cognition Task Force (ICCTF) established guidelines for neuropsychological assessment, however many neuropsychological tests lack validity for oncological patients.
Aim: This systematic review aims to identify and summarise the most commonly used neuropsychological tests in cognitive screening and assessment in non-CNS cancer patients.
Method: A search of electronic databases (PUBMED, EMBASE, and SCOPUS) includes 1) research articles using 2) neuropsychological tests 3) on non-CNS cancer patients, 4) aged between 18 and 80 years old, 5) published in the English 6) from January 2011 to October 2023. Quality assessment was assessed by MMAT Guidelines.
Results: 178 studies met the eligibility criteria, adopting a total of 151 different neuropsychological tests. The most widely used screening test was the Mini-Mental State Examination (N=41). Among the main cognitive domains analyzed, the Hopkins Verbal Learning Test-Revised (N=61) was the most commonly used to assess memory. The Controlled Oral Word Association Test (N=24) was primarily utilized regarding language and the Trail Making Test-part A (TMT-A) (N=37) was the most frequently used for attention. Moreover, executive functions were predominantly studied using the TMT-B (N=45). Among the included studies, only 42 adhered to the guidelines provided by the ICCTF.
Conclusion: Despite the available guidelines, the wide variability of the utilized tests undermines the generalisability of results. These findings underscore the necessity of developing and implementing assessment and screening tools tailored specifically for cancer patients within the oncology practice
Patients’ Perceptions and Attitudes to the Use of Artificial Intelligence in Breast Cancer Diagnosis: A Narrative Review
No full textBreast cancer remains the most prevalent cancer among women worldwide, necessitating advancements in diagnostic methods. The integration of artificial intelligence (AI) into mammography has shown promise in enhancing diagnostic accuracy. However, understanding patient perspectives, particularly considering the psychological impact of breast cancer diagnoses, is crucial. This narrative review synthesizes literature from 2000 to 2023 to examine breast cancer patients’ attitudes towards AI in breast imaging, focusing on trust, acceptance, and demographic influences on these views. Methodologically, we employed a systematic literature search across databases such as PubMed, Embase, Medline, and Scopus, selecting studies that provided insights into patients’ perceptions of AI in diagnostics. Our review included a sample of seven key studies after rigorous screening, reflecting varied patient trust and acceptance levels towards AI. Overall, we found a clear preference among patients for AI to augment rather than replace the diagnostic process, emphasizing the necessity of radiologists’ expertise in conjunction with AI to enhance decision-making accuracy. This paper highlights the importance of aligning AI implementation in clinical settings with patient needs and expectations, emphasizing the need for human interaction in healthcare. Our findings advocate for a model where AI augments the diagnostic process, underlining the necessity for educational efforts to mitigate concerns and enhance patient trust in AI-enhanced diagnostics
How the COVID-19 pandemic reshaped telepsychology: Insights from an Italian survey
No full textThe coronavirus disease 2019 (COVID-19) pandemic rapidly boosted the introduction of certain changes in mental healthcare services, consequently driving up the adoption of remote care delivery options. We conducted an online Italian survey to evaluate telepsychology use, attitudes, acceptance, and training needs, as well as to understand patient-professional interactions in video-consultations, aiming to inform future mental healthcare practices and policies. The current study's survey responses were collected using an anonymous, self-reported questionnaire on the ‘REDCap’ platform from 25 October 2022 to 26 July 2023. In total, 128 mental health professionals and 113 patients completed the survey. In our sample, 69 % of patients and 79.7 % of mental health professionals reported having used telepsychology during COVID-19 pandemic; in particular, 84.6 % of patients and 95.1 % of professionals selected video-consultation modality. Data showed that participants expressed high satisfaction with this communication tool. The increase in satisfaction was directly proportional to increase in the quality of interactions and in relation to the quality of the experiences. The critical factors influencing the video-consultation experience include communication style, information completeness, patient-centredness, and the comfort underscoring the central role of the professional-patient relationship, which, substantially, remains a key element in the psychological treatment process. These findings reinforce the need for continued refinement and expansion of telepsychology services, thus highlighting the potential for integrating innovative technologies into mental health practise
Table_1_Changes in non-motor symptoms in patients with Parkinson's disease following COVID-19 pandemic restrictions: A systematic review.docx
No full textThis review discussed the effects of the impact of the Coronavirus Disease 2019 (COVID-19) pandemic on the psychological wellbeing of people with Parkinson's disease (PD) focusing specifically on depressive symptoms, anxiety levels, sleep, and quality of life (QoL). Together with motor symptoms, psychological symptoms are common and disabling conditions in the clinical course of PD becoming a relevant topic as a result of the lockdown measure due to alter their everyday life. We searched on PubMed online electronic databases for English articles published between January 2020 and 31 December 2021. Twenty-eight relevant studies were found and included in the review. Heterogeneous data emerged from the topics analyzed. Overall, data from depression studies showed significant depressive symptoms if the patient was analyzed longitudinally or vs. a control group consisting in healthy subjects, while these differences become minimal when the control group is a family member. Differently, in most of the studies reviewed there is no evidence of a statistically significant impact on anxiety disorders, nor on the quality of sleep. Conversely, PD patients showed a statistically significant negative impact of QoL compared with control groups or other neurological conditions. Although these findings must be interpreted carefully in the light of the studies' limitations, both in methodology and design, collectively our review showed that COVID-19 pandemic has had negative effects on the mental health of people with PD, due to disruption of healthcare services, loss of usual activities and supports and reduction in physical activity.</p
Transmission of HIV drug resistance and the predicted effect on current first-line regimens in Europe
No full textBackground. Numerous studies have shown that baseline drug resistance patterns may influence the outcome of antiretroviral therapy. Therefore, guidelines recommend drug resistance testing to guide the choice of initial regimen. In addition to optimizing individual patient management, these baseline resistance data enable transmitted drug resistance (TDR) to be surveyed for public health purposes. The SPREAD program systematically collects data to gain insight into TDR occurring in Europe since 2001. Methods. Demographic, clinical, and virological data from 4140 antiretroviral-naive human immunodeficiency virus (HIV)-infected individuals from 26 countries who were newly diagnosed between 2008 and 2010 were analyzed. Evidence of TDR was defined using the WHO list for surveillance of drug resistance mutations. Prevalence of TDR was assessed over time by comparing the results to SPREAD data from 2002 to 2007. Baseline susceptibility to antiretroviral drugs was predicted using the Stanford HIVdb program version 7.0. Results. The overall prevalence of TDR did not change significantly over time and was 8.3% (95% confidence interval, 7.2%-9.5%) in 2008-2010. The most frequent indicators of TDR were nucleoside reverse transcriptase inhibitor (NRTI) mutations (4.5%), followed by nonnucleoside reverse transcriptase inhibitor (NNRTI) mutations (2.9%) and protease inhibitor mutations (2.0%). Baseline mutations were most predictive of reduced susceptibility to initial NNRTI-based regimens: 4.5% and 6.5% of patient isolates were predicted to have resistance to regimens containing efavirenz or rilpivirine, respectively, independent of current NRTI backbones. Conclusions. Although TDR was highest for NRTIs, the impact of baseline drug resistance patterns on susceptibility was largest for NNRTIs. The prevalence of TDR assessed by epidemiological surveys does not clearly indicate to what degree susceptibility to different drug classes is affected. © The Author 2015
