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For many years, biofeedback and neurofeedback have been implemented in the treatment of depression. However, the effectiveness of these techniques on depressive symptomatology is still controversial. Hence, we conducted a meta-analysis of studies extracted from PubMed, Scopus, Web of Science and Embase. Two different strings were considered for each of the two objectives of the study: A first group comprising studies patients with major depressive disorder (MDD) and a second group including studies targeting depressive symptomatology reduction in other mental or medical conditions. In the first group of studies including patients with MDD, the within-group analyses yielded an effect size of Hedges' g = 0.717, while the between-group analysis an effect size of Hedges' g = 1.050. Moderator analyses indicate that treatment efficacy is only significant when accounting for experimental design, in favor of randomized controlled trials (RCTs) in comparison to non RCTs, whereas the type of neurofeedback, trial design, year of publication, number of sessions, age, sex and quality of study did not influence treatment efficacy. In the second group of studies, a small but significant effect between groups was found (Hedges' g = 0.303) in favor of bio- and neurofeedback against control groups. Moderator analyses revealed that treatment efficacy was not moderated by any of the sociodemographic and clinical variables. Heart rate variability (HRV) biofeedback and neurofeedback are associated with a reduction in self-reported depression. Despite the fact that the field has still a large room for improvement in terms of research quality, the results presented in this study suggests that both modalities may become relevant complementary strategies for the treatment of MDD and depressive symptomatology in the coming years.

Personalized medicine (PM) aims to establish a new approach in clinical decision-making, based upon a patient's individual profile in order to tailor treatment to each patient's characteristics. Although this has become a focus of the discussion also in the psychiatric field, with evidence of its high potential coming from several proof-of-concept studies, nearly no tools have been developed by now that are ready to be applied in clinical practice. In this paper, we discuss recent technological advances that can make a shift toward a clinical application of the PM paradigm. We focus specifically on those technologies that allow both the collection of massive as much as real-time data, i.e., electronic medical records and smart wearable devices, and to achieve relevant predictions using these data, i.e. the application of machine learning techniques.

The MEG experiment, designed to search for the μ+→e+γ decay, completed data-taking in 2013 reaching a sensitivity level of 5.3×10-13 for the branching ratio. In order to increase the sensitivity reach of the experiment by an order of magnitude to the level of 6×10-14, a total upgrade, involving substantial changes to the experiment, has been undertaken, known as MEG II. We present both the motivation for the upgrade and a detailed overview of the design of the experiment and of the expected detector performance.

The cylindrical drift chamber is the most innovative part of the MEG II detector, the upgraded version of the MEG experiment. The MEG II chamber differs from the MEG one because it is a single volume cylindrical structure, instead of a segmented one, chosen to improve its resolutions and efficiency in detecting low energy positrons from muon decays at rest. In this paper, we show the characteristics and performances of this fundamental part of the MEG II apparatus and we discuss the impact of its higher resolution and efficiency on the sensitivity of the MEG II experiment. Because of its innovative structure and high quality resolution and efficiency the MEG II cylindrical drift chamber will be a cornerstone in the development of an ideal tracking detector for future positron-electron collider machines.

Background Multifocal choroiditis (MFC) is a relatively uncommon bilateral inflammatory chorioretinopathy affecting Caucasian young women with myopia. We present images from a case of completely unilateral multifocal choroiditis following EBV-positive mononucleosis that demonstrated a dramatic clinical response to immunosuppression. Case presentation A 20-year-old woman with bilateral high myopia (−6D) and a documented normal prior retinal examination presented with visual loss in the right eye 2 months following confirmed Epstein-Barr virus (EBV) positive mononucleosis. Ophthalmoscopic examination showed completely unilateral placoid lesions of variable age. The left eye was unaffected. Fluorescein angiography revealed active leakage, especially in the parafovea. Spectral domain optical coherence tomography (SD-OCT) demonstrated sub-retinal pigment epithelial nodular deposits, some of which were confluent with overlying intra-retinal fluid and indistinct margins. Upon treatment with the immunosuppressant azathioprine there was significant resolution of the lesions in her right eye along with improvement in vision. Conclusion This is a rare case of completely unilateral MFC following an episode of EBV positive mononucleosis that showed a dramatic response to immunosuppression.

