Sapienza University Research Articles

P–511 Characteristics of psychological services for couples undergoing ART treatment in Italy

Abstract Study question What are the characteristics of the psychological services for couples undergoing ART treatment in Italy? Summary answer In the 47% of ART clinics the psychologist is a stable member of the team whereas psychological services are used by 10–20% of couples. What is known already: ART treatments are complex and emotionally demanding for both men and women. During the procedure the couples often experience stress and several negative emotions. In Italy the Law 40/2004 establishes the guidelines for ART application. This law sustains the importance of offering psychological support to the people who undergo ART treatments at any stage of the medical procedure. However, in Italy there are no specific recommendations or protocols for psychological interventions in ART centres. Furthermore, there is little or no studies regarding the characteristics of the psychological services offered to those undergoing ART treatments. Study design, size, duration This observational study aims to explore the characteristics of psychological services in ART clinics. Therefore, the ART Italian National Register (National Health Institute) with the Department of Dynamic and Clinical Psychology and Health study (Sapienza University) proposed a national survay to the 306 Italian ART centres. The Medical Director of each centre was invited to participate by e-mail and to fill a questionnaire on an on-line platform. Data collection was between Jenuary to February 2020. Participants/materials, setting, methods The participation has been proposed to all the Italian ART centres (n = 306). 35 centres have been previously excluded because participating in the first phase of the study regarding the questionnaire construction. Around the 40% of the centres participated in the study (n = 113). The questionnaire contains 26 items with multiple response answers. It mainly explored: the presence of the psychologist in the ART centres, charachteristics of the intervention offered, percentage of couples using the psychological service. Main results and the role of chance In the 47% of ART centres the psychologist is a stable member of the team. The 38% of respondents reported that the psychologist works on call in the centre, the 18% reported that the psychologist is present in the centre 1–2 times a week whereas the 32% reported that the psychologist works in a private practice outside the centre. The reported percentages of couples using the psychological service are: 10–20% (69%), 20–30% (13%), 30–50% (5%), more than 50% (5%) and around the 100% (8%). The number of psychological sessions usually offered are: up to five (9%), four (13%), three (29%), two (27%), one (10%). Couples interventions represent the 73%, single patient intervention the 14%, whereas the 13% are group interventions. The 60% of respondent reported the absence of a protocol for psychological intervention in the ART centre whereas the 40% reported the presence of a protocol. In around the 50% of cases the psychological service represents an extra cost for the couple/individual. In the 60% of cases the psychologist is not involved in the team meeting, however the 87% of respondents reported that confronting with the psychologist on patients is percived as useful. Limitations, reasons for caution These results should be considered with cautions due to the rate of participation (around 40%). Furthermore, this is a national study and the charachteristics of psychological services offered in ART centres of different countries should be investigated. Wider implications of the findings: In conclusion, the results show that psychological services in Italian ART centers are not yet fully operational and integrated in the ART procedure. All of this highlights the importance of further investigations with the aim to shared information to use to establish common protocols for psychological interventions in ART centres. Trial registration number Not applicable

Stratospheric balloon tracking system design through Software Defined Radio applications: STRAINS experiment

The new concept aerospace mission profiles, such as stratospheric airships or suborbital vehicles, impose new requirements for the tracking and surveillance systems, with particular regards to manned missions. New technologies and innovative tracking systems can be supporting such operations. The STRAINS (Stratospheric Tracking Innovative Systems) Experiment, conceived by Sapienza University of Rome and ALTEC (Aerospace Logistics Technology Engineering Company) and supported by ASI (Italian Space Agency), to be launched in Q3/Q4 2021, is aiming at demonstrating TDOA (Time Difference of Arrival), FDOA (Frequency Difference of Arrival) and single station tracking for a Zero-Pressure Balloon Flight in the framework of the HEMERA H2020 balloon launch infrastructure. This paper describes the design of the STRAINS stratospheric experiment, including the stratospheric and the ground segment, the analyses carried out for optimizing the experiment functionalities, the mission analysis for defining the multi-lateration stations locations and the performance evaluation for the designed TDOA tracking system.

