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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.

Autophagosomes are double-membrane vesicles that sequester cytoplasmic material for lysosomal degradation. Their biogenesis is initiated by recruitment of Atg9-vesicles to the phagophore assembly site. This process depends on the regulated activation of the Atg1–kinase complex. However, the underlying molecular mechanism remains unclear. Here we reconstitute this early step in autophagy from purified components in vitro . We find that on assembly from its cytoplasmic subcomplexes, the Atg1–kinase complex becomes activated, enabling it to recruit and tether Atg9-vesicles. The scaffolding protein Atg17 targets the Atg1–kinase complex to autophagic membranes by specifically recognizing the membrane protein Atg9. This interaction is inhibited by the two regulatory subunits Atg31 and Atg29. Engagement of the Atg1–Atg13 subcomplex restores the Atg9-binding and membrane-tethering activity of Atg17. Our data help to unravel the mechanism that controls Atg17-mediated tethering of Atg9-vesicles, providing the molecular basis to understand initiation of autophagosome-biogenesis. Autophagosome biogenesis is initiated by recruitment of Atg9-vesicles to the phagophore assembly site. Here Rao et al. use a reconstituted in vitro system to describe the mechanism by which activation of the Atg1-kinase complex from its constituent parts recruits and tethers Atg9-vesicles.

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.

Cold-water corals, such as Lophelia pertusa, are key habitat-forming organisms found throughout the world's oceans to 3000 m deep. The complex three-dimensional framework made by these vulnerable marine ecosystems support high biodiversity and commercially important species. Given their importance, a key question is how both the living and the dead framework will fare under projected climate change. Here, we demonstrate that over 12 months L. pertusa can physiologically acclimate to increased CO2, showing sustained net calcification. However, their new skeletal structure changes and exhibits decreased crystallographic and molecular-scale bonding organization. Although physiological acclimatization was evident, we also demonstrate that there is a negative correlation between increasing CO2 levels and breaking strength of exposed framework (approx. 20–30% weaker after 12 months), meaning the exposed bases of reefs will be less effective ‘load-bearers’, and will become more susceptible to bioerosion and mechanical damage by 2100.

To understand the effects of ocean acidification (OA) on marine calcifiers, the trade-offs among different sublethal responses within individual species and the emergent effects of these trade-offs must be determined in an ecosystem setting. Crustose coralline algae (CCA) provide a model to test the ecological consequences of such sublethal effects as they are important in ecosystem functioning, service provision, carbon cycling and use dissolved inorganic carbon to calcify and photosynthesize. Settlement tiles were placed in ambient pH, low pH and extremely low pH conditions for 14 months at a natural CO2 vent. The size, magnesium (Mg) content and molecular-scale skeletal disorder of CCA patches were assessed at 3.5, 6.5 and 14 months from tile deployment. Despite reductions in their abundance in low pH, the largest CCA from ambient and low pH zones were of similar sizes and had similar Mg content and skeletal disorder. This suggests that the most resilient CCA in low pH did not trade-off skeletal structure to maintain growth. CCA that settled in the extremely low pH, however, were significantly smaller and exhibited altered skeletal mineralogy (high Mg calcite to gypsum (hydrated calcium sulfate)), although at present it is unclear if these mineralogical changes offered any fitness benefits in extreme low pH. This field assessment of biological effects of OA provides endpoint information needed to generate an ecosystem relevant understanding of calcifying system persistence.

