Rest tremor in Parkinson's disease: body distribution and time of appearance

Objective To assess body distribution and timing of appearance of rest tremor in Parkinson's disease. Methods Information was obtained by a computerized database containing historical information collected at the first visit and data collected during the subsequent follow-up visits. Information on rest tremor developed during the follow-up could be therefore obtained by our own observation in a proportion of patients. Results Among 289 patients, rest tremor was reported at disease onset in 65.4% of cases and detected at last follow-up examination in 74.4% of patients. Analysis of patients who did not report rest tremor at disease onset indicated that 26% of such patients (9% in the overall population) manifested rest tremor over the disease course. Rest tremor spread to new sites in 39% of patients who manifested rest tremor at disease onset. Regardless of tremor presentation at disease onset or during the follow-up, upper limb was the most frequent tremor localization. Over the follow-up, rest tremor developed faster in the upper limb than in other body sites. The risk of developing rest tremor during the follow-up was not affected by sex, side of motor symptom onset and site of tremor presentation. However, age of disease onset > 63 years was associated with an increased risk of rest tremor spread. Conclusions This study provides new information about body distribution and timing of rest tremor appearance during the course of early stages of Parkinson's disease that may help clinicians in patients' counselling

Prognostic impact of coronary microcirculation abnormalities in systemic sclerosis: a prospective study to evaluate the role of non-invasive tests

INTRODUCTION: Microcirculation dysfunction is a typical feature of systemic sclerosis (SSc) and represents the earliest abnormality of primary myocardial involvement. We assessed coronary microcirculation status by combining two functional tests in SSc patients and estimating its impact on disease outcome. METHODS: Forty-one SSc patients, asymptomatic for coronary artery disease, were tested for coronary flow velocity reserve (CFR) by transthoracic-echo-Doppler with adenosine infusion (A-TTE) and for left ventricular wall motion abnormalities (WMA) by dobutamine stress echocardiography (DSE). Myocardial multi-detector computed tomography (MDCT) enabled the presence of epicardial stenosis, which could interfere with the accuracy of the tests, to be excluded. Patient survival rate was assessed over a 6.7- ± 3.5-year follow-up. RESULTS: Nineteen out of 41 (46%) SSc patients had a reduced CFR (≤2.5) and in 16/41 (39%) a WMA was observed during DSE. Furthermore, 13/41 (32%) patients showed pathological CFR and WMA. An inverse correlation between wall motion score index (WMSI) during DSE and CFR value (r = -0.57, P <0.0001) was observed; in addition, CFR was significantly reduced (2.21 ± 0.38) in patients with WMA as compared to those without (2.94 ± 0.60) (P <0.0001). In 12 patients with abnormal DSE, MDCT was used to exclude macrovasculopathy. During a 6.7- ± 3.5-year follow-up seven patients with abnormal coronary functional tests died of disease-related causes, compared to only one patient with normal tests. CONCLUSIONS: A-TTE and DSE tests are useful tools to detect non-invasively pre-clinical microcirculation abnormalities in SSc patients; moreover, abnormal CFR and WMA might be related to a worse disease outcome suggesting a prognostic value of these tests, similar to other myocardial diseases

Ventricular arrhythmias in young competitive athletes: Prevalence, determinants, and underlying substrate

Whether ventricular arrhythmias (VAs) represent a feature of the adaptive changes of the athlete's heart remains elusive. We aimed to assess the prevalence, determinants, and underlying substrates of VAs in young competitive athletes.Background--Whether ventricular arrhythmias (VAs) represent a feature of the adaptive changes of the athlete's heart remains elusive. We aimed to assess the prevalence, determinants, and underlying substrates of VAs in young competitive athletes. Method and Results--We studied 288 competitive athletes (age range, 16-35 years; median age, 21 years) and 144 sedentary individuals matched for age and sex who underwent 12-lead 24-hour ambulatory electrocardiographic monitoring. VAs were evaluated in terms of number, complexity (ie, couplet, triplet, or nonsustained ventricular tachycardia), exercise inducibility, and morphologic features. Twenty-eight athletes (10%) and 13 sedentary individuals (11%) showed > 10 isolated premature ventricular beats (PVBs) or 651 complex VA (P=0.81). Athletes with > 10 isolated PVBs or 651 complex VA were older (median age, 26 versus 20 years; P=0.008) but did not differ with regard to type of sport, hours of training, and years of activity compared with the remaining athletes. All athletes with > 10 isolated PVBs or 651 complex VA had a normal echocardiographic examination; 17 of them showing > 500 isolated PVBs, exercise-induced PVBs, and/or complex VA underwent additional cardiac magnetic resonance, which demonstrated nonischemic left ventricular late gadolinium enhancement in 3 athletes with right bundle branch block PVBs morphologic features. Conclusions--The prevalence of > 10 isolated PVBs or 651 complex VA at 24-hour ambulatory electrocardiographic monitoring did not differ between young competitive athletes and sedentary individuals and was unrelated to type, intensity, and years of sports practice. An underlying myocardial substrate was uncommon and distinctively associated with right bundle branch block VA morphologic features