Performance evaluation and monitoring of the tunnel excavation with a Mobile Tunnel Borer

The use of Tunnel Boring Machines (TBM) for tunnel excavation is widespread around the world for its capabilities and great advantages against the traditional tunnel excavation method, but sometimes this technology can be difficult to manage, requiring huge spaces for the assembly on the job site and involving complex installations at the tail of the machine.Aiming at creating a versatile and compact tunnel borer, TunnelPro and Master Drilling designed the MTB (Mobile Tunnel Borer) that is built on crawlers, easy and fast to assembly with no need of special equipment. This prototype MTB is currently excavating a Platinum mine in South Africa, being tested in very hard rocks.The study here presented, carried out by GEEG srl, startup of Sapienza University of Rome, compares the actual values of thrust, torque, penetration and cutter wear recorded during the trial excavation monitoring with those estimated with models commonly used in TBM performance prediction. The aims of this study, still ongoing, are a better comprehension of the MTB operation in terms of efficiency, work of the excavation tools, load distribution, and the evaluation of the adequacy of the most known methods when applied to this prototype machine.

Preliminary uncertainty quantification of the core degradation models in predicting the Fukushima Daiichi unit 3 severe accident

A MELCOR model of a boiling water reactor has been developed by Sapienza University of Rome in the framework of the MUSA project aiming at identifying and quantifying uncertainty sources in severe accidents analyses. To develop the model, the Fukushima Unit 3 boiling water reactor has been taken as reference, and a preliminary sensitivity analysis with RAVEN software coupled with MELCOR has been performed to quantify the influence of core degradation parameters on selected key figures-of-merit, such as pressure vessel and containment pressures, core liquid level, hydrogen generation, lower head breach time and source term.Results of base case satisfactorily predict main pressure and liquid level data measurement from TEPCO. As well as, results from the uncertainty analysis envelope the majority of thermohydraulic TEPCO reported measured data. Furthermore, median of calculated core status is in likely agreement with recent TEPCO containment inspections and muon measurements, with about 25% of fuel rods remained intact in RPV and 65% of core masses ejected to the pedestal.

Rapidly progressive dementia and Parkinsonism as the first symptoms of dural arteriovenous fistula. The Sapienza University experience and comprehensive literature review concerning the clinical course of 102 patients

BackgroundDementia is a chronic loss of neurocognitive function that is progressive and irreversible. Dural arteriovenous fistulas (DAVFs) are acquired lesions that account for 10–15% of intracranial vascular malformations that could present with a rapid decline in neurocognitive function with or without Parkinson-like symptoms and evolve in a rapidly progressive dementia (RPD). Often the DAVFs are not even included in the differential hypotheses of this type of dementia and are not present in any type of diagnostic algorithm for evaluating RPD. MethodsWe performed a systematic review of the international literature and adding the cases coming from our institutional experience and we have collected all the reported cases of DAVFs that debut with ROD identifying the most frequent forms in terms of location and type, reporting the neurological characteristics and the outcome of each patient. ResultsThe exact pathogenesis for developing dementia in patients with DAVFs remains largely unknown. The imaging changes and pathologic findings support the hypothesis that the clinical course results from the delivery of excessive volumes of blood flow into a venous system with outflow obstruction and venous congestion. The large variety of clinical manifestations of DAVFs depends on its location but this is not exactly valid for the onset of dementia. It supposed that the highly variable clinical manifestation of DAVFs has been convincingly related to the pattern of venous drainage more than location. ConclusionsNeurologists and clinicians generally are familiar with the differential diagnoses of slowly progressive neurodegenerative dementias, but the diagnosis of RPD entails a different diagnostic approach. Due to their curable nature, the diagnosis of DAVFs must be suspected when facing a RPD picture, even more so if it is associated with characteristic abnormalities of the hemispheric white matter.

