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4. Consequences of the COVID-19 pandemic on admissions to general hospital psychiatric wards in Italy: Reduced psychiatric hospitalizations and increased suicidality

Author

Boldrini, T, Girardi, P, Clerici, M, Conca, A, Creati, C, Di Cicilia, G, Ducci, G, Durbano, F, Maci, C, Maone, A, Nicolo, G, Oasi, O, Percudani, M, Polselli, G, Pompili, M, Rossi, A, Salcuni, S, Tarallo, F, Vita, A, Lingiardi, V, Barlati, S, de Bertoldi, F, Carnaghi, G, Chiesa, G, Dell'Erba, A, Elmo, M, Malvini, L, Monaco, L, Erbuto, D, Pessina, R, Pontillo, M, Riggio, F, Rossi, C, Santorelli, M, Lomoriello, A, Tamorri, S, Venturini, P, Vicari, S, Boldrini T., Girardi P., Clerici M., Conca A., Creati C., Di Cicilia G., Ducci G., Durbano F., Maci C., Maone A., Nicolo G., Oasi O., Percudani M., Polselli G. M., Pompili M., Rossi A., Salcuni S., Tarallo F., Vita A., Lingiardi V., Barlati S., de Bertoldi F., Carnaghi G., Chiesa G. L., Dell'Erba A., Elmo M. G., Malvini L., Monaco L., Erbuto D., Pessina R. L., Pontillo M., Riggio F., Rossi C., Santorelli M., Lomoriello A. S., Tamorri S. M., Venturini P., Vicari S., Boldrini, T, Girardi, P, Clerici, M, Conca, A, Creati, C, Di Cicilia, G, Ducci, G, Durbano, F, Maci, C, Maone, A, Nicolo, G, Oasi, O, Percudani, M, Polselli, G, Pompili, M, Rossi, A, Salcuni, S, Tarallo, F, Vita, A, Lingiardi, V, Barlati, S, de Bertoldi, F, Carnaghi, G, Chiesa, G, Dell'Erba, A, Elmo, M, Malvini, L, Monaco, L, Erbuto, D, Pessina, R, Pontillo, M, Riggio, F, Rossi, C, Santorelli, M, Lomoriello, A, Tamorri, S, Venturini, P, Vicari, S, Boldrini T., Girardi P., Clerici M., Conca A., Creati C., Di Cicilia G., Ducci G., Durbano F., Maci C., Maone A., Nicolo G., Oasi O., Percudani M., Polselli G. M., Pompili M., Rossi A., Salcuni S., Tarallo F., Vita A., Lingiardi V., Barlati S., de Bertoldi F., Carnaghi G., Chiesa G. L., Dell'Erba A., Elmo M. G., Malvini L., Monaco L., Erbuto D., Pessina R. L., Pontillo M., Riggio F., Rossi C., Santorelli M., Lomoriello A. S., Tamorri S. M., Venturini P., and Vicari S.

Abstract

Aims: The present investigation aimed at evaluating differences in psychiatric hospitalizations in Italy during and after the lockdown due to the novel coronavirus disease 2019 (COVID-19), compared to the same periods in 2018 and 2019. Methods: We obtained and analyzed anonymized data on psychiatric admissions (n = 4550) from 12 general hospital psychiatric wards (GHPWs) in different Italian regions (catchment area = 3.71 millions of inhabitants). Using a mixed-effects Poisson regression model, we compared admission characteristics across three periods: (a) March 1–June 30, 2018 and 2019; (b) March 1–April 30, 2020 (i.e., lockdown); and (c) May 1–June 30, 2020 (i.e., post-lockdown). Results: During the COVID-19 lockdown, there was a 41% reduction (IRR = 0.59; p < 0.001, CI: 0.45–0.79) in psychiatric admissions in the enrolled GHPWs with respect to the 2018 and 2019 control period. Conversely, admission rates in the post-lockdown period were similar to those observed in the control period. Notably, a consistent and significant reduction in psychiatric hospitalizations of older patients (aged >65 years) was observed in the lockdown (40%; IRR = 0.60; 95% CI: 0.44–0.82) and post-lockdown (28%; IRR = 0.72; 95% CI: 0.54–0.96) periods. Long-stay admissions (>14 days) increased (63%; IRR = 1.63; 95% CI: 1.32–2.02) during the lockdown and decreased by 39% thereafter (IRR = 0.61; 95% CI: 0.49–0.75). A significant 35% increase in patients reporting suicidal ideation was observed in the post-lockdown period, compared to the rate observed in the 2018 and 2019 control period (IRR = 1.35; 95% CI: 1.01–1.79). Conclusion: The COVID-19 lockdown was associated with changes in the number of psychiatric admissions, particularly for older patients and long-stay hospitalizations. Increased admission of patients reporting suicidal ideation in the post-lockdown period merits special attention. Further studies are required to gain insight into the observed phenomena.

