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Background and Objectives: Medical students represent the ideal target group for promoting mental health and mental wellbeing, being exposed to specific risk factors, such as the content of medical training, the exposure to sickness and death, and a stressful academic routine. Medical students report high levels of cynicism and emotional exhaustion, which represent two of the essential features of burnout syndrome. In this systematic review, studies assessing the levels of burnout among medical students through validated tools worldwide were analyzed. Materials and Methods: A systematic review has been performed in order to identify studies: (1) focusing on samples of medical students; (2) evaluating burnout syndrome using validated tools; (3) providing prevalence data on burnout; and (4) written in English. Results: Out of the 5547 papers initially obtained, 64 were finally included in the analysis. The sample sizes ranged from 51 to 2682 participants. Almost all studies had a cross-sectional design; the Maslach Burnout Inventory and its related versions were the most frequently used assessment tools. The prevalence of burnout, which was stratified based on gender and academic stage, ranged from 5.6 to 88%. Burnout was mostly predicted by thoughts of stopping medical education, negative life events, lack of support, dissatisfaction, and poor motivation. Conclusions: The prevalence of burnout syndrome in medical students is quite heterogeneous, reaching a peak of 88% in some countries. However, several predictors have been identified, including negative life events or poor motivation. These findings highlight the need to develop preventive interventions targeting the future generation of medical doctors, in order to improve their coping strategies and resilience styles.

IntroductionMany patients fail to respond to multiple antidepressant interventions, being defined as “treatment-resistant depression” (TRD) patients. TRD is usually associated with increased severity and chronicity of symptoms, increased risk of comorbidity, and higher suicide rates, which make the clinical management challenging. Efforts to distinguish between TRD patients and those who will respond to treatment have been unfruitful so far. Several studies have tried to identify the biological, psychopathological, and psychosocial correlates of depression, with particular attention to the inflammatory system. In this paper we aim to review available studies assessing the full range of biomarkers in TRD patients in order to reshape TRD definition and improve its diagnosis, treatment, and prognosis.MethodsWe searched the most relevant medical databases and included studies reporting original data on possible biomarkers of TRD. The keywords “treatment resistant depression” or “TRD” matched with “biomarker,” “inflammation,” “hormone,” “cytokine” or “biological marker” were entered in PubMed, ISI Web of Knowledge and SCOPUS databases. Articles were included if they included a comparison with healthy controls (HC).ResultsOf the 1878 papers identified, 35 were included in the present study. Higher plasma levels of IL-6 and TNF-α were detected in TRD patients compared to HC. While only a few studies on cortisol have been found, four papers showed elevated levels of C-reactive protein among these patients and four articles focused on immunological cells. Altered kynurenine metabolism in TRD patients was reported in two studies, while contrasting results were found with regard to BDNF.ConclusionOnly a few biological alterations correlate with TRD. TNF-α seems to be the most relevant biomarker to discriminate TRD patients from both HC and treatment-responsive MDD patients. Moreover, several discrepancies among studies have been found, due to methodological differences and the lack of a standardized diagnostic definition of TRD.

This contribution describes the acquisition and trigger system for the HEPD-02 calorimeter that will be used onboard the CSES-02 satellite for the CSES/Limadou mission. This mission arises from the collaboration between the Chinese Space Agency (CNSA) and the Italian Space Agency (ASI) and plans the realization of a constellation of satellites which will monitor ionospheric parameters supposed to be related to earthquakes. It will also monitor the solar activity and the interaction with the magnetosphere and will study the cosmic rays in low energy ranges, extending data from PAMELA and AMS. The CSES-02 satellite will be equipped with various instruments, including the High-Energy Particle Detector (HEPD-02), which was designed to measure the energy of particles coming from Van Allen belts. Signals from the HEPD-02 are acquired and digitized by an electronic board that also produces the trigger for the experiment. A new generation ASIC (CITIROC) for the amplification, shaping and memorization of signals from PMTs will be used on this board. The new ASIC allows the use of the peak detector feature, optimizing the acquisition of signals with different temporal characteristics. Along with this, new algorithms for trigger generation have been developed, providing trigger pre-scaling, concurrent trigger masks and Gamma Ray Burst detection. Using pre-scaled concurrent triggers will allow the study of very sensitive regions of a satellite’s orbit such as the South Atlantic Anomaly and polar regions and to detect rare events such as GRBs while still monitoring particle bursts. In this contribution, the progress status of this work will be presented along with the measurements and tests made to finalize the flight model of the board.