Differences in visual information processing style between Idiopathic Generalized Epilepsy with and without photosensitivity

PurposeRecently, altered visual cortical processes i.e., lack of habituation to visual evoked potentials (VEP), has been highlighted in both photosensitive epilepsy and in a specific i.e., analytic mode of processing visual inputs. In this study we aimed at evaluating the relationship between photosensitivity (PS) and analytic style of processing visual information, in a sample of 30 patients with Idiopathic Generalized Epilepsy (IGE) and matched healthy controls. MethodsAt our Epilepsy unit of the Sapienza University of Rome, we consecutively enrolled 15 patients with IGE with PSand matched them with 15 patients with IGE without PS and 15 Healthy Volunteers. All patients underwent EEG recording in basal conditions during hyperventilation (3 Min), and intermittent light stimulation. The most effective frequencies comprised from 12 to 16 Hz.The instruments used to gather psychological cognitive behavioral data, consisted of participation in two tests: the Sternberg-Wagner Self-Assessment Inventory and the Mariani Learning Style Questionnaire. ResultsCompared to controls, both IGE groups show significantly higher scores for the analytic style (One-way ANOVA, F(2,44) = 110.3, p < 0.0001). Epilepsy groups thereby showed very distinctive cognitive styles as measured with the Sternberg test. In the visual style, scores of the photosensitive Individuals with IGE were significantly higher than the non-photosensitive individuals with IGE (p < 0.0001, Tukey’s post hoc test). ConclusionsAn association between analytic style of processing visual information and PS in IGE has been shown. The common neurophysiological features between these two factors, suggest the possibility to evaluate this cognitive behavior as a potential target for nonpharmacological therapeutic strategies in photosensitive epilepsy.

Development and validation of a test for the assessment of knowledge learned by healthcare students during an online course on COVID-19: cross-sectional study.

Many Italian universities during the COVID-19 pandemic had numerous students attending hospital wards. The training of health care students was necessary to prepare for good practices in implementing knowledge about COVID-19 and minimizing contagion among students who carried out the internship. In February 2020, a course aiming to guide health personnel so that they can appropriately address the health emergency posed by the new coronavirus was created, making use of the scientific evidence currently available as well as official sources of information and updates. The aim of this study was the development and validation of a useful tool to evaluate the progress in knowledge regarding COVID-19 of students in degree courses for the health care professions. The reliability of the test was assessed using Cronbach's alpha (α) coefficient, while the responsiveness of the test between T0 and T1 was measured with a student t test. The standard error of measurement was used to calculate the minimal detectable change of the tool. The test is made up of 31 items with four multiple-choice answers, one of which is correct. Fifteen bachelor's degree courses at the Sapienza University of Rome were enrolled, for a total population of 1,017 students from different course years. The test showed good internal consistency, with Cronbach's α values of 0.82. The item-total analysis also showed good results, with homogeneous α values from 0.80 to 0.82 for each item. The student t test showed a difference of 3.59 between T0 and T1 (p < 0.001). The minimal detectable change was 0.47. The test is a useful tool for assessing progress in skills regarding COVID-19 for students from bachelor's degree courses in the health professions. It allows the improvement and acquisition of skills as well as a qualitative analysis of the organization of internship degree courses.

Emotional textual analysis as a semiotic action–research method to work with emotions within organisations

This article aims to contribute to the special issue for the twentieth anniversary of the Organisational and Social Dynamics journal presenting a semiotic action–research method called emotional textual analysis (ETA). ETA, developed in Italy by the Studio of Psychosociology and the Chair of Clinical Psychology at Sapienza University of Rome, is an explorative abductive method that consents to analyse how the organisation symbolically interacts with its context. In ETA methodology the interdependence between the organisational system and the client system is considered as the product of socially shared emotional cultures. This article describes the theoretical and methodological foundation of the ETA method and presents the results of a recent action–research project carried out by the authors within a National Health System organisation. In the conclusion, the added value of using ETA to work with organisations facing contextual changes in the current historical period is discussed.