Published
2021

12. Consequences of the COVID-19 pandemic on admissions to general hospital psychiatric wards in Italy: Reduced psychiatric hospitalizations and increased suicidality

Author

Boldrini, Marco Tobia Mario, Girardi, P., Clerici, Anna Marina, Conca, A., Creati, C., Di Cicilia, G., Ducci, G., Durbano, F., Maci, C., Maone, A., Nicolo, G., Oasi, Osmano, Percudani, M., Polselli, G. M., Pompili, M., Rossi, A., Salcuni, S., Tarallo, F., Vita, A., Lingiardi, Vittorio, Barlati, S., de Bertoldi, F., Carnaghi, G., Chiesa, G. L., Dell'Erba, A., Elmo, M. G., Malvini, Lara, Monaco, L., Erbuto, D., Pessina, R. L., Pontillo, M., Riggio, F., Rossi, Chiara, Santorelli, M., Lomoriello, A. S., Tamorri, S. M., Venturini, P., Vicari, Stefano, Boldrini T., Clerici M., Oasi O. (ORCID:0000-0003-2134-397X), Lingiardi V., Malvini L., Rossi C. (ORCID:0000-0002-3570-2710), Vicari S. (ORCID:0000-0002-5395-2262), Boldrini, Marco Tobia Mario, Girardi, P., Clerici, Anna Marina, Conca, A., Creati, C., Di Cicilia, G., Ducci, G., Durbano, F., Maci, C., Maone, A., Nicolo, G., Oasi, Osmano, Percudani, M., Polselli, G. M., Pompili, M., Rossi, A., Salcuni, S., Tarallo, F., Vita, A., Lingiardi, Vittorio, Barlati, S., de Bertoldi, F., Carnaghi, G., Chiesa, G. L., Dell'Erba, A., Elmo, M. G., Malvini, Lara, Monaco, L., Erbuto, D., Pessina, R. L., Pontillo, M., Riggio, F., Rossi, Chiara, Santorelli, M., Lomoriello, A. S., Tamorri, S. M., Venturini, P., Vicari, Stefano, Boldrini T., Clerici M., Oasi O. (ORCID:0000-0003-2134-397X), Lingiardi V., Malvini L., Rossi C. (ORCID:0000-0002-3570-2710), and Vicari S. (ORCID:0000-0002-5395-2262)

Abstract

Aims: The present investigation aimed at evaluating differences in psychiatric hospitalizations in Italy during and after the lockdown due to the novel coronavirus disease 2019 (COVID-19), compared to the same periods in 2018 and 2019. Methods: We obtained and analyzed anonymized data on psychiatric admissions (n = 4550) from 12 general hospital psychiatric wards (GHPWs) in different Italian regions (catchment area = 3.71 millions of inhabitants). Using a mixed-effects Poisson regression model, we compared admission characteristics across three periods: (a) March 1–June 30, 2018 and 2019; (b) March 1–April 30, 2020 (i.e., lockdown); and (c) May 1–June 30, 2020 (i.e., post-lockdown). Results: During the COVID-19 lockdown, there was a 41% reduction (IRR = 0.59; p < 0.001, CI: 0.45–0.79) in psychiatric admissions in the enrolled GHPWs with respect to the 2018 and 2019 control period. Conversely, admission rates in the post-lockdown period were similar to those observed in the control period. Notably, a consistent and significant reduction in psychiatric hospitalizations of older patients (aged >65 years) was observed in the lockdown (40%; IRR = 0.60; 95% CI: 0.44–0.82) and post-lockdown (28%; IRR = 0.72; 95% CI: 0.54–0.96) periods. Long-stay admissions (>14 days) increased (63%; IRR = 1.63; 95% CI: 1.32–2.02) during the lockdown and decreased by 39% thereafter (IRR = 0.61; 95% CI: 0.49–0.75). A significant 35% increase in patients reporting suicidal ideation was observed in the post-lockdown period, compared to the rate observed in the 2018 and 2019 control period (IRR = 1.35; 95% CI: 1.01–1.79). Conclusion: The COVID-19 lockdown was associated with changes in the number of psychiatric admissions, particularly for older patients and long-stay hospitalizations. Increased admission of patients reporting suicidal ideation in the post-lockdown period merits special attention. Further studies are required to gain insight into the observed phenomena.

