Seizure prediction and control in epilepsy

The first part of my thesis presents an overview of the different approaches used in the past two decades in the attempt to forecast epileptic seizure on the basis of intracranial and scalp EEG. Past research could reveal some value of linear and nonlinear algorithms to detect EEG features changing over different phases of the epileptic cycle. However, their exact value for seizure prediction, in terms of sensitivity and specificity, is still discussed and has to be evaluated. In particular, the monitored EEG features may fluctuate with the vigilance state and lead to false alarms. Recently, such a dependency on vigilance states has been reported for some seizure prediction methods, suggesting a reduced reliability. An additional factor limiting application and validation of most seizure-prediction techniques is their computational load. For the first time, the reliability of permutation entropy [PE] was verified in seizure prediction on scalp EEG data, contemporarily controlling for its dependency on different vigilance states. PE was recently introduced as an extremely fast and robust complexity measure for chaotic time series and thus suitable for online application even in portable systems. The capability of PE to distinguish between preictal and interictal state has been demonstrated using Receiver Operating Characteristics (ROC) analysis. Correlation analysis was used to assess dependency of PE on vigilance states. Scalp EEG-Data from two right temporal epileptic lobe (RTLE) patients and from one patient with right frontal lobe epilepsy were analysed. The last patient was included only in the correlation analysis, since no datasets including seizures have been available for him. The ROC analysis showed a good separability of interictal and preictal phases for both RTLE patients, suggesting that PE could be sensitive to EEG modifications, not visible on visual inspection, that might occur well in advance respect to the EEG and clinical onset of seizures. However, the simultaneous assessment of the changes in vigilance showed that: a) all seizures occurred in association with the transition of vigilance states; b) PE was sensitive in detecting different vigilance states, independently of seizure occurrences. Due to the limitations of the datasets, these results cannot rule out the capability of PE to detect preictal states. However, the good separability between pre- and interictal phases might depend exclusively on the coincidence of epileptic seizure onset with a transition from a state of low vigilance to a state of increased vigilance. The finding of a dependency of PE on vigilance state is an original finding, not reported in literature, and suggesting the possibility to classify vigilance states by means of PE in an authomatic and objectic way. The second part of my thesis provides the description of a novel behavioral task based on motor imagery skills, firstly introduced (Bruzzo et al. 2007), in order to study mental simulation of biological and non-biological movement in paranoid schizophrenics (PS). Immediately after the presentation of a real movement, participants had to imagine or re-enact the very same movement. By key release and key press respectively, participants had to indicate when they started and ended the mental simulation or the re-enactment, making it feasible to measure the duration of the simulated or re-enacted movements. The proportional error between duration of the re-enacted/simulated movement and the template movement were compared between different conditions, as well as between PS and healthy subjects. Results revealed a double dissociation between the mechanisms of mental simulation involved in biological and non-biologial movement simulation. While for PS were found large errors for simulation of biological movements, while being more acurate than healthy subjects during simulation of non-biological movements. Healthy subjects showed the opposite relationship, making errors during simulation of non-biological movements, but being most accurate during simulation of non-biological movements. However, the good timing precision during re-enactment of the movements in all conditions and in both groups of participants suggests that perception, memory and attention, as well as motor control processes were not affected. Based upon a long history of literature reporting the existence of psychotic episodes in epileptic patients, a longitudinal study, using a slightly modified behavioral paradigm, was carried out with two RTLE patients, one patient with idiopathic generalized epilepsy and one patient with extratemporal lobe epilepsy. Results provide strong evidence for a possibility to predict upcoming seizures in RTLE patients behaviorally. In the last part of the thesis it has been validated a behavioural strategy based on neurobiofeedback training, to voluntarily control seizures and to reduce there frequency. Three epileptic patients were included in this study. The biofeedback was based on monitoring of slow cortical potentials (SCPs) extracted online from scalp EEG. Patients were trained to produce positive shifts of SCPs. After a training phase patients were monitored for 6 months in order to validate the ability of the learned strategy to reduce seizure frequency. Two of the three refractory epileptic patients recruited for this study showed improvements in self-management and reduction of ictal episodes, even six months after the last training session.