Studio pilota del questionario sulle strategie di lettura «Dimmi come leggi» per il triennio della scuola secondaria di secondo grado e studenti universitari

The study presents the factorial validity, using graphic organizers, controlling the process of the version of the questionnaire on reading strategies, «Tell me How to Read», aimed at the students of upper secondary school and university students. The dimensions investigated correspond to the 7 strategies already tested in the previous versions (lower secondary and primary school, Castellana, 2018, 2020a): identifying reading purposes, activating previous knowledge, making predictions, selecting main information, using graphic organizers and a scale on the self-perception of the difficulties. The new questionnaire consisting of 82 items, was linguistically revised and items that investigate more complex levels of the reading process were added. It was administered to a convenience sample of 543 students, attending the fourth and fifth grades of upper secondary school and Ist-IIIrd year students of the Sapienza University of Rome and Parma. The factor analysis of the questionnaire confirmed the 7 dimensional structure. The questionnaire reduced to 53 items was used within the OFA Italian course of the Department of Psychology at Sapienza University, as an instrument for metacognitive self-assessment of reading and as support for teaching understanding. The scores obtained by the students (99) on the QSL were correlated with the scores of the final test of the course. The value of correlation found between the tests and questionnaire is significant and equal to .377.

Fecal High-Mobility Group Box 1 as a Marker of Early Stage of Necrotizing Enterocolitis in Preterm Neonates.

Introduction: An early diagnosis of necrotizing enterocolitis (NEC), a major gastrointestinal emergency in preterm newborns, is crucial to improve diagnostic approach and prognosis. We evaluated whether fecal high-mobility group box protein 1 (HMGB1) may early identify preterms at risk of developing NEC.Materials and Methods: A case-control study including neonates admitted at the Neonatal Intensive Care Unit (NICU) of the Sapienza University Hospital “Umberto I” in Rome, from July 2015 to December 2016. Stool samples obtained from cases (preterm newborns with NEC) and controls (newborns without NEC) were collected at the enrolment (T0) and within 7–14 days after the first sample collection (T1). HMGB1, extracted and measured with western blot, was reported as densitometry units (DUS).Results: HMGB1 levels in 30 cases (n = 28—Bell stage 1, n = 2 Bell stage 2) were higher [T0: 21,462 DUS (95% CI, 16,370–26,553 DUS)—T1: 17,533 DUS (95% CI, 13,052–22,014 DUS)] than in 30 preterm controls [T0: 9,446 DUS (95% CI, 6,147–12,746 DUS)—T1: 9,261 DUS (95% CI, 5,126–13,396 DUS), p < 0.001). Preterm newborns showed significant higher levels of HMGB1 (15,690 DUS (95% CI, 11,929–19,451 DUS)] in comparison with 30 full-term neonates with birth weight >2,500 g [6,599 DUS (95% CI, 3,141–10,058 DUS), p = 0.003]. Multivariate analysis showed that the risk of NEC was significantly (p = 0.012) related to the HMGB1 fecal levels at T0.Conclusions: We suggest fecal HMGB1 as a reliable marker of early NEC in preterm neonates. This study supports further investigation on the role of fecal HMGB1 assessment in managing preterm newborns at risk of NEC. Further studies are advocated to evaluate diagnostic accuracy of this marker in more severe forms of the disease.

Non-organ-specific autoimmunity in adult 47,XXY Klinefelter patients and higher-grade X-chromosome aneuploidies.

Current literature regarding systemic autoimmune diseases in X-chromosome aneuploidies is scarce and limited to case reports. Our aim was to evaluate the frequency of anti-nuclear (ANAs), extractable nuclear (ENA), anti-double-stranded DNA (dsDNAs), anti-smooth muscle (ASMAs) and anti-mitochondrial (AMAs) antibodies in a large cohort of adults with Klinefelter's syndrome (KS, 47,XXY) and rare higher-grade sex chromosome aneuploidies (HGAs) for the first time. Sera from 138 X-chromosome aneuploid patients [124 adult patients with 47,XXY KS and 14 patients with HGA (six children, eight adults)] and 50 age-matched 46,XY controls were recruited from the Sapienza University of Rome (2007-17) and tested for ANAs, ENAs, anti-dsDNAs, ASMAs and AMAs. Non-organ-specific immunoreactivity was found to be significantly higher in patients with 47,XXY KS (14%) than in the controls (2%, p=0.002). Among all the antibodies investigated, only ANAs were observed significantly more frequently in patients with 47,XXY KS (12.1%) than in the controls (2%, p=0.004). No anti-dsDNA immunoreactivity was found. Stratifying by testosterone replacement therapy (TRT), non-organ-specific autoantibody frequencies were higher in TRT-naive (p=0.01) and TRT-treated groups than in controls. No patients with HGA were found positive for the various autoantibodies. Non-organ-specific autoantibodies were significantly present in 47,XXY adult patients. Conversely, HGAs did not appear to be target of non-organ-specific immunoreactivity, suggesting that KS and HGAs should be considered as two distinct conditions. The classification and diagnosis of systemic autoimmune diseases is frequently difficult. To support a correct clinical evaluation of KS disease and to prevent eventual secondary irreversible immune-mediated damages, we highlight the importance of screening for non-organ-specific autoimmunity in Klinefelter's syndrome.