Electric dipole moments (EDM) of fundamental particles inherently violate time-reversal (T) and the combined charge-conjugation and parity symmetry (CP). We aim to measure the EDM of the muon using the frozen-spin technique within a compact storage trap. This method exploits the high effective electric field, E ≈ 165 MV / m , experienced in the rest frame of the muon with a momentum of about 23 MeV / c when it passes through a solenoidal magnetic field of | B → | = 2.5 T . In this paper, we outline the fundamental considerations for a muon EDM search and present a conceptual design for a demonstration experiment to be conducted at secondary muon beamlines of the Paul Scherrer Institute in Switzerland. In Phase I, with an anticipated data acquisition period of 200 days, the expected sensitivity to a muon EDM is σ ( d ) ≤ 4 E - 21 e · cm . In a subsequent phase, Phase II, we propose to improve the sensitivity to σ ( d ) ≤ 6 E - 23 e · cm using a dedicated instrument installed on a different beamline that produces muons of momentum 125  MeV / c .

Background Comprehensive next-generation sequencing is widely used for precision oncology and precision prevention approaches. We aimed to determine the yield of actionable gene variants, the capacity to uncover hereditary predisposition and liquid biopsy appropriateness instead of, or in addition to, tumor tissue analysis, in a real-world cohort of cancer patients, who may benefit the most from comprehensive genomic profiling. Methods Seventy-eight matched germline/tumor tissue/liquid biopsy DNA and RNA samples were profiled using the Hereditary Cancer Panel (germline) and the TruSight Oncology 500 panel (tumor tissue/cfDNA) from 23 patients consecutively enrolled at our center according to at least one of the following criteria: no available therapeutic options; long responding patients potentially fit for other therapies; rare tumor; suspected hereditary cancer; primary cancer with high metastatic potential; tumor of unknown primary origin. Variants were annotated for OncoKB and AMP/ASCO/CAP classification. Results The overall yield of actionable somatic and germline variants was 57% (13/23 patients), and 43.5%, excluding variants previously identified by somatic or germline routine testing. The accuracy of tumor/cfDNA germline-focused analysis was demonstrated by overlapping results of germline testing. Five germline variants in BRCA1 , VHL , CHEK1, ATM genes would have been missed without extended genomic profiling. A previously undetected BRAF p.V600E mutation was emblematic of the clinical utility of this approach in a patient with a liver undifferentiated embryonal sarcoma responsive to BRAF/MEK inhibition. Conclusions Our study confirms the clinical relevance of performing extended parallel tumor DNA and cfDNA testing to broaden therapeutic options, to longitudinally monitor cfDNA during patient treatment, and to uncover possible hereditary predisposition following tumor sequencing in patient care.

We present the first direct search for lepton flavour violating muon decay mediated by a new light particle X, μ + → e + X , X → γ γ . This search uses a dataset resulting from 7.5 × 10 14 stopped muons collected by the MEG experiment at the Paul Scherrer Institut in the period 2009–2013. No significant excess is found in the mass region 20–45 MeV/c 2 for lifetimes below 40 ps, and we set the most stringent branching ratio upper limits in the mass region of 20–40 MeV/c 2 , down to O ( 10 - 11 ) at 90% confidence level.