Published
2021

27. Radical Innovation and End-User Involvement: The Ambilight Case

Author

Henriette C. M. Hoonhout and Elmo M. A. Diederiks

Subjects
Engineering, Philosophy of science, Ambilight, Knowledge management, business.industry, Product innovation, End user, Perspective (graphical), law.invention, Competition (economics), History and Philosophy of Science, law, Product (category theory), business, Social Sciences (miscellaneous), Philosophy of technology
Abstract

To make technology research more effective and to deal with fierce cost competition, technology research should be more focused on radical innovation and needs to adopt a more end-user-focused approach. Product improvement is already quite often building on knowledge collected around consumers’ experiences with these products to come with a next, improved generation of products. However, in case of creating novel products from “scratch,” this will be more difficult. The user-centered research approach including insights, scenarios, and experience prototypes provides a good method to incorporate the consumer perspective in the earliest stages of the product creation process. The development of the Ambilight TV will be used as a case to illustrate this approach.

Published
2007
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28. Diaphragm Dysfunction from Covid-19 Phrenic Neuropathy: Utilization of Diaphragm Pacing for Recovery.

Author

Onders, R., Elmo, M., Carl, N., Hejal, R., and Schilz, R.

Subjects
*DIAPHRAGM (Anatomy), *PHRENIC nerve, *COVID-19, *CHEST X rays, *ELECTRIC stimulation, *NONINVASIVE ventilation, *ARTIFICIAL respiration
Abstract

Literature identifies 4.1% patients with an elevated diaphragm post COVID-19 pneumonia secondary to neuropathy. 7% of lung transplantations were performed secondary to COVID-19. Diaphragm pacing(DP) has been shown to help in recovery of phrenic/diaphragm dysfunction (DD) in 86% of patients. We report our experience of DP in phrenic/DD post COVID-19. This is a retrospective analysis of prospective non-randomized interventional experiences at a single institution of an FDA approved humanitarian use device under IRB approval. Two intramuscular electrodes were placed in each diaphragm and electrical stimulation was begun immediately post-operatively to facilitate diaphragm strengthening and phrenic nerve recovery. Serial diaphragmatic electromyography (dEMG) through the implanted electrodes, chest radiographs (CXR), and ventilation use identified. All patients implanted with diaphragm pacers from 1/1/2020 to 9/1/22 were reviewed. 5 out of 262 patients were identified with phrenic/DD secondary to COVID-19. None of the patients had elevated diaphragms prior to COVID-19. Average age was 57(range 39-62) with 2 females. Time from COVID-19 to surgery was 6 months (range 1-9 months). One had bilateral phrenic/DD the remainder (4) had unilateral involvement. Two patients were on invasive mechanical ventilation: 1 had complete recovery of phrenic/diaphragms with decannulation of tracheostomy and the other withdrew life support and expired. The three remaining patients had outpatient implantation for unilateral DD; all showing recovery through dEMG analysis and are still utilizing DP. Intra-operative evaluation of the diaphragm and post-operative evaluation with dEMG confirmed all patients had phrenic neuropathy that led to DD. There were no implantation complications or device related morbidity. Phrenic nerve dysfunction and DD may contribute to post-acute sequela of COVID-19 leading to breathlessness. DP was safely used in this report and improved recovery of the involved phrenic nerves and diaphragms. Phrenic nerve dysfunction should be identified prior to lung transplant for possible rehabilitation prior to transplant. There is now also the availability of a temporary DP system that can be placed at the time of lung transplant which would allow earlier recognition and therapy for phrenic nerve or diaphragm dysfunction. [ABSTRACT FROM AUTHOR]

Published
2023
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29. The experience of being connected

Author

Elmo M. A. Diederiks and Richard van de Sluis

Subjects
Multimedia, Computer Networks and Communications, Computer science, business.industry, Broadband connection, computer.software_genre, Human-Computer Interaction, Broadband, Isolation (psychology), Active listening, Videophone, The Internet, business, computer, Computer communication networks, Software, Information Systems
Abstract

The rapid spread of broadband always-on Internet is expected to change the way people will communicate and share content and experiences in the near future. This broadband connection can enhance the communication among family members and friends. It can also make it easy to share content and activities such as watching a movie together or listening to the same music while having a videophone chat. While using all these functions people want to be able to move freely through their home. The advance of portable devices fulfils this need for mobility. These portable devices can be used either in isolation or in co-operation with the stationary devices in the house. This paper describes the development and evaluation of two novel interaction concepts that support sociability and mobility for people inhabiting the connected home.