The effects of orally administered lactoferrin in the prevention and management of viral infections: A systematic review.

SummaryIt has been demonstrated that lactoferrin (LF) plays a role in host defence, but evidence on its potential antiviral property from clinical studies is fragmented. Our systematic review aimed at identifying the effects of orally administered LF against virus infections. The systematic search was conducted on PubMed, Scopus, Web of Science, BioRxiv.org and ClinicalTrials.gov from database inception to 7th January 2021. Eligible articles investigated any virus family and provided data on the effects of orally administered LF of any origin in the prevention and/or management of confirmed viral infections in people of any age. A narrative synthesis of the results was performed. Quality was assessed with the Cochrane Risk‐Of‐Bias and ROBINS‐1 tools. A total of 27 records were included, nine of which were registered protocols. We found data on Flaviviridae (n = 10), Retroviridae (n = 3), Coronaviridae (n = 2), Reoviridae (n = 2) and Caliciviridae (n = 1). Most published trials were at high risk of bias. The findings were heterogeneous across and within viral families regarding virological, immunological and biological response, with no clear conclusion. Some weak but positive results were reported about decrease of symptom severity and duration, or reduction in viral loads. Despite high tolerability, the effects of LF as oral supplement are still inconsistent, both in preventing and managing viral infections. Small sample sizes, variety in recruitment and treatment protocols, and low study quality may have contributed to such heterogeneity. Better‐designed studies are needed to further investigate its potential benefits against viral infections, including SARS‐CoV‐2.

What is the Risk of Developing Medication-Related Osteonecrosis in Patients With Extraction Sockets Left to Heal by Secondary Intention? A Retrospective Case Series Study

Tooth and root extractions represent trigger factors for medication-related osteonecrosis of the jaw (MRONJ). The best healing modality for postextraction sockets is still debated. The aim of the study was to estimate the incidence of MRONJ after extractions whose sockets were left to heal by secondary intention. A retrospective case series study was performed at the Department of Odontostomatological and Maxillofacial Sciences, Sapienza University of Rome. Only patients who underwent nonsurgical extractions, healed by secondary intention, were included in the study. The following parameters were considered: age, sex, pathologies for which bisphosphonates or other drugs related to MRONJ were prescribed, any local or systemic risk factors, type of drug used, route of administration, number of extractions performed, and number of sessions required to complete the extraction program. The main outcome variable was the occurrence of MRONJ. Statistical analysis was performed with SPSS statistical software. Two hundred twenty-one patients were treated from 2007 to 2020 with 639 tooth/root extractions. All patients were treated under antibiotic prophylaxis and with anesthesia without vasoconstrictors. No cases of MRONJ occurred. The mean age of patients was 68.02 ± 11.17. Most of the study sample was represented by women (201=90.95%) undergoing treatment for osteometabolic pathologies, most frequently postmenopausal osteoporosis. Alendronate was the most frequently prescribed drug, taken mainly orally. Most patients had local and/or systemic risk factors. Each patient had from 1 to 17 tooth/root extractions (mean=2.87 ± 2.59) during 1 to 4 sessions (mean=1.41 ± 0.64). Extractions mainly involved single-rooted teeth/roots, equally distributed between the maxilla and mandible. Secondary intention healing after nonsurgical tooth extraction does not seem to predispose to MRONJ. It can be advisable to perform extractions under antibiotic prophylaxis using anesthetics without vasoconstrictors and chlorhexidine mouth rinses in the 7 following days.