This study provides insights into the tectonic evolution of the normal Mt Morrone Fault System (MMFS) in Central Italy and highlights the utility of multidisciplinary approaches in reconstructing the seismic history of dormant fault systems. The MMFS comprises two parallel normal faults that traverse the western slope of Mt. Morrone, and although the system can produce M > 6 earthquakes, it has been aseismic in post Roman times. Here, we combine geochemical analysis of carbonate fault‐scarp samples with new structural fault data and Lidar‐based topographic analysis to provide new constraints on fault geometries and kinematics, the paleo‐earthquake history of MMFS since the Last Glacial Maximum and its slip rates. Structural analysis reveals kinematic similarities between the two parallel strands, reflecting their response to the same stress regime. Rare Earth Elements analyses on 53 limestone samples reveal a minimum of eight concentration fluctuations upscarp, here interpreted as tectonic exhumation of the fault scarp due to post LGM earthquakes. Slip per event ranges from 30 to 110 cm typical of earthquakes with 6.3 ≤ M ≤ 6.8. Lidar analysis reveals triangular slip profiles on both fault strands. We estimate that an earthquake with an average M = 6.5–6.6 would have a recurrence interval of ∼2,125 ± 125 years. Slip rates were calculated to be 0.5–0.65 mm/yr on the lower and 0.65–0.7 mm/yr on the upper fault strand, with the combined system having slip rates of 0.62–0.69 mm/yr. Our findings indicate that both strands of the MMFS are active and accumulate slip interdependently, a finding that is critical for seismic hazard assessment. Plain Language Summary This study focuses on Mount Morrone in central Italy, which is affected by faults that haven't caused significant earthquakes in post Roman times but have the potential for strong earthquakes (magnitude >6). We combined different techniques to study the fault's characteristics, history, and how it has moved over time. Techniques include: (a) geochemical analysis on rock samples from a carbonate fault scarp, which records past movements caused by earthquakes through changes in the content of chemical elements; (b) structural‐geological data collected from faults exposed in the area; (c) displacement measurements using high‐resolution terrain models. By analyzing carbonate samples, we found at least eight past earthquakes, each causing the fault to move between 30 and 110 cm, equivalent to earthquakes 6.3 ≤ M ≤ 6.8. Structural analysis shows that the mount is affected by two faults responding to the same stress in the Earth's crust. We estimate that a significant earthquake (around magnitude 6.5) could occur approximately every 2,125 years. The fault moves at a rate of ∼0.62–0.69 mm per year. These insights are crucial for assessing the seismic risk in the densely populated Sulmona Basin, as understanding the behavior of the MMFS can improve safety measures in the region. Key Points The Mt Morrone fault ruptured at the surface 8 times in the past 17 ky with M6.3–6.8 earthquakes with an average return time of 2,125 ± 125 years Post‐17 ky slip rates are 0.5–0.65 and 0.65–0.7 mm/yr for the lower and upper fault strands, respectively, and 0.62–0.69 mm/yr when combined The two parallel fault strands of Mt Morrone have similar post‐17ky slip patterns associated with triangular and/or asymmetric slip profiles

Blood is a fluid connective tissue of human body, where it plays vital functions for the nutrition, defense and well-being of the organism. When circulating in peripheral districts, it is exposed to some physical stresses coming from outside the human body, as electromagnetic fields (EMFs) which can cross the skin. Such fields may interact with biomolecules possibly inducing non thermal-mediated biological effects at the cellular level. In this study, the occurrence of biochemical/biological modifications in human peripheral blood lympho-monocytes exposed in a reverberation chamber for times ranging from 1 to 20 h to EMFs at 1.8 GHz frequency and 200 V/m electric field strength was investigated. Morphological analysis of adherent cells unveiled, in some of these, appearance of an enlarged and deformed shape after EMFs exposure. Raman spectra of the nuclear compartment of cells exposed to EMFs revealed the onset of biochemical modifications, mainly consisting in the reduction of the DNA backbone-linked vibrational modes. Respirometric measurements of mitochondrial activity in intact lympho-monocytes resulted in increase of the resting oxygen consumption rate after 20 h of exposure, which was coupled to a significant increase of the FoF1-ATP synthase-related oxygen consumption. Notably, at lower time-intervals of EMFs exposure (i.e. 5 and 12 h) a large increase of the proton leak-related respiration was observed which, however, recovered at control levels after 20 h exposure. Confocal microscopy analysis of the mitochondrial membrane potential supported the respiratory activities whereas no significant variations in the mitochondrial mass/morphology was observed in EMFs-exposed lympho-monocytes. Finally, altered redox homeostasis was shown in EMFs-exposed lympho-monocytes, which progressed differently in nucleated cellular subsets. This results suggest the occurrence of adaptive mechanisms put in action, likely via redox signaling, to compensate for early impairments of the oxidative phosphorylation system caused by exposure to EMFs. Overall the data presented warn for health safety of people involved in long-term exposure to electromagnetic fields, although further studies are required to pinpoint the leukocyte cellular subset(s) selectively targeted by the EMFs action and the mechanisms by which it is achieved.