The G-NUMEN array is the future gamma spectrometer of the NUMEN experiment (nuclear matrix element for neutrinoless double beta decay), to be installed around the object point of the MAGNEX magnetic spectrometer at the INFN-LNS laboratory. This project aims to explore double-charge exchange (DCE) reactions in order to obtain crucial information about neutrinoless double beta decay (0νββ). The primary objective of the G-NUMEN array is to detect the gamma rays emitted from the de-excitation of the excited states that are populated via DCE reactions with a good energy resolution and detection efficiency, amidst a background composed of the transitions from competing reaction channels with far higher cross sections. To achieve this, G-NUMEN signals will be processed in coincidence with those generated by the detection of reaction ejectiles by the MAGNEX focal plane detector (FPD). Under the expected experimental conditions, G-NUMEN detectors will operate at high counting rates, of the order of hundreds of kHz per detector, while maintaining excellent energy and timing resolutions. The complete array will consist of over 100 LaBr3(Ce) scintillators. Initial tests were conducted on the first detectors of the array, allowing for the determination of their performance at high rates.

Brain-derived neurotrophic factor (BDNF) plays a key role in brain development, contributing to neuronal survival and neuroplasticity. Previous works have found that BDNF is involved in several neurological or psychiatric diseases. In this review, we aimed to collect all available data on BDNF and bipolar disorder (BD) and assess if BDNF could be considered a biomarker for BD. We searched the most relevant medical databases and included studies reporting original data on BDNF circulating levels or Val66Met polymorphism. Only articles including a direct comparison with healthy controls (HC) and patients diagnosed with BD according to international classification systems were included. Of the 2430 identified articles, 29 were included in the present review. Results of the present review show a reduction in BDNF circulating levels during acute phases of BD compared to HC, which increase after effective therapy of the disorders. The Val66Met polymorphism was related to features usually associated with worse outcomes. High heterogeneity has been observed regarding sample size, clinical differences of included patients, and data analysis approaches, reducing comparisons among studies. Although more studies are needed, BDNF seems to be a promising biomarker for BD.

This study aims to assess the efficacy of a psychoeducational family intervention (PFI) to reduce the severity of depressive symptoms and to improve psychosocial functioning and to increase social contacts in a sample of patients with major depressive disorder (MDD). The degree to which PFI will reduce patients’ relapses, hospitalizations, and self-stigmatization and will improve their quality of life will also be assessed. Other secondary outcomes include the improvement of relatives’ coping strategies, family burden, expressed emotions and quality of life. This non-profit, unfunded, national, multicentric randomized controlled trial with blinded outcome assessments will be carried out in 24 Italian university outpatient units. Families will be assessed at baseline and at 6, 12, and 24 months post-randomization. Our working hypothesis is that the PFIs will reduce the patients’ severity of depressive symptoms, their relapses, and their hospitalizations, and that they will improve their psychosocial functioning and quality of life. We expect these results to be maintained after 12 and 24 months, albeit with a reduction in magnitude. The sample will consist of 384 patients randomized at a 1:1 ratio and stratified according to center, age, gender, and educational level.