Conservation and Reassessment of an Overlooked Skeletal Collection Preserved Since 1901 at the Museum of Anthropology “G. Sergi”, Rome

The osteological investigation of archived and historic skeletal collections can often provide clues to how they were organised and managed, offering key osteobiographical insight into past populations. A small, yet significant, collection of skulls housed at the Museum “Giuseppe Sergi” of the Sapienza University of Rome, remained anonymous prior to a recent reassessment protocol started in 2018. This collection was excavated from a funerary area discovered during the 19th century from the site of Castel Trosino (Ascoli Piceno, Italy). The cemetery was part of an important community during the Longobard domination of Italy, as testified by the richness of the cultural artefacts reported with the burials. The 19 skulls presented in this paper are the only ones available for assessment; all the others were lost shortly after the first excavation. Their importance is related to providing a better understanding of biological evidence of a community that lived in Italy during the Early Middle Ages.

POS1238 ANTIPHOSPHOLIPID ANTIBODIES AND COVID-19: TREND OVER TIME

Background:Since the beginning of the SARS-CoV-2 outbreak, antiphospholipid antibodies (aPL), a known thrombotic risk factor, have been studied in COVID-19 patients, in whom thromboembolic events have been associated with poor prognosis. To date, the pathogenetic role of aPL and the trend over time is still unknown.Objectives:Aim of the study was to investigate whether aPL positivity was correlated with thrombosis in COVID-19 patients and whether it was a transient or persistent.Methods:We included all consecutive COVID-19 patients hospitalized at Policlinico Umberto I, Sapienza University of Rome from April 1, 2020 to June 7, 2020. In these patients, serum levels of anti-cardiolipin (aCL) IgM, IgG, IgA, anti-β2glycoprotein I (aβ2GPI) IgM, IgG were measured by enzyme-linked immunosorbent assay (ELISA) and Lupus Anticoagulant (LA) was detected with coagulatory tests in patients not in treatment with anticoagulant drugs.Results:Five out of 73 (6.8%) patients resulted positive for aCL IgM, 3 of them also tested positive for aβ2GPI IgM. aCL IgA were tested positive in 14 out of 46 patients (30.4%). Overall 18 patients resulted positive for at least one test. Seven (9.6%) patients developed thrombotic events during hospitalization, 3 of them resulting positive for aPL (Table 1. below).Table 1.Clinical and demographic features of the 7 Covid-19 patients that presented thrombotic eventsFeaturesPatient 1Patient 2Patient 3Patient 4Patient 5Patient 6Patient 7Age - yr67788343707495SexfemalefemalefemalemalemalefemalemaleMedical HistoryMalignancy, HypertensionStrokeChronic obstructive pulmonary diseaseNo medical historyChronic obstructive pulmonary disease, HypertensionMalignancy,HypertensionInitial findingsSigns and symptomsDyspneaDyspneaDyspneaFever, ageusia/anosmia, chest painFever, coughDyspneaDyspneaHRCT chest: Bilateralground glass opacityyesyesyesyesyesyesyesBaseline laboratory valuesLymphocytecount, cells x 106/L2202102330158016806001390Lactatedehydrogenase, U/L223321199227226349199Ferritin mcg/L6143172133874622455197D-dimer mcg/L7301213291228268812981097PaO2:FIO2, mm Hg132120442534348493314Anticoagulant therapy at the time of the thrombotic eventTherapeutic dosageProphylactic dosageProphylactic dosageNot administeredTherapeutic dosageTherapeutic dosageTherapeutic dosageThrombotic eventsStrokePulmonary embolismPeripheral venous thrombosisMyocardial infarctionPulmonary embolismMyocardial infarction, peripheral arterial thrombosis, peripheral venous thrombosisPeripheral venous thrombosisAntiphospholipid antibodiesnegativeAnti-cardiolipin IgM low title, anti-β2glicoprotein I IgM low titlenegativenegativenegativeAnti-cardiolipin IgM low title, anti-β2glicoprotein I IgM low titleAnti-cardiolipin IgA low titleOutcomeExitusExitusSuicideDischargedDischargedDischargedExitusAntiphospholipid antibodies tested after at least 12 weeksNPNPNPNPNPNegativeNPWe observed that patients showing double positivity for aCL IgM and aβ2GPI IgM had a likelihood positive ratio of 6.3 for thrombotic events (p=0.012) and a likelihood positive ratio of 4.9 for increased D-dimer levels (p=0.027). aCL IgA, the most prevalent aPL in this cohort, was not associated with thrombosis. Of the 18 aPL positive patients, 5 died, 3 were lost to follow-up, and 10 were tested on a second occasion at least 12 weeks, two patients confirmed positivity without clinical signs suggestive of APS.Conclusion:These results suggest that double positivity for aCL and aβ2GPI IgM increases the risk of thrombosis in COVID-19 patients, unlike aCL IgA. APL positivity may be persistent and it is advisable to monitor it over time.Disclosure of Interests:None declared

