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A pilot study to investigate possible differences between a virtual reality-based neurofeedback and a traditional neurofeedback is presented. Neurofeedback training aimed to strengthen the emotional regulation capacity. The neurofeedback task is to down-regulate negative emotions by decreasing the beta band power measured in the midline areas of the scalp (i.e., Fcz-Cpz). Negative International Affective Picture System images were chosen as eliciting stimuli. Three healthy subjects participated in the experimental activities. Each of them underwent three VR-based neurofeedback sessions and three neurofeedback sessions delivered on a traditional 2D screen. The neurofeedback training session was preceded by a calibration phase allowing to record the rest and the baseline values to adapt the neurofeedback system to the user. For the majority of sessions, the average value of the high beta band power during the neurofeedback training remained below the baseline, as expected. In compliance with previous studies, future works should investigate the virtual reality-based neurofeedback efficacy in physiological responses and behavioral performance.

This work details the latest advancements on a single-channel, reactive Brain-Computer Interfaces developed at the Interdepartmental Research Center in Health Management and Innovation in Healthcare (CIRMIS) of the University of Naples Federico II. The proposed instrumentation is based on Extended Reality (XR) and exploits the acquisition and classification of the Steady-State Visually Evoked Potentials (SSVEPs). In particular, an XR headset is employed for generating the flickering stimuli necessary to the SSVEP elicitation. The users brain signals are captured by means of a highly wearable and portable electroencephalografic acquisition unit, which is connected to a portable processing unit in charge of processing in real time the incoming data. In this way, a deeper interaction between users and external devices with respect to traditional architectures is guaranteed. The classification capability of the proposed instrument has been significantly improved over the years. Currently, in fact, a classification accuracy up to 90 % is obtained with at least 2 s of acquisition time.

Aim: To investigate the potential association among Craniopharyngioma (CP), chronotypes and metabolic risk profile. Subjects and Methods: The study population included 28 patients (46.4% males; 42.6 ± 15.8 years) and 28 controls, age, gender and BMI matched (46.4% males; 46.5 ± 12.9 years). In this study sample, we evaluated: anthropometric measurements (waist circumference, WC; BMI), plasma glucose, lipid profile, and systolic (SBP) and diastolic (DBP) blood pressure. Morningness-Eveningness was measured with the Horne-Ostberg Morningness-Eveningness Questionnaire (MEQ), which included 19 questions about preferred sleep time and daily performance. Results: in both patients and controls grade I obesity was detected in 15 subjects (53.6%), grade II obesity in 13 subjects (46.4%). In the patient group, the mean score of chronotype was 47.8 ± 12.6. In particular, 9 patients (32.1%) exhibited the morning chronotype, 6 (21.4%) the intermediate chronotype and 13 (46.4.%) the evening chronotype. No significant difference was found in gender and age among the chronotype categories. Patients with the evening chronotype had higher blood pressure values and worse metabolic parameters than those with the morning chronotype. In the control group, the mean score of the chronotype was 57.6 ± 9.5. In particular, 16 (57.1%) subjects exhibited the morning chronotype, 10 (35.7%) the intermediate chronotype and only 2 (7.1.%) the evening chronotype. The prevalence of intermediate and evening chronotypes was higher in females than males (p = 0.021), while males have a higher prevalence of the morning chronotype. Subjects with intermediate and evening chronotypes had worse metabolic parameters than those with the morning chronotype. In patients, the chronotype score was inversely correlated to WC, BMI, SBP, DBP, plasma glucose, total cholesterol, triglycerides, LDL cholesterol and positively correlated with HDL cholesterol. No correlation was found between age and chronotype. In controls, the chronotype score was inversely correlated to WC, BMI, plasma glucose, total cholesterol, LDL cholesterol. No correlation was found among chronotype and age, blood pressure, triglycerides, HDL cholesterol. Considering the whole population of the study (patients and controls), at logistic regression the chronotype score was significantly associated with the presence of CP. Conclusions: for the first time thus far, our study puts the light on the association of the CP with chronotypes and metabolic alterations in this disease, which are the main determinants of the reduced quality of life, higher morbidity and mortality in this setting of patients. This finding suggests that alterations of chronotype might represent an adjunctive risk for CP patients and a possible target for their integrate management.

Background: Guidelines on Irritable Bowel Syndrome (IBS) are usually developed by specialists, with a possible translational gap in primary care. Aims: To evaluate the knowledge of IBS of Italian General Practitioners (GPs) and the difference compared to doctors in Training for General Practice (ITGPs). Methods: A questionnaire was completed by 170 GPs and 64 ITGPs. Results: The Rome Criteria and Bristol Scale are more familiar to ITGPs than GPs. The most frequently used diagnostic symptoms are abdominal pain, bowel movement frequency and bloating. GPs and ITGPs think that bloating and abdominal discomfort should be introduced into the definition of IBS. Intestinal motility disorders and psychological factors are considered to be the most probable cause of IBS. GPs report more frequently than ITGPs that the patient's request and difficulties in managing the disorder are reasons for a gastroenterological referral. Conclusions: There is still a gap between the indications provided by the experts and clinical practice, and this seems greater on the part of GPs than ITGPs. Abdominal pain and bowel frequency changes are considered the main symptoms for diagnosing IBS, but most GPs and ITGPs would like to include bloating among the diagnostic criteria. It would be highly desirable to develop commonly shared guidelines between gastroenterologists and GPs.

This paper proposes an augmented reality (AR)-based system for monitoring patient's vitals in the operating room (OR) is proposed. An optical see-through (OST) headset, worn by the anesthetist or by the OR nurses, shows in real-time the patient's vitals acquired from the electromedical equipment available in the OR. A dedicated application was developed to allow a hands-free fruition of the AR content. Experimental tests were carried out acquiring the vital parameters from two pieces of equipment typically available in the OR, namely a ventilator and a monitor. The experimental assessment of the transmission error rate and of latency demonstrated the reliability of the proposed AR-based monitoring system.