The impact of L-carnitine on human semen quality upon cryopreservation, its association with sperm fatty acids, and assessment of a novel analytical tool for DNA fragmentation in mammals

Reduced male fertility is associated with reduced semen quality and can result from medical conditions, such as infections or blockages in the reproductive organs, and lifestyle factors like obesity. However, the cause of reduced fertility remains unexplained in about 50% of affected males. Even though semen analysis constitutes a central and initial part of male infertility investigation, relying on it alone is insufficient for a comprehensive diagnosis of male infertility. Recent studies suggest that oxidative stress may be a contributing factor in male infertility. Oxidative stress arises from an imbalance between reactive oxygen species (ROS) production and the body's antioxidant defence, leading to sperm DNA damage at various stages of sperm development. While sperm fatty acids are vital for sperm function, L-carnitine is equally important, facilitating the transport of long-chain fatty acids for β-oxidation and supporting antioxidant defence. High levels of L-carnitine from the epididymis are found in seminal plasma and positively correlate with sperm concentration and motility. Additionally, L-carnitine supplementation in cryopreservation media improves post-thaw semen quality by reducing ROS levels and DNA fragmentation. The primary objective of this project was to assess the effect of endogenous seminal L-carnitine on human sperm parameters in fresh and post-thaw semen samples. Additionally, we explored alternative approaches for evaluating DNA fragmentation, using bull spermatozoa as a model system. In the first article, we revealed that free seminal L-carnitine levels positively correlate with palmitic acid, docosahexaenoic acid, and total n-3 PUFAs in sperm. Seminal L-carnitine levels were not linked to BMI, indicating that the reduced semen quality associated with obesity is unrelated to L-carnitine. These results support the role of the epididymis in sperm maturation. In the second paper, we showed that both endogenous L-carnitine and L-carnitine supplemented to the cryopreservation medium improve sperm motility and mitigate the oxidative stress caused by freezing. In addition, this study evaluated alternative methods to the Sperm Chromatin Structure Assay (SCSA) for detecting DNA damage in bovine sperm. Our study found that SCSA and Sperm Chromatin Dispersion (SCD) tests both effectively identified increased DNA damage in bull spermatozoa exposed to high H₂O₂ concentrations, whereas Sensitive Recognition of Individual DNA Ends (dSTRIDE) test did not. These results suggest that SCD is a promising alternative to SCSA for assessing DNA damage, while dSTRIDE needs further refinement. Redusert mannlig fertilitet er forbundet med nedsatt sædkvalitet og kan ha ulike årsaker som medisinske tilstander, som infeksjoner eller blokkeringer i reproduktive organer, eller livsstilsfaktorer som fedme. Hos rundt 50% av menn med nedsatt fertilitet er årsaken fortsatt ukjent. Selv om en sædanalyse utgjør en sentral og innledende del av undersøkelsen av mannlig infertilitet, er den alene ikke tilstrekkelig for å stille en fullstendig diagnose. Nyere forskning antyder at oksidativt stress kan være en medvirkende faktor til mannlig infertilitet. Oksidativt stress oppstår som følge av en ubalanse mellom produksjon av reaktive oksygenforbindelser (ROF) og kroppens antioksidantforsvar, noe som kan føre til DNA-skader i sædceller i ulike stadier av spermieutviklingen. Fettsyrer er viktige for sædfunksjonen, mens L-karnitin spiller en sentral rolle ved å transportere langkjedede fettsyrer for β-oksidasjon og styrke antioksidantforsvaret. Høye nivåer av L-karnitin fra epididymis finnes i sædplasma og viser en positiv sammenheng med sædkonsentrasjon og motilitet. Tilsetning av L-karnitin i frysemedia har vist å forbedre kvaliteten på opptint sæd ved å redusere ROF-nivåer og DNA-skader. Hovedmålet med dette prosjektet var å undersøke effekten av endogent seminalt L-karnitin på sædparametere i både ferske og tinte sædprøver hos mennesker. I tillegg ble alternative metoder for å vurdere DNA-fragmentering testet ved bruk av sædceller fra okse som dyremodell. Vår studie viste en positiv sammenheng mellom endogene nivåer av L-karnitin i sædplasma og fettsyrer som palmitinsyre, docosahexaensyre og totale n-3 flerumettede fettsyrer. Det ble ikke funnet noen sammenheng mellom L-karnitin-nivåer og BMI, noe som antyder at redusert sædkvalitet assosiert med fedme er uavhengig av L-karnitin. Funnene våre bekrefter rollen til epididymis i spermiemodning. Studien viste også at både endogene nivåer og tilsatt L-karnitin forbedret sædmotilitet, reduserte oksidativt stress og beskyttet mot fryseindusert skade. Videre testet vi alternative metoder til Sperm Chromatin Structure Assay (SCSA) test for å oppdage DNA-skader i oksesæd. Resultatene viste at både SCSA og Sperm Chromatin Dispersion (SCD) tester effektivt identifiserte økt DNA-skade i prøver eksponert for høye H₂O₂-konsentrasjoner, mens Sensitive Recognition of Individual DNA Ends (dSTRIDE) test ikke gjorde det. Dette indikerer at SCD er et lovende alternativ til SCSA for å vurdere DNA-skader, mens dSTRIDE krever videre utvikling av metoden.publishedVersio