Working in "smart" mode during the Covid-19 pandemic. Validation of a questionnaire in the healthcare sector.

The present tool is adequate to investigate attitudes towards Smart Working among healthcare workers. During the most difficult phases of the Covid-19 he-alth emergency, when access to the usual work location was not allowed due to the constraints related to the pandemic, Smart Working enabled business continuity in the face of the ongoing health emergency. Mo-dern technology serves a new way of working, allowing workers to effectively manage their professional and personal spheres in a world that increasingly requires them to optimize their time. The main objective of this research is to validate a Smart Working questionnaire administered to healthcare workers. The questionnaire, reported in Annex I, consisting of 30 questions and submitted electronically through Google Forms, was administered in Italian to healthcare personnel of the Teaching hospi-tal Umberto I and Sapienza University of Rome between September and October 2020. The questionnaire analyzed the characteristics of the sample and investigated the perception and attitude of healthcare personnel towards seven different aspects of Smart Working. A descriptive analysis of the sample examined and an internal consistency analysis was performed through the use of the SPSS (Statistical Package for Social Science) program version 25.0. Cronbach's alpha statistical indicator, which measures reprodu-cibility over time, reliability, and homogeneity of questions, was used for the analysis. A total number of 53 health care providers answered the online questionnaire. The majority of the respondents were female (60.4%); 73.6% of respondents reported having a college degree or a higher educational level. The analysis showed an overall standardized Cronbach's Alpha of 0.709, which corresponds to a good reliability. In the items analysis, the alpha value ranged from a minimum of 0.652 to a maximum of 0.756.

Optimal Self-Scheduling of a Real Energy Hub Considering Local DG Units and Demand Response Under Uncertainties

In this article, a cost-based mathematical optimization is used to evaluate the optimal amount of imported power from the public main grid to a private microgrid (MG), that is the “LAMBDA lab MG” testbed placed at the Sapienza University of Rome. In this regard, this article considers five tests based on using different sources, including a photovoltaic (PV) array, an emergency generator set, a fuel cell, and the main grid, for load satisfaction. The “LAMBDA lab” can be considered as a “multisource multioutput energy hub” with three optional sources and both electrical and heat demands in output. This article considers PV production and load demand as indeterministic parameters and evaluates the problem under uncertainties. As a result, a stochastic programming model is defined, and a powerful optimization function is used to reach the optimal power received from the main grid. Besides, information gap decision theory is used to model the robustness of the problem against uncertainties associated with renewable generation units (PV system) and electricity loads applied on a real case for the first time. In the result section, the contribution of each source in electrical and heat load demands is presented in addition to the cost of each test by evaluating the effect of demand response of 15%. Finally, a comparison between the stochastic programming method and IGDT has been accomplished.