Advanced spectroscopic techniques and chemometric analysis for atmospheric organic aerosol characterization and source apportionment

Atmospheric aerosol particles directly impact air quality and participate in controlling the climate system. Organic Aerosol (OA) in general accounts for a large fraction (10–90%) of the global submicron (PM1) particulate mass. Chemometric methods for source identification are used in many disciplines, but methods relying on the analysis of NMR datasets are rarely used in atmospheric sciences. This thesis provides an original application of NMR-based chemometric methods to atmospheric OA source apportionment. The method was tested on chemical composition databases obtained from samples collected at different environments in Europe, hence exploring the impact of a great diversity of natural and anthropogenic sources. We focused on sources of water-soluble OA (WSOA), for which NMR analysis provides substantial advantages compared to alternative methods. Different factor analysis techniques are applied independently to NMR datasets from nine field campaigns of the project EUCAARI and allowed the identification of recurrent source contributions to WSOA in European background troposphere: 1) Marine SOA; 2) Aliphatic amines from ground sources (agricultural activities, etc.); 3) Biomass burning POA; 4) Biogenic SOA from terpene oxidation; 5) “Aged” SOAs, including humic-like substances (HULIS); 6) Other factors possibly including contributions from Primary Biological Aerosol Particles, and products of cooking activities. Biomass burning POA accounted for more than 50% of WSOC in winter months. Aged SOA associated with HULIS was predominant (> 75%) during the spring-summer, suggesting that secondary sources and transboundary transport become more important in spring and summer. Complex aerosol measurements carried out, involving several foreign research groups, provided the opportunity to compare source apportionment results obtained by NMR analysis with those provided by more widespread Aerodyne aerosol mass spectrometers (AMS) techniques that now provided categorization schemes of OA which are becoming a standard for atmospheric chemists. Results emerging from this thesis partly confirm AMS classification and partly challenge it.

Analysis of the Slow Food movement impact on the farmers and rural areas’ sustainable development

The evaluation of the farmers’ communities’ approach to the Slow Food vision, their perception of the Slow Food role in supporting their activity and their appreciation and expectations from participating in the event of Mother Earth were studied. The Unified Theory of Acceptance and Use of Technology (UTAUT) model was adopted in an agro-food sector context. A survey was conducted, 120 questionnaires from farmers attending the Mother Earth in Turin in 2010 were collected. The descriptive statistical analysis showed that both Slow Food membership and participation to Mother Earth Meeting were much appreciated for the support provided to their business and the contribution to a more sustainable and fair development. A positive social, environmental and psychological impact on farmers also resulted. Results showed also an interesting perspective on the possible universality of the Slow Food and Mother Earth values. Farmers declared that Slow Food is supporting them by preserving the biodiversity and orienting them to the use of local resources and reducing the chemical inputs. Many farmers mentioned the language/culture and administration/bureaucratic issues as an obstacle to be a member in the movement and to participate to the event. Participation to Mother Earth gives an opportunity to exchange information with other farmers’ communities and to participate to seminars and debates, helpful for their business development. The absolute majority of positive answers associated to the farmers’ willingness to relate to Slow Food and participate to the next Mother Earth editions negatively influenced the UTAUT model results. A factor analysis showed that the variables associated to the UTAUT model constructs Performance Expectancy and Effort Expectancy were consistent, able to explain the construct variability, and their measurement reliable. Their inclusion in a simplest Technology Acceptance Model could be considered in future researches.