Abstract A double-phase argon Time Projection Chamber (TPC), with an active mass of 185 g, has been designed and constructed for the Recoil Directionality (ReD) experiment. The aim of the ReD project is to investigate the directional sensitivity of argon-based TPCs via columnar recombination to nuclear recoils in the energy range of interest (20– $$200\,\hbox {keV}_{nr}$$ 200 keV nr ) for direct dark matter searches. The key novel feature of the ReD TPC is a readout system based on cryogenic Silicon Photomultipliers (SiPMs), which are employed and operated continuously for the first time in an argon TPC. Over the course of 6 months, the ReD TPC was commissioned and characterised under various operating conditions using $$\gamma $$ γ -ray and neutron sources, demonstrating remarkable stability of the optical sensors and reproducibility of the results. The scintillation gain and ionisation amplification of the TPC were measured to be $$g_1 = (0.194 \pm 0.013)$$ g 1 = ( 0.194 ± 0.013 ) photoelectrons/photon and $$g_2 = (20.0 \pm 0.9)$$ g 2 = ( 20.0 ± 0.9 ) photoelectrons/electron, respectively. The ratio of the ionisation to scintillation signals (S2/S1), instrumental for the positive identification of a candidate directional signal induced by WIMPs, has been investigated for both nuclear and electron recoils. At a drift field of 183 V/cm, an S2/S1 dispersion of 12% was measured for nuclear recoils of approximately 60– $$90\,\hbox {keV}_{nr}$$ 90 keV nr , as compared to 18% for electron recoils depositing 60 keV of energy. The detector performance reported here meets the requirements needed to achieve the principal scientific goals of the ReD experiment in the search for a directional effect due to columnar recombination. A phenomenological parameterisation of the recombination probability in LAr is presented and employed for modeling the dependence of scintillation quenching and charge yield on the drift field for electron recoils between 50–500 keV and fields up to 1000 V/cm.

The GALILEO γ -ray spectrometer has been constructed at the Legnaro National Laboratory of INFN (LNL-INFN). It can be coupled to advanced ancillary devices which allows nuclear structure studies employing the variety of in-beam γ -ray spectroscopy methods. Such studies benefit from reactions induced by the intense stable beams delivered by the Tandem-ALPI-PIAVE accelerator complex and by the radioactive beams which will be provided by the SPES facility. In this paper we outline two experiments performed within the experimental campaign at GALILEO coupled to the EUCLIDES Si-ball and the Neutron Wall array. The first one was aimed at spectroscopic studies in A=31 mirror nuclei and the second one at measurements of lifetimes of excited states in nuclei in the vicinity of 100 Sn.

The decay of the 21.47-MeV stretched resonance in 13C, arising from p3/2→d5/2 nucleon excitation coupled to maximum spin, was investigated in a (p,p′) experiment at 135 MeV proton bombarding energy, performed at the Cyclotron Centre Bronowice (CCB) at IFJ PAN in Krakow. First experimental information on the proton and neutron decay branches from this state was obtained by using coincidence measurement of protons inelastically scattered on a 13C target and γ rays from daughter nuclei, namely, 12B (proton decay) and 12C (neutron decay). The main branches lead to the Jπ=2+, first-excited state at 0.953 MeV in 12B, and to the Jπ=1+, T=1 level at 15.110 MeV in 12C. The results were compared with predictions from the Gamow Shell Model (GSM), which was used to describe the stretched resonance in terms of its energy, width, electromagnetic transition strengths and decay pattern. A very good agreement was obtained between the measured and calculated properties of the 21.47-MeV stretched resonance in 13C, demonstrating the high-quality and precision of the GSM wave function calculations, which include coupling to the resonant and non-resonant particle continuum.

This study focused on the relations between vocational identity, future orientation, and resilience. Southern Italian high school students (N = 342) were assessed using the Vocational Identity Scale Assessment (VISA) and Design My Future to evaluate future orientation and resilience. Future orientation and resilience were correlated positively with commitment making, identification with commitment and exploration, and negatively with vocational flexibility and self-doubt. A cluster analysis revealed six aspects of vocational identity, whose relations with future orientation and resilience are explored. The results can support career programs in high school environments aimed to develop vocational identity construction, and provide suggestions for orientation programs.

The low-energy light radioactive ion beam in-flight facility EXOTIC and the associated experimental set-up,operational at Legnaro National Laboratories of the National Institute of Nuclear Physics (LNL-INFN, Italy) and designed for nuclear physics and nuclear astrophysics experiments, were described. The outline of the experimental program carried out employing the produced radioactive ion beams was presented and the perspectives of the EXOTIC project were discussed.