An Understanding of Human Thought through the Lens of Stream of Consciousness

openThis thesis explores the concept of "stream of consciousness" across philosophy, psychology, and literature. It examines William James's and René Descartes's philosophical contributions to understanding consciousness and time, highlighting James's concept of the "stream" as a continuous flow of entangled past, present, and future realities. Freud's psychoanalytic approach, utilizing stream of consciousness in therapy, is analysed, emphasizing its influence on understanding the unconscious mind and the development of psychoanalytic treatments. Finally, the thesis investigates how writers employed stream of consciousness techniques in novels, showcasing a shift from objective narrative to subjective inner experience, exemplified by the interior monologue. The study concludes that stream of consciousness offers a multidisciplinary perspective on human thought, revealing the interconnectedness of subjective and shared realities.This thesis explores the concept of "stream of consciousness" across philosophy, psychology, and literature. It examines William James's and René Descartes's philosophical contributions to understanding consciousness and time, highlighting James's concept of the "stream" as a continuous flow of entangled past, present, and future realities. Freud's psychoanalytic approach, utilizing stream of consciousness in therapy, is analysed, emphasizing its influence on understanding the unconscious mind and the development of psychoanalytic treatments. Finally, the thesis investigates how writers employed stream of consciousness techniques in novels, showcasing a shift from objective narrative to subjective inner experience, exemplified by the interior monologue. The study concludes that stream of consciousness offers a multidisciplinary perspective on human thought, revealing the interconnectedness of subjective and shared realities

Effects of L-carnitine administration on left ventricular remodeling after acute anterior myocardial infarction: The L-carnitine Ecocardiografia Digitalizzata Infarto Miocardico (CEDIM) trial

Objectives. This study was performed to evaluate the effects of l-carnitine administration on long-term left ventricular dilation in patients with acute anterior myocardial infarction. Background. Carnitine is a physiologic compound that performs an essential role in myocardial energy production at the mitochondrial level. Myocardial carnitine deprivation occurs during ischemia, acute myocardial infarction and cardiac failure. Experimental studies have suggested that exogenous carnitine administration during these events has a beneficial effect on function. Methods. The l-Carnitine Ecocardiografia Digitalizzata Infarto Miocardico (CEDIM) trial was a randomized, double-blind, placebo-controlled, multicenter trial in which 472 patients with a first acute myocardial infarction and high quality two-dimensional echocardiograms received either placebo (239 patients) or l-carnitine (233 patients) within 24 h of onset of chest pain. Placebo or l-carnitine was given at a dose of 9 g/day intravenously for the first 5 days and then 6 g/day orally for the next 12 months. Left ventricular volumes and ejection fraction were evaluated on admission, at discharge from hospital and at 3, 6 and 12 months after acute myocardial infarction. Results. A significant attenuation of left ventricular dilation in the first year after acute myocardial infarction was observed in patients treated with l-carnitine compared with those receiving placebo. The percent increase in both end-diastolic and endsystolic volumes from admission to 3-, 6- and 12-mouth evaluation was significantly reduced in the l-carnitine group. No significant differences were observed in left ventricular ejection fraction changes over time in the two groups. Although not designed to demonstrate differences in clinical end points, the combined incidence of death and congestive heart failure after discharge was 14 (6%) in the l-carnitine treatment group versus 23 (9.6%) in the placebo group (p = NS). Incidence of ischemic events during follow-up was similar in the two groups of patients. Conclusions. l-Carnitine treatment initiated early after acute myocardial infarction and continued for 12 months can attenuate left ventricular dilation during the first year after an acute myocardial infarction, resulting in smaller left ventricular volumes at 3, 6 and 12 months after the emergent event