Institutional Processes and Discursive Strategies: Rhetoric and Vocabulary Analysis of CSR and Sustainability

The candidate tackled an important issue in contemporary management: the role of CSR and Sustainability. The research proposal focused on a longitudinal and inductive research, directed to specify the evolution of CSR and contribute to the new institutional theory, in particular institutional work framework, and to the relation between institutions and discourse analysis. The documental analysis covers all the evolution of CSR, focusing also on a number of important networks and associations. Some of the methodologies employed in the thesis have been employed as a consequence of data analysis, in a truly inductive research process. The thesis is composed by two section. The first section mainly describes the research process and the analyses results. The candidates employed several research methods: a longitudinal content analysis of documents, a vocabulary research with statistical metrics as cluster analysis and factor analysis, a rhetorical analysis of justifications. The second section puts in relation the analysis results with theoretical frameworks and contributions. The candidate confronted with several frameworks: Actor-Network-Theory, Institutional work and Boundary Work, Institutional Logic. Chapters are focused on different issues: a historical reconstruction of CSR; a reflection about symbolic adoption of recurrent labels; two case studies of Italian networks, in order to confront institutional and boundary works; a theoretical model of institutional change based on contradiction and institutional complexity; the application of the model to CSR and Sustainability, proposing Sustainability as a possible institutional logic.

La valutazione della ricerca scientifica: Uno studio empirico nelle Scienze umane

Nel corso degli ultimi anni si è assistito ad un ampio dibattito sull’uso della valutazione della ricerca nelle università e nelle strutture di ricerca. Nell’ambito di tale dibattito, nella presente tesi, vengono analizzate le più importanti metodologie per la valutazione della ricerca presenti a livello internazionale, i principali strumenti qualitativi di valutazione della ricerca (in particolare la peer review), gli strumenti quantitativi, quali la bibliometria, e le caratteristiche dei più importanti archivi bibliografici citazionali (es. Scopus, Web of Science), approfondendo i principali indicatori citazionali utilizzati nelle scienze umane e sociali (es. Indice H). Inoltre la tesi affronta il tema dell’impatto socio-economico della ricerca e le principali criticità di questo innovativo strumento, attraverso uno studio di caso realizzato nel Regno Unito. Una successiva analisi empirica riguarda le principali liste di riviste realizzate a livello internazionale e nazionale, nel settore scientifico di Storia e Filosofia della scienza. I risultati degli studi mostrano che le liste internazionali di riviste possono rappresentare, un punto di partenza a cui devono necessariamente essere affiancati altri strumenti di valutazione (peer review, analisi citazionali, etc); mentre le liste nazionali rischiano, invece, di essere uno strumento poco utile ed in alcuni casi inadeguato al fine di una corretta valutazione della ricerca, a causa della scarsa internazionalizzazione dei repertori e dei giudizi generalmente troppo elevati attribuiti alle riviste. Un ulteriore risultato raggiunto nella presente tesi riguarda la valutazione della ricerca nelle diverse discipline scientifiche: nelle Scienze umane e sociali risulta esserci uno scarso grado di presenza di pubblicazioni scientifiche nei principali archivi bibliografici e citazionali internazionali. Questa situazione limita fortemente l’attendibilità delle analisi statistiche basate su indici e indicatori quantitativi, per valutare la produttività scientifica di un ricercatore, oppure di una istituzione di ricerca.

Obsessed With Work: A multi-causal and multi-rater approach to workaholism

Workaholism is defined as the combination of two underlying dimensions: working excessively and working compulsively. The present thesis aims at achieving the following purposes: 1) to test whether the interaction between environmental and personal antecedents may enhance workaholism; 2) to develop a questionnaire aimed to assess overwork climate in the workplace; 3) to contrast focal employees’ and coworkers’ perceptions of employees’ workaholism and engagement. Concerning the first purpose, the interaction between overwork climate and person characteristics (achievement motivation, perfectionism, conscientiousness, self-efficacy) was explored on a sample of 333 Dutch employees. The results of moderated regression analyses showed that the interaction between overwork climate and person characteristics is related to workaholism. The second purpose was pursued with two interrelated studies. In Study 1 the Overwork Climate Scale (OWCS) was developed and tested using a principal component analysis (N = 395) and a confirmatory factor analysis (N = 396). Two overwork climate dimensions were distinguished, overwork endorsement and lacking overwork rewards. In Study 2 the total sample (N = 791) was used to explore the association of overwork climate with two types of working hard: work engagement and workaholism. Lacking overwork rewards was negatively associated with engagement, whereas overwork endorsement showed a positive association with workaholism. Concerning the third purpose, using a sample of 73 dyads composed by focal employees and their coworkers, a multitrait-multimethod matrix and a correlated trait-correlated method model, i.e. the CT-C(M–1) model, were examined. Our results showed a considerable agreement between raters on focal employees' engagement and workaholism. In contrast, we observed a significant difference concerning the cognitive dimension of workaholism, working compulsively. Moreover, we provided further evidence for the discriminant validity between engagement and workaholism. Overall, workaholism appears as a negative work-related state that could be better explained by assuming a multi-causal and multi-rater approach.