The recently-emerged amphibian chytrid fungus Batrachochytrium dendrobatidis (Bd) has had an unprecedented impact on global amphibian populations, and highlights the urgent need to develop effective mitigation strategies. We conducted in-situ antifungal treatment experiments in wild populations of the endangered mountain yellow-legged frog during or immediately after Bd-caused mass die-off events. The objective of treatments was to reduce Bd infection intensity (“load”) and in doing so alter frog-Bd dynamics and increase the probability of frog population persistence despite ongoing Bd infection. Experiments included treatment of early life stages (tadpoles and subadults) with the antifungal drug itraconazole, treatment of adults with itraconazole, and augmentation of the skin microbiome of subadults with Janthinobacterium lividum, a commensal bacterium with antifungal properties. All itraconazole treatments caused immediate reductions in Bd load, and produced longer-term effects that differed between life stages. In experiments focused on early life stages, Bd load was reduced in the 2 months immediately following treatment and was associated with increased survival of subadults. However, Bd load and frog survival returned to pre-treatment levels in less than 1 year, and treatment had no effect on population persistence. In adults, treatment reduced Bd load and increased frog survival over the entire 3-year post-treatment period, consistent with frogs having developed an effective adaptive immune response against Bd. Despite this protracted period of reduced impacts of Bd on adults, recruitment into the adult population was limited and the population eventually declined to near-extirpation. In the microbiome augmentation experiment, exposure of subadults to a solution of J. lividum increased concentrations of this potentially protective bacterium on frogs. However, concentrations declined to baseline levels within 1 month and did not have a protective effect against Bd infection. Collectively, these results indicate that our mitigation efforts were ineffective in causing long-term changes in frog-Bd dynamics and increasing population persistence, due largely to the inability of early life stages to mount an effective immune response against Bd. This results in repeated recruitment failure and a low probability of population persistence in the face of ongoing Bd infection.

Experimental fission studies for reaction physics or nuclear spectroscopy can profit from fast, efficient, and radiation-resistant fission fragment (FF) detectors. When such experiments are performed in-beam in intense thermal neutron beams, additional constraints arise in terms of target-detector interface, beam-induced background, etc. Therefore, wide gap semi-conductor detectors were tested with the aim of developing innovative instrumentation for such applications. The detector characterization was performed with mass- and energy-separated fission fragment beams at the ILL (Institut Laue Langevin) LOHENGRIN spectrometer. Two single crystal diamonds, three polycrystalline and one diamond-on-iridium as well as a silicon carbide detector were characterized as solid state ionization chamber for FF detection. Timing measurements were performed with a 500-µm thick single crystal diamond detector read out by a broadband amplifier. A timing resolution of ∼10.2 ps RMS was obtained for FF with mass A = 98 at 90 MeV kinetic energy. Using a spectroscopic preamplifier developed at INFN-Milano, the energy resolution measured for the same FF was found to be slightly better for a ∼50-µm thin single crystal diamond detector (∼1.4% RMS) than for the 500-µm thick one (∼1.6% RMS), while a value of 3.4% RMS was obtained with the 400-µm silicon carbide detector. The Pulse Height Defect (PHD), which is significant in silicon detectors, was also investigated with the two single crystal diamond detectors. The comparison with results from α and triton measurements enabled us to conclude that PHD leads to ∼50% loss of the initial generated charge carriers for FF. In view of these results, a possible detector configuration and integration for in-beam experiments has been discussed.

Background and Objectives: Medical students represent the ideal target group for promoting mental health and mental wellbeing, being exposed to specific risk factors, such as the content of medical training, the exposure to sickness and death, and a stressful academic routine. Medical students report high levels of cynicism and emotional exhaustion, which represent two of the essential features of burnout syndrome. In this systematic review, studies assessing the levels of burnout among medical students through validated tools worldwide were analyzed. Materials and Methods: A systematic review has been performed in order to identify studies: (1) focusing on samples of medical students; (2) evaluating burnout syndrome using validated tools; (3) providing prevalence data on burnout; and (4) written in English. Results: Out of the 5547 papers initially obtained, 64 were finally included in the analysis. The sample sizes ranged from 51 to 2682 participants. Almost all studies had a cross-sectional design; the Maslach Burnout Inventory and its related versions were the most frequently used assessment tools. The prevalence of burnout, which was stratified based on gender and academic stage, ranged from 5.6 to 88%. Burnout was mostly predicted by thoughts of stopping medical education, negative life events, lack of support, dissatisfaction, and poor motivation. Conclusions: The prevalence of burnout syndrome in medical students is quite heterogeneous, reaching a peak of 88% in some countries. However, several predictors have been identified, including negative life events or poor motivation. These findings highlight the need to develop preventive interventions targeting the future generation of medical doctors, in order to improve their coping strategies and resilience styles. [ABSTRACT FROM AUTHOR]