Despite the considerable research efforts being made to learn more about COVID-19, little is known about the presence of SARS-CoV-2 genetic material in biological fluids other than respiratory droplets, blood, and feces 1,2. In particular, little is known about the presence of SARS-CoV-2 in the joints either post mortem3 or in vivo4. To the best of our knowledge, only Lopéz-Gonzalez et al.5 have published a description of acute arthritides occurring during hospitalisation due to COVID-19, and they did not find any SARS-CoV-2 genetic material in the patients' synovial fluid samples. The aim of this post mortem study was to assess the presence of SARS-CoV-2 RNA in the knee synovial fluid, synovial tissue, and bone tissue of COVID-19 patients in order to discover whether the joint is a possible route of transmission during orthopaedic surgical procedures, and clarify the possible role of SARS-CoV-2 as a directly arthritogenic virus. Post mortem synovial fluid, synovial tissue and bone tissue samples were collected from the knees of five patients who died of COVID-19 in our hospital between September and October 2020, and analysed for the presence of SARS-CoV-2 using a commercial real-time polymerase chain reaction (RT-PCR) panel. Quantitative RT-PCR was used to test post mortem nasopharyngeal swabs of all of the patients. No SARS-CoV-2 RNA was detected in any of the knee samples, despite the positivity of the throat swab. Our findings indicate that SARS-CoV-2 was not detected in knee synovial fluid, synovial membrane or bone. Therefore, our results suggest that all healthcare professionals performing surgical procedures on the joints of COVID-19 patients are exposed to a risk of contagion due to exposure to respiratory droplets, blood and body fluids, but not to direct exposure to joint- or bone-related tissues. Furthermore, given that some case reports of arthritis in COVID-19 patients 5-8 show that it is possible that COVID-19 patients display viral-mediated arthralgias and arthritis, the absence of the virus in the knee highlighted by our study suggests that it is unlikely that SARS-CoV-2 has a direct inflammatory action on the joint, but it could induce an inflammation-related reaction, manifesting as a reactive arthritis 9. [1]Cheng ZJ, Shan J. 2019 Novel coronavirus: where we are and what we know. Infection. 2020;(0123456789):1-9. doi:10.1007/s15010-020-01401-y [2]Chen Y, Chen L, Deng Q, et al. The Presence of SARS-CoV-2 RNA in Feces of COVID-19 Patients. J Med Virol. April 2020. doi:10.1002/jmv.25825 [3]Maiese A, Manetti AC, La Russa R, et al. Autopsy findings in COVID-19-related deaths: a literature review. Forensic Sci Med Pathol. 2020. doi:10.1007/s12024-020-00310-8 [4]Baldanti F, Novazzi F, Cassaniti I, Piralla A, Di A, Bruno R. Detection of the SARS-CoV-2 in different biologic specimens from positive patients with COVID-19, in Northern Italy. Authorea. 2020. doi:10.22541/au.159724509.93056098 [5]López-González M-C, Peral-Garrido ML, Calabuig I, et al. Case series of acute arthritis during COVID-19 admission. Ann Rheum Dis. 2020;0(0):annrheumdis-2020-217914. doi:10.1136/annrheumdis-2020-217914 [6]Parisi S, Borrelli R, Bianchi S, Fusaro E. Viral arthritis and COVID-19. Lancet Rheumatol. 2020;2(11):e655-e657. doi:10.1016/S2665-9913(20)30348-9 [7]Alivernini S, Cingolani A, Gessi M, et al. Comparative analysis of synovial inflammation after SARS-CoV-2 infection. Ann Rheum Dis. 2020;0(0):2-3. doi:10.1136/annrheumdis-2020-218315 [8]Talarico R, Stagnaro C, Ferro F, Carli L, Mosca M. Symmetric peripheral polyarthritis developed during SARS-CoV-2 infection. Lancet Rheumatol. 2020;2(9):e518-e519. doi:10.1016/S2665-9913(20)30216-2 [9]Di Carlo M, Tardella M, Salaffi F. Can SARS-CoV-2 induce reactive arthritis? Clin Exp Rheumatol. 2020;In press. We would like to thank the clinical staff of the Pathology Unit for their collaboration in performing the autopsies. None declared