Published
2004
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32. Combined multistep approach in a locally advanced rectal cancer with sacral invasion: case report

Author

Delrio P, Fazioli F, Di Marzo M, Antonio Avallone, Elmo M, Pecori B, Ravo V, Dn, Idà, Bianchi P, Cremona F, De Rosa V, and Parisi V

Subjects
Adult, Male, Sacrum, Rectal Neoplasms, Humans, Bone Neoplasms, Neoplasm Invasiveness, Combined Modality Therapy
Abstract

Composite pelvic resection with sacrectomy may provide good local control in case of locally advanced rectal cancer infiltrating the sacral bone. A combined multidisciplinary approach including chemotherapy and radiotherapy is here presented for a case of rectal tumor invading the sacrum.

Published
2006

33. [Primary neuroectodermal tumor with unusual spinal cord localization. A case report]

Author

Covelli EM, Stefano ML, Panico L, Elmo M, Frezza P, BRUNETTI, ARTURO, Covelli, Em, Stefano, Ml, Panico, L, Elmo, M, Frezza, P, and Brunetti, Arturo

Subjects
Male, Time Factors, Adolescent, spinal cord, neuroectodermal tumor, Humans, Neuroectodermal Tumors, Primitive, Radiotherapy Dosage, Spinal Cord Neoplasms, Particle Accelerators, Magnetic Resonance Imaging, Follow-Up Studies
Abstract

Description of imaging findings (case report) of a spinal localization of a primary neuroectodermal tumor

Published
1995

34. Temporary Diaphragm Pacing Wires in Lung Transplant Patients: Diagnostic and Therapeutic Utilization.

Author

Onders, R., Elmo, M., Carl, N., Elgudin, Y., Abu-Omar, Y., Pelletier, M., and Schilz, R.

Subjects
*LUNG transplantation, *ELECTRIC stimulation, *PHRENIC nerve, *DIAPHRAGM (Anatomy), *NEURAL stimulation, *KIDNEY transplantation, *RESPIRATORY muscles
Abstract

Three recent prospective publications have identified diaphragmatic dysfunction (DD) in up to 62% of patients after lung transplantation secondary to phrenic nerve neuropraxia or moderate axonotmesis. Diaphragm pacing (DP) prevents ventilator induced diaphragm dysfunction (VIDD) while on mechanical ventilation (MV) and improves phrenic nerve recovery via functional electrical stimulation. This is a single center prospective observational cohort analysis of lung transplant recipients utilizing a new FDA authorized DP system. Prior to chest closure two temporary DP electrodes were placed in each hemi-diaphragm exiting percutaneously. The electrodes monitor and record diaphragm burst electromyography (dEMG). DP stimulation ensued if needed to wean from MV or for nerve recovery using disposable multi-channel stimulator generating a fused diaphragm contraction. From 4/2020 through 8/22, 17 lung transplant patients had DP electrodes implanted (15 bilateral and 2 right unilateral). Average age was 55(24-70) with 11 females. Average anesthesia time for transplant 8.4 hours (6-10). There were no device related complications. EMG analysis and appropriate stimulation was achieved in all. Based on initial and subsequent dEMG analysis, patients were divided into 4 specific groups. Group one: excellent dEMG (5 patients), no DP stimulation and average MV time was 19.8 hours (range 9.5 to 44). Group two: absent or decreased dEMG (6 patients), DP stimulation and subsequent recovery, average MV of 52.6 hours (7-152) and DP use of 15 days (8-28 days). Group three:(2 patients) pre-operative hyperinflation of lungs and post-op absent dEMG activity until recovery of dEMG with DP stimulation at 20 and 186 days with MV of 20 hours and 22 days(tracheostomy). Group 3 patients most likely had diaphragm dysfunction pre-operatively with abnormal respiratory neuroplasticity utilizing accessary muscles and not diaphragm. Group four:(4 patients), absent dEMG activity and no recovery, 3 prolonged tracheostomy MV, 1 plication and 3 deaths at 2, 6 and 18 months post-transplant. Temporary DP electrodes through dEMG can help predict patient's prognosis by identifying phrenic nerve/DD immediately postoperatively. DP can be used therapeutically to prevent VIDD and facilitate and monitor recovery. Future studies can further elucidate benefits. [ABSTRACT FROM AUTHOR]