Summary Introduction Research has demonstrated that patients with insomnia are at an increased risk of experiencing suicidal ideation and/or making a suicide attempt. Objectives To evaluate the relation between insomnia and suicidal behaviour. Aims To examine factors associated with a diagnosis of insomnia in patients admitted to an Emergency Department (ED) and assessed by the psychiatrist in charge. Methods Participants were 843 patients consecutively admitted to the ED of Sant'Andrea Hospital in Rome, between January 2010 and December 2011. All patients admitted were referred to a psychiatrist. A clinical interview based on the Mini International Neuropsychiatric Interview (MINI) and a semi‐structured interview was conducted. Patients were asked about ‘ongoing’ suicidal ideation or plans for suicide. Results Forty‐eight percent of patients received a diagnosis of bipolar disorder (BD), major depressive disorder (MDD) or an anxiety disorder; whereas, 17.1% were diagnosed with Schizophrenia or other non‐affective psychosis. Patients with insomnia (compared to patients without insomnia) more frequently had a diagnosis of BD (23.9% vs. 12.4%) or MDD (13.3% vs. 9.5%; p < 0.001). Moreover, patients with insomnia less frequently had attempted suicide in the past 24 h (5.3% vs. 9.5%; p < 0.05) as compared with other patients, but those patients with insomnia who attempted suicide more frequently used a violent method (64.3% vs. 23.6%; p < 0.01) compared to other suicide attempters. Conclusions Our results do not support an association between insomnia and suicidal behaviour. However, suicide attempters with insomnia more frequently used violent methods, and this phenomenon should be taken into serious consideration by clinicians.

IntroductionThe COVID-19 pandemic has been causing relevant public health and psychosocial consequences.ObjectivesTo assess the impact of the COVID-19 pandemic on mental health, lifestyle and personal relationships in the Italian general population.MethodsAn online survey spread between May and June 2020 to collect socio-demographic, clinical, lifestyle, relationship, and mental health self-reported information. Mental disorder screening was performed by the Patient Health Questionnaire and PTSD Checklist for DSM-5.ResultsParticipants were 2003, 1504 of which (75%) completed the entire questionnaire (1157 females, 77%). Among the completers who have not had any mental disorder before (n=524, 35%), 263 (51.7%) met cut-off scores for psychiatric diagnoses on the self-report psychiatric screeners during the pandemic (i.e., Major Depressive Disorder, 11.3%, with death thoughts in approximately half of the cases; Panic Disorder, 1.1%; Generalized Anxiety Disorder, 13%.3, Obsessive-Compulsive Disorder, 13.2%, Post-Traumatic Stress Disorder, 7.3%; Alcohol Abuse, 5.5%). In line with this, 39% of completers complained of insomnia, while 12% and 10% started using anxiolytics and antidepressants, respectively. Approximately 7-8 % of completers started/increased alcohol and/or nicotine consumption, 33% quitted/decreased physical activity, and 40% declared decreased sexual satisfaction. Approximately 21% and 38% declared worsening in relationship with partner and difficulty in child-caring, respectively.ConclusionsThe COVID-19 pandemic appears to be a risk factor for new onset of mental disorders and worsening in lifestyle and familial relationships in the Italian population. These results should be confirmed by clinical interviews, and may represent a starting point for further monitoring of the medium and long-term consequences of the COVID-19 pandemic.DisclosureNo significant relationships.