Spatially defined peptidomimetics for pain relief and for targeted cancer therapy and diagnostics

Cancer is a disease that has plagued scientists for decades, and how to treat cancer and its complications are inevitable topics in current scientific research. Cancer pain is a major factor that reduces the quality of life of patients. Therefore, the development of analgesic agents with minimal adverse side effects, especially with low addiction, has attracted more and more attention. Among them, opioid analgesics are widely used to alleviate cancer pain and improve the quality of life of patients with advanced cancer, such as in the palliative therapy. Although peptide drugs are efficient, selective and safe, they have several unignorable disadvantages such as poor biological stability, rapid excretion, difficulty in penetrate blood brain barrier. In order to solve these problems, peptidomimetics were developed by introducing unnatural/modified amino acids, decorated peptide backbone, conformational restrictions and secondary structure mimics in peptide sequence. Compared with peptides, peptidomimetics have improved biological stability, increased bioavailability, high affinity and selectivity for receptor binding, and decreased adverse side effects. As the second part of this thesis, I explored the opportunity to design peptide-functionalized responsive biomaterials for the detection of cancer cell and the selective delivery of cytotoxic drugs. The conjugation of peptides with biomaterials enhanced the stability of the loaded drugs, improved targeted delivery, decreased side effects, and increased bioavailability. The precise and controllable drug delivery platform has profound application prospects in cancer treatment. Grafting specific peptides sequence on the surface of biomaterials can satisfy different drug delivery demands according to the characteristics of both peptides and biomaterials. For example, the introduction of tumor-targeting peptides can guide biomaterials into tumor lesions, and blood-brain barrier (BBB) shuttle peptides can lead biomaterials to penetrate the BBB, etc.

Psychological characterization of hypertensive patients: associations with adherence to pharmacological treatment and self-management

Introduction: The role of psychosocial factors in the onset and progression of essential hypertension has been object of a large body of literature, yet findings appear to be controversial. Aims: We assessed the predictive role of psychosomatic syndromes, affective symptomatology, psychological reactance, psychological distress, well-being and quality of life on adherence to antihypertensive medications, lifestyle behaviors, hypertension severity and absolute cardiovascular risk grading, as well as their temporal stability at 1-year follow-up, in a sample of hypertensive patients. In addition, we aimed to validate the Italian version of the Hong Psychological Reactance Scale (HPRS). Methods: Eighty consecutive hypertensive outpatients treated with antihypertensive medications were compared to 80 controls. Psychosocial variables were assessed using clinical interviews and self-rating questionnaires at baseline and at 1-year follow-up. Cardiac parameters were also collected. One-hundred and fifty individuals from general population provided data for the HPRS validation. Results: Hypertensive patients reported significantly higher levels of psychological distress and lower levels of psychological well-being at baseline compared to controls. Among hypertensive patients, allostatic overload (AO) was the most frequently reported psychosomatic syndrome at baseline. Patients with AO displayed significantly greater levels of psychological distress and lower levels of well-being and quality of life than those without. Further, patients with illness denial were significantly more likely to report poor adherence to pharmacological treatment and, as well as those with higher levels of affective symptomatology, were less likely to follow a balanced diet. At follow-up, patients displayed significantly higher levels of well-being and lower levels of stress, mental pain and quality of life. Conclusions: Findings suggest the clinical relevance of psychosocial factors and psychosomatic syndromes in the progression of hypertension, with important implications for its management. As to the Italian validation of the HPRS, results support previous findings, even though a confirmatory factor analysis should be carried out.