This paper discusses three case studies of early science museum-related websites in the 1990s and early 2000s, when web technology was still relatively new and evolving. The Virtual Museum of Computing (VMoC) was a completely virtual museum, originally produced in 1995 as part of the Virtual Library museums pages (VLmp), an international online museum directory within the WWW Virtual Library, adopted by the International Council of Museums (ICOM). The Science Museum in London was one of the first museums in the United Kingdom to have its own web server. The museum hosted an early meeting on web service provision by and for museums, concurrently with an exhibition on the Information Superhighway at the museum in 1995. Exhiblets were launched online in 1998. Ingenious was a multi-site digital collections transformation project, launched as a website in 2003. Virtual Leonardo and Leonardo's Ideal City were two experiments conducted by the digital team of the Science and Technology Museum of Milan, between 1999 and 2001. The experiment consisted of the creation of a shared online 3D world, namely a reconstruction of the real museum in the first case and a completely imaginary world in the second case. This paper describes the above three case studies from the early World Wide Web and then draws some conclusions, from first-hand experience of developments at the time. We cover both the advantages and the challenges encountered by the various projects and illustrate why they did not necessarily become established, despite promising early results. [ABSTRACT FROM AUTHOR]

This contribution describes the acquisition and trigger system for the HEPD-02 calorimeter that will be used onboard the CSES-02 satellite for the CSES/Limadou mission. This mission arises from the collaboration between the Chinese Space Agency (CNSA) and the Italian Space Agency (ASI) and plans the realization of a constellation of satellites which will monitor ionospheric parameters supposed to be related to earthquakes. It will also monitor the solar activity and the interaction with the magnetosphere and will study the cosmic rays in low energy ranges, extending data from PAMELA and AMS. The CSES-02 satellite will be equipped with various instruments, including the High-Energy Particle Detector (HEPD-02), which was designed to measure the energy of particles coming from Van Allen belts. Signals from the HEPD-02 are acquired and digitized by an electronic board that also produces the trigger for the experiment. A new generation ASIC (CITIROC) for the amplification, shaping and memorization of signals from PMTs will be used on this board. The new ASIC allows the use of the peak detector feature, optimizing the acquisition of signals with different temporal characteristics. Along with this, new algorithms for trigger generation have been developed, providing trigger pre-scaling, concurrent trigger masks and Gamma Ray Burst detection. Using pre-scaled concurrent triggers will allow the study of very sensitive regions of a satellite's orbit such as the South Atlantic Anomaly and polar regions and to detect rare events such as GRBs while still monitoring particle bursts. In this contribution, the progress status of this work will be presented along with the measurements and tests made to finalize the flight model of the board. [ABSTRACT FROM AUTHOR]