Published
2023
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35. From Imagination to Experience: The Role of Feasibility Studies in Gathering Requirements for Ambient Intelligent Products

Author

Tatiana Aleksandrovna Lashina, Elmo M. A. Diederiks, and Andrés Lucero

Subjects
Imagination, Product (business), Ambient calculus, business.industry, Computer science, media_common.quotation_subject, Perspective (graphical), Design process, Artificial intelligence, business, Data science, media_common
Abstract

From a User-Centered Design perspective, technology pushes are often regarded to as negative because the ideas behind these pushes not always address user needs, often causing products to fail in the market. Feasibility studies help close the gap between technology pushes and demand pulls. By inviting users to witness feasibility studies in an early stage of a design process, participants not only are able to provide input long before full functionality has been developed, but it also allows them to make that important step from imagining what an Ambient Intelligent product can do for them in their daily lives, to actually experiencing it.

Published
2004
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36. Sociability and Mobility Concepts for the Connected Home

Author

Elmo M. A. Diederiks, Ramon E. F. Van De Ven, and Richard van de Sluis

Subjects
business.product_category, business.industry, Computer science, Internet access, The Internet, Isolation (database systems), Telecommunications, business
Abstract

The functionality offered by interconnected devices in a networked home will be drastically increased by the possibilities of always-on broadband Internet. This broadband connection can enhance the communication among family members and friends. It can also make it easy to share content and activities such as watching a movie together or listen to the same music while having a videophone chat. While using all these functions people want to be able to move freely through their home. The advance of portable devices fulfils this need for mobility. These portable devices can be used either in isolation or in co-operation with the stationary devices in the house. Two novel interaction concepts are described that support sociability and mobility for people inhabiting the connected home.

Published
2003
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37. Energy loss for electrons in the Heliosphere and local interstellar spectrum for solar modulation

Author

Giani, S, Leroy, C, Rancoita, PG, Bobik, P, Boella, G, Boschini, M, Consolandi, C, Della Torre, S, Gervasi, M, Grandi, D, Elmo, M, Kudela, K, Memola, E, Pensotti, S, Rancoita, P, Rozza, D, Tacconi, M, Boschini, MJ, ROZZA, DAVIDE, BOELLA, GIULIANO FILIPPO, CONSOLANDI, CRISTINA, GERVASI, MASSIMO, PENSOTTI, SIMONETTA, TACCONI, MAURO, Giani, S, Leroy, C, Rancoita, PG, Bobik, P, Boella, G, Boschini, M, Consolandi, C, Della Torre, S, Gervasi, M, Grandi, D, Elmo, M, Kudela, K, Memola, E, Pensotti, S, Rancoita, P, Rozza, D, Tacconi, M, Boschini, MJ, ROZZA, DAVIDE, BOELLA, GIULIANO FILIPPO, CONSOLANDI, CRISTINA, GERVASI, MASSIMO, PENSOTTI, SIMONETTA, and TACCONI, MAURO

Abstract

Galactic Cosmic Rays (GCR) entering the Heliosphere are a®ected by the solar modulation, a combination of di®usion, convection, magnetic drift and adiabatic energy loss usually seen as a decrease in the °ux at low energy (less than » 10 GeV). We have improved a quasi time-dependent 2D Stochastic Simulation code describing this e®ects. We focused our attention on the electron modulation, adding energy losses in the Heliosphere that can be neglected for protons and ions: inverse Compton, ionization, synchrotron and bremsstrahlung. These effects have been evaluated in the region affected by the solar magnetic field, up to 100 AU, where the environment conditions are not constant, especially the magnetic field intensity and the photon density. In our calculation the inverse compton energy losses are dominant, but they contribute only a few percent in comparison with the adiabatic losses. We also compared the Local Interstellar Spectrum (LIS) of primary electrons with experimental data collected in the past years at energies > 20 GeV. We found that, inside one standard deviation, LIS fits the data and can be used in a Monte carlo code reproducing CR propagation in the Heliosphere.

Published
2011

39. ENERGY LOSS FOR ELECTRONS IN THE HELIOSPHERE AND LOCAL INTERSTELLAR SPECTRUM FOR SOLAR MODULATION

Author

Bobik, P., primary, Boella, G., additional, Boschini, M.J., additional, Consolandi, C., additional, Della Torre, S., additional, Gervasi, M., additional, Grandi, D., additional, Elmo, M., additional, Kudela, K., additional, Memola, E., additional, Pensotti, S., additional, Rancoita, P.G., additional, Rozza, D., additional, and Tacconi, M., additional

Published
2011
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