The Italian version of the Wong-Law Emotional Intelligence Scale (WLEIS-I): a second-order factor analysis

The Wong and Law Emotional Intelligence Scale (WLEIS) is a 16-item self-report measure of emotional intelligence, based on the revised model by Mayer and Salovey. The scale measures four dimensions: Self-Emotional Appraisal, Others' Emotion Appraisal, Use Of Emotion, Regulation Of Emotions, loading onto a higher-order emotional intelligence factor. The WLEIS has been translated and validated in several cultural contexts, but to date there is no Italian translation, and no studies investigated its factor structure in the Italian community. This study aimed at translating the WLEIS in Italian, analysing its psychometric properties in Italian adults from the community, and testing the fit between the data and the original model by Wong and Law. We also tested correlations between WLEIS and measures of the Big Five personality factors and attachment. We found that the scale was internally consistent, and the second-order factor solution fit the data well. We also found significant positive correlations with agreeableness, extraversion, and perception of the self and the others, and negative correlation with neuroticism. These results represent a preliminary attempt to study the application of the WLEIS in Italian community settings, with implications for assessment and intervention to enhance the subjective and psychological well-being of individuals

Flexibility Benefits for Power System Resilience

As cheap and affordable variable Renewable Energy Sources (vRES), such as wind farms and photovoltaics, are foreseen to dominate the future energy mix, the abundance of green electricity will allow the replacement of fossil fuels in sectors such as heating, cooling, industrial processes, and transport. The intermittency and/or low controllability of vRES implies the significant systemic needs of flexible solutions; therefore, the developments of the energy system in general, and the power sector in particular, have led to significant innovation activities in the fields of power system flexibility. At the same time, the complexity and interdependencies of system components and multitude of actors increase the risks of service failures, thus raising needs of stronger and more flexible resilience means and countermeasures. Power system resilience reflects the impact of severe and/or unpredictable events and is an overarching concept, covering the whole spectrum of the power system from design and investment decisions to planning, operations, maintenance, and asset management functions. Flexibility concerns the power systems ability to manage changes; the future wide portfolio of flexibility means and their features can also improve the resilience characteristics of the broader view system of systems, provided that they are integrated in grid planning, grid operation, defence plans, and properly evaluated in the energy market design. In this paper we are discussing on “How can flexibility also support resilience?”, considering the increased societal needs of a secure electricity supply.publishedVersio

Individual differences in interpersonal security predict suicidal ideation and problem gambling

Suicidality and problem gambling represent global health issues. Based on evidence from recent literature, the aim of the present study was to test a theoretical model, in which: (1) Emotional Intelligence and Self and Other Representations of adult attachment combine into a latent factor representing Interpersonal Security; (2) Interpersonal Security negatively predicts Problem Gambling and Suicidal Ideation, respectively; (3) Problem Gambling positively predicts Suicidal Ideation. We used Structural Equation Modelling to test the study hypotheses. The model showed good fit to the data. Factor loadings were high and statistically significant. We found that the hypothesis of Emotional Intelligence and Self and Other Representations combining into a common factor, Interpersonal Security, is empirically supported. The joint effect of Interpersonal Security and Problem Gambling explains about the 63% of variance of Suicidal ideation. The path from Interpersonal Security to Suicidal Ideation is significant and high, whilst the path from Problem Gambling to Suicidal Ideation is not significant. Interpersonal Security explains about 16% of the variance of Problem Gambling. These results outline an integrated model of Suicidal Ideation and Problem Gambling in the community from an interpersonal-psychological perspective, with important implications for researchers, mental health practitioners, and policymakers