Introduction: Many patients fail to respond to multiple antidepressant interventions, being defined as "treatment-resistant depression" (TRD) patients. TRD is usually associated with increased severity and chronicity of symptoms, increased risk of comorbidity, and higher suicide rates, which make the clinical management challenging. Efforts to distinguish between TRD patients and those who will respond to treatment have been unfruitful so far. Several studies have tried to identify the biological, psychopathological, and psychosocial correlates of depression, with particular attention to the inflammatory system. In this paper we aim to review available studies assessing the full range of biomarkers in TRD patients in order to reshape TRD definition and improve its diagnosis, treatment, and prognosis. Methods: We searched the most relevant medical databases and included studies reporting original data on possible biomarkers of TRD. The keywords "treatment resistant depression" or "TRD" matched with "biomarker," "inflammation," "hormone," "cytokine" or "biological marker" were entered in PubMed, ISI Web of Knowledge and SCOPUS databases. Articles were included if they included a comparison with healthy controls (HC). Results: Of the 1878 papers identified, 35 were included in the present study. Higher plasma levels of IL-6 and TNF-" were detected in TRD patients compared to HC. While only a few studies on cortisol have been found, four papers showed elevated levels of C-reactive protein among these patients and four articles focused on immunological cells. Altered kynurenine metabolism in TRD patients was reported in two studies, while contrasting results were found with regard to BDNF. Conclusion: Only a few biological alterations correlate with TRD. TNF-α seems to be the most relevant biomarker to discriminate TRD patients from both HC and treatment-responsive MDD patients. Moreover, several discrepancies among studies have been found, due to methodological differences and the lack of a standardized diagnostic definition of TRD. [ABSTRACT FROM AUTHOR]

The G-NUMEN array is the future gamma spectrometer of the NUMEN experiment (nuclear matrix element for neutrinoless double beta decay), to be installed around the object point of the MAGNEX magnetic spectrometer at the INFN-LNS laboratory. This project aims to explore double-charge exchange (DCE) reactions in order to obtain crucial information about neutrinoless double beta decay (0νββ). The primary objective of the G-NUMEN array is to detect the gamma rays emitted from the de-excitation of the excited states that are populated via DCE reactions with a good energy resolution and detection efficiency, amidst a background composed of the transitions from competing reaction channels with far higher cross sections. To achieve this, G-NUMEN signals will be processed in coincidence with those generated by the detection of reaction ejectiles by the MAGNEX focal plane detector (FPD). Under the expected experimental conditions, G-NUMEN detectors will operate at high counting rates, of the order of hundreds of kHz per detector, while maintaining excellent energy and timing resolutions. The complete array will consist of over 100 LaBr3(Ce) scintillators. Initial tests were conducted on the first detectors of the array, allowing for the determination of their performance at high rates. [ABSTRACT FROM AUTHOR]

Brain-derived neurotrophic factor (BDNF) plays a key role in brain development, contributing to neuronal survival and neuroplasticity. Previous works have found that BDNF is involved in several neurological or psychiatric diseases. In this review, we aimed to collect all available data on BDNF and bipolar disorder (BD) and assess if BDNF could be considered a biomarker for BD. We searched the most relevant medical databases and included studies reporting original data on BDNF circulating levels or Val66Met polymorphism. Only articles including a direct comparison with healthy controls (HC) and patients diagnosed with BD according to international classification systems were included. Of the 2430 identified articles, 29 were included in the present review. Results of the present review show a reduction in BDNF circulating levels during acute phases of BD compared to HC, which increase after effective therapy of the disorders. The Val66Met polymorphism was related to features usually associated with worse outcomes. High heterogeneity has been observed regarding sample size, clinical differences of included patients, and data analysis approaches, reducing comparisons among studies. Although more studies are needed, BDNF seems to be a promising biomarker for BD. [ABSTRACT FROM AUTHOR]

This study aims to assess the efficacy of a psychoeducational family intervention (PFI) to reduce the severity of depressive symptoms and to improve psychosocial functioning and to increase social contacts in a sample of patients with major depressive disorder (MDD). The degree to which PFI will reduce patients' relapses, hospitalizations, and self-stigmatization and will improve their quality of life will also be assessed. Other secondary outcomes include the improvement of relatives' coping strategies, family burden, expressed emotions and quality of life. This non-profit, unfunded, national, multicentric randomized controlled trial with blinded outcome assessments will be carried out in 24 Italian university outpatient units. Families will be assessed at baseline and at 6, 12, and 24 months post-randomization. Our working hypothesis is that the PFIs will reduce the patients' severity of depressive symptoms, their relapses, and their hospitalizations, and that they will improve their psychosocial functioning and quality of life. We expect these results to be maintained after 12 and 24 months, albeit with a reduction in magnitude. The sample will consist of 384 patients randomized at a 1:1 ratio and stratified according to center, age, gender, and educational level. [ABSTRACT FROM AUTHOR]