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Perra A, Sancassiani F, Cantone E, Pintus E, D’Oca S, Casula A, Littarru S, Zucca S, Tumolillo D, Pinna I, Primavera D, Cossu G, Nardi AE, Kalcev G, Carta MG. An e-Health Psychoeducation Program for Managing the Mental Health of People with Bipolar Disorder during the COVID-19 Pandemic: A Randomized Controlled Study. J Clin Med 2024; 13:3468. [PMID: 38929997 PMCID: PMC11204713 DOI: 10.3390/jcm13123468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Revised: 06/06/2024] [Accepted: 06/11/2024] [Indexed: 06/28/2024] Open
Abstract
Background: Social rhythm dysregulation has been identified as a determining factor in bipolar disorder (BD) relapses. It directly impacts individuals' quality of life (QoL). This study aims to present preliminary data on the efficacy of an e-health psychoeducational intervention for BD for improving clinical outcomes. Methods: This study used an open-label, crossover, randomized controlled trial design. The inclusion criteria consisted of a BD diagnosis, affiliation with the Consultation Psychiatry and Psychosomatic Center at the University Hospital in Cagliari, Italy, age over 18, and the obtaining of informed consent. Anxiety and depressive symptoms, QoL, and social and biological rhythms were measured using standardized instruments validated in Italian. Results: A total of 36 individuals were included in the experimental group (EG) and 18 in the control group (CG). The final sample consisted of 25 in the EG and 14 in the CG. A statistically significant improvement in QoL was found in the EG post-treatment (p = 0.011). Significant correlations were found between QoL and the dysregulation of biorhythms in the EG at T0 (p = 0.0048) and T1 (p = 0.0014). Conclusions: This study shows that, during extreme distress, an e-health group psychoeducation intervention for people with BD could significantly improve the perception of QoL. The results must be confirmed by studies conducted with larger-sized samples.
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Affiliation(s)
- Alessandra Perra
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria, S.P. Monserrato-Sestu km 0,700, 09042 Cagliari, Italy; (A.P.); (F.S.); (E.C.); (E.P.); (S.D.); (A.C.); (S.L.); (S.Z.); (D.T.); (I.P.); (D.P.); (G.C.); (M.G.C.)
| | - Federica Sancassiani
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria, S.P. Monserrato-Sestu km 0,700, 09042 Cagliari, Italy; