Il trattamento ortodontico nei bambini con particolari necessità sanitarie (SHCN): una valutazione della durata e del risultato clinico utilizzando l'indice PAR (Peer Assessment Rating), la componente DHC (Dental Health Component) e la componente AC (Aesthetic Component) dell'indice IOTN (Orthodontic Treatment Need Index)

Obbiettivo: Valutazione delle eventuali differenze nel trattamento ortodontico di un gruppo di bambini con particolari necessità sanitarie (SHCN) rispetto ad un gruppo di bambini non diagnosticati con SHCN. Materiali e Metodi: Il gruppo campione (SHCN) è costituito da 50 bambini con SHCN. Il gruppo di controllo (NO SHCN) è costituito da 50 bambini non diagnosticati con SHCN pienamente corrispondenti per età, genere e tipo di apparecchio ortodontico utilizzato con i pazienti del gruppo di studio. I dati riguardanti i gruppi SHCN e NO SHCN sono stati analizzati in modo retrospettivo, valutando: - il punteggio pre- e post-trattamento e la riduzione finale dei valori dell'indice PAR (Peer Assessment Rating), della componente DHC (Dental Health Component) e della componente AC (Aesthetic Component) dell'indice IOTN (Orthodontic Treatment Need Index), - il numero di appuntamenti, - il numero di sedute semplici e complesse, - la durata complessiva del trattamento, - l'età all’inizio ed alla fine della terapia. Risultati: Non sono state rilevate differenze statisticamente significative tra i due gruppi per quanto concerne il numero di appuntamenti, la durata complessiva del trattamento, l'età all’inizio ed alla fine della terapia ortodontica (valori del p-value:0.682, 0.458, 0.535, 0.675). Sono state rilevate differenze statisticamente significative tra i due gruppi per quanto riguarda i punteggi dell’indice PAR, delle componenti DHC e AC dello IOTN pre- e post-trattamento, il numero di sedute semplici e complesse (valori del p-value:0.030, 0.000, 0.020, 0.023, 0.000, 0.000, 0.043, 0.037). Per quanto concerne la riduzione finale del valore dell’indice PAR, della componente DHC e di quella AC dello IOTN non sono state riscontrate differenze statisticamente significative tra i due gruppi (valori del p-value:0.060, 0.765, 0.825). Conclusioni: Lo studio incoraggia gli ortodontisti a trattare i bambini con SHCN nell'obiettivo di migliorarne la qualità di vita, pur evidenziando la necessità di un maggior numero di sedute complesse.

Development, degeneration and neural network of the bodily self

The question addressed by this dissertation is how the human brain builds a coherent representation of the body, and how this representation is used to recognize its own body. Recent approaches by neuroimaging and TMS revealed hints for a distinct brain representation of human body, as compared with other stimulus categories. Neuropsychological studies demonstrated that body-parts and self body-parts recognition are separate processes sub-served by two different, even if possibly overlapping, networks within the brain. Bodily self-recognition is one aspect of our ability to distinguish between self and others and the self/other distinction is a crucial aspect of social behaviour. This is the reason why I have conducted a series of experiment on subjects with everyday difficulties in social and emotional behaviour, such as patients with autism spectrum disorders (ASD) and patients with Parkinson’s disease (PD). More specifically, I studied the implicit self body/face recognition (Chapter 6) and the influence of emotional body postures on bodily self-processing in TD children as well as in ASD children (Chapter 7). I found that the bodily self-recognition is present in TD and in ASD children and that emotional body postures modulate self and others’ body processing. Subsequently, I compared implicit and explicit bodily self-recognition in a neuro-degenerative pathology, such as in PD patients, and I found a selective deficit in implicit but not in explicit self-recognition (Chapter 8). This finding suggests that implicit and explicit bodily self-recognition are separate processes subtended by different mechanisms that can be selectively impaired. If the bodily self is crucial for self/other distinction, the space around the body (personal space) represents the space of interaction and communication with others. When, I studied this space in autism, I found that personal space regulation is impaired in ASD children (Chapter 9).

Identity dynamics and the emergence of new organizational arrangements: A multi-level study

Organizational and institutional scholars have advocated the need to examine how processes originating at an individual level can change organizations or even create new organizational arrangements able to affect institutional dynamics (Chreim et al., 2007; Powell & Colyvas, 2008; Smets et al., 2012). Conversely, research on identity work has mainly investigated the different ways individuals can modify the boundaries of their work in actual occupations, thus paying particular attention to ‘internal’ self-crafting (e.g. Wrzesniewski & Dutton, 2001). Drawing from literatures on possible and alternative self and on positive organizational scholarship (e.g., Obodaru, 2012; Roberts & Dutton, 2009), my argument is that individuals’ identity work can go well beyond the boundaries of internal self-crafting to the creation of new organizational arrangements. In this contribution I analyze, through multiple case studies, healthcare professionals who spontaneously participated in the creation of new organizational arrangements, namely health structures called Community Hospitals. The contribution develops this form of identity work by building a grounded model. My findings disclose the process that leads from the search for the enactment of different self-concepts to positive identities, through the creation of a new organizational arrangement. I contend that this is a particularly complex form of collective identity work because it requires, to be successful, concerted actions of several internal, external and institutional actors, and it also requires balanced tensions that – at the same time - enable individuals’ aspirations and organizational equilibrium. I name this process organizational collective crafting. Moreover I inquire the role of context in supporting the triggering power of those unrealized selves. I contribute to the comprehension of the consequences of self-comparisons, organizational identity variance, and positive identity. The study bears important insights on how identity work originating from individuals can influence organizational outcomes and larger social systems.

Interactions between the gut microbiota, short-chain fatty acids and the immune system in pediatric patients undergoing hematopoietic stem cell transplantation

The gut microbiota (GM) is essential for human health and contributes to several diseases; indeed it can be considered an extension of the self and, together with the genetic makeup, determines the physiology of an organism. In this thesis has been studied the peripheral immune system reconstitution in pediatric patients undergoing allogeneic hematopoietic stem cell transplantation (aHSCT) in the early phase; in parallel, have been also explored the gut microbiota variations as one of the of primary factors in governing the fate of the immunological recovery, predisposing or protecting from complications such as the onset of acute graft-versus-host disease (GvHD). Has been demonstrated, to our knowledge for the first time, that aHSCT in pediatric patients is associated to a profound modification of the GM ecosystem with a disruption of its mutualistic asset. aGvHD and non-aGvHD subjects showed differences in the process of GM recovery, in members abundance of the phylum Bacteroidetes, and in propionate fecal concentration; the latter are higher in the pre-HSCT composition of non-GvHD subjects than GvHD ones. Short-chain fatty acids (SCFAs), such as acetate, butyrate and propionate, are end-products of microbial fermentation of macronutrients and distribute systemically from the gut to blood. For this reason, has been studied their effect in vitro on human DCs, the key regulators of our immune system and the main player of aGvHD onset. Has been observed that propionate and, particularly, butyrate show a strong and direct immunomodulatory activity on DCs reducing inflammatory markers such as chemokines and interleukins. This study, with the needed caution, suggests that the pre-existing GM structure can be protective against aGvHD onset, exerting its protective role through SCFAs. They, indeed, may regulate cell traffic within secondary lymphoid tissues, influence T cell development during antigen recognition, and, thus, directly shape the immune system.

Development and characterization of deep learning techniques for neuroimaging data

Deep learning methods are extremely promising machine learning tools to analyze neuroimaging data. However, their potential use in clinical settings is limited because of the existing challenges of applying these methods to neuroimaging data. In this study, first a data leakage type caused by slice-level data split that is introduced during training and validation of a 2D CNN is surveyed and a quantitative assessment of the model’s performance overestimation is presented. Second, an interpretable, leakage-fee deep learning software written in a python language with a wide range of options has been developed to conduct both classification and regression analysis. The software was applied to the study of mild cognitive impairment (MCI) in patients with small vessel disease (SVD) using multi-parametric MRI data where the cognitive performance of 58 patients measured by five neuropsychological tests is predicted using a multi-input CNN model taking brain image and demographic data. Each of the cognitive test scores was predicted using different MRI-derived features. As MCI due to SVD has been hypothesized to be the effect of white matter damage, DTI-derived features MD and FA produced the best prediction outcome of the TMT-A score which is consistent with the existing literature. In a second study, an interpretable deep learning system aimed at 1) classifying Alzheimer disease and healthy subjects 2) examining the neural correlates of the disease that causes a cognitive decline in AD patients using CNN visualization tools and 3) highlighting the potential of interpretability techniques to capture a biased deep learning model is developed. Structural magnetic resonance imaging (MRI) data of 200 subjects was used by the proposed CNN model which was trained using a transfer learning-based approach producing a balanced accuracy of 71.6%. Brain regions in the frontal and parietal lobe showing the cerebral cortex atrophy were highlighted by the visualization tools.

The dark and bright side of remote work: social isolation, concentration, and performance of remote workers

This dissertation, comprised of three separate studies, focuses on the relationship between remote work adoption and employee job performance, analyzing employee social isolation and job concentration as the main mediators of this relationship. It also examines the impact of concern about COVID-19 and emotional stability as moderators of these relationships. Using a survey-based method in an emergency homeworking context, the first study found that social isolation had a negative effect on remote work productivity and satisfaction, and that COVID-19 concerns affected this relationship differently for individuals with high and low levels of concern. The second study, a diary study analyzing hybrid workers, found a positive correlation between work from home (WFH) adoption and job performance through social isolation and job concentration, with emotional stability serving respectively as a buffer and booster in the relationships between WFH and the mediators. The third study, even in this case a diary study of hybrid workers, confirmed the benefits of work from home on job performance and the importance of job concentration as a mediator, while suggesting that social isolation may not be significant when studying employee job performance, but it is relevant for employee well-being. Although each study provides autonomously a discussion and research and practical implications, this dissertation also presents a general discussion on remote work and its psychological implications, highlighting areas for future research

Experimenting with the role of performance of hygiene and motivators on customer satisfaction: studying the temporal effect

Marketers continuously attempt to identify important attributes and innovate in order to understand how attribute performance could lead to customer satisfaction in the short term and in the long term. Understanding the impact of customer satisfaction may offer a competitive edge to companies. Researchers are discussing the importance of performance attributes in leading to satisfaction; however, there is no clear understanding of whether an attribute that leads to satisfaction at one time (e.g., short run) can cause it also in the long run, without excluding the possibility that it could lead to dissatisfaction and no satisfaction. The present research tries to understand anomalies related to asymmetric attribute performance and satisfaction over time with the help of Herzberg's (1967) Two-Factor Theory (TFT) and construal level theory (CLT). More precisely, there are main purposes of this dissertation. First, the present research tries to understand whether positive or negative hygiene attribute performance and motivator attribute factors exert different weights on overall customer satisfaction depending on the time elapsed from the service experience. Second, to test if positive or negative hygiene/motivator attribute performance affect to revisit intention and to word of mouth by considering mediating role of satisfaction. The results reveal that in the near past (NP) experience, the positive performance of hygiene concrete attributes creates a differential effect on overall satisfaction higher than the negative performance of hygiene concrete attributes. Results also confirmed mediating role of satisfaction in the relationship between attribute performance and revisit intention for near past condition but not for distant past. Likewise significant relationship was found for the mediating role of satisfaction in the relationship between attribute performance and word of mouth (WOM) for near past condition but not for distant past.