The relationship between self-disorders (SDS) and depressive/anxious symptoms in a clinical sample of adolescents

IntroductionSelf-disorders (SDs) have been described as a core feature of schizophrenia-spectrum disorders. Previous studies conducted on heterogeneous clinical adult and adolescents samples demonstrated that SDs aggregate selectively in the schizophrenia spectrum disorders compared to other disorders.ObjectivesTo examine the specificity of SDs for schizophrenia spectrum disorders in adolescent inpatient sample.MethodsFifty-five adolescent inpatients admitted to the Child Psychiatry Unit at the Sapienza University in Rome were assessed for psychopathology using Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS-PL), Structured Interview for Prodromal Syndromes (SIPS/SOPS),Examination of Anomalous Self-Experiences (EASE), Multidimensional Anxiety Scale for Children (MASC), Calgary depression scale for schizophrenia (CDSS)ResultsPatients, aged 14-18 years, were divided in four diagnostic groups: schizophrenia spectrum disorders (5 pts.), mood disorders (19 pts.), anxiety disorders (27 pts.) and other disorders (4 pts.). Frequency of self-disorders was different among the 4 groups. Including patients schizotypal personality disorder in the schizophrenia-spectrum disorder group, the difference is still significant. Mann-Whitney U test shows no differences between EOP and UHR patients in SD. Furthermore, correlations between EASE total score and Calgary and MASC total scores were significant.ConclusionsOur results confirm the specificity of SDs for schizophrenia spectrum disorders and also the belonging of schizotypal personality disorder to schizophrenia-spectrum.

Are demoralization and insight involved in suicide risk? An observational study on psychiatric inpatients

IntroductionAlthough several authors have investigated the relationship between demoralization, insight, and suicide risk, the role of these factors in determining suicide risk in patients with psychiatric disorders is still unclear [Berardelli et al., 2019; Costanza et al., 2020].ObjectivesThe main aim of this study was therefore to determine whether suicide risk was associated with better insight and worse demoralization in a sample of 100 adult psychiatric inpatients.MethodsThe study was performed on 100 psychiatric hospitalized adult patients consecutively enrolled between January 2019 and April 2020 at psychiatric units of Sant’Andrea Medical Center, Sapienza University of Rome. The Columbia Suicide Severity Rating Scale (C-SSRS) was used to assess suicide risk, Demoralization was assessed using the Demoralization Scale (DS) [Kissane et al., 2004] and for the assessment of insight we used the The Insight Scale (IS).ResultsOnly age was significantly associated with higher suicide risk (χ2=9.07, p&lt;0.01). The variable mood disorder was significantly associated with higher suicide risk (χ22=7.50, p&lt;0.05). Non-suicidal self-harm behaviors in the last 3 months (χ2=5.89, p&lt;0.05) and lifetime suicide attempts (χ2=21.80, p&lt;0.001) were significantly associated with higher suicide risk. Only the insight-high dimension (χ2=8.01, p&lt;0.01) and lifetime suicide attempts (χ2=12.33, p&lt;0.001) were significantly associated with higher suicide risk.ConclusionsOur results don’t confirm the role of demoralization in suicide risk. In our sample of patients, only high insigth of illness and other psychological variables are involved in suicide risk.DisclosureNo significant relationships.

Multi-isotopic regional-scale screening on drinking groundwater in Lombardy Region (Italy)

Groundwater is the main and safest source of water used for drinking purposes in many urban and rural communities worldwide. A deep knowledge of aquifer systems in terms of quality, vulnerability and renewability is fundamental to preserving groundwater resources. Thanks to contributions by different members of Water Alliance in synergy with Sapienza University, during November 2019 a multiisotopic regional scale analysis was carried out on groundwater tapped for drinking purposes in a wide area of the Lombardy Region. The study aimed to improve knowledge of recharge mechanisms, the groundwater’s relative age, and the impact of human activities on groundwater quality. Each Water Alliance supplier selected some wells and springs drawing water from different aquifer groups and distributed from north to south, for a total of 121 samples. Groundwater stable isotope analyses were performed on all the monitoring points, while tritium, nitrogen isotopes (15N and 18O in nitrates), sulphate isotopes (34S and 18O) and 13C isotope in Dissolved Inorganic Carbon (DIC) were analysed in selected monitoring wells based on previous data and major ion concentration results. The results confirm the key role of a multi-isotopic approach in defining aquifer recharge processes, relative groundwater age and the origin of pollutants, offering a useful tool to highlight local issues which could be investigated in depth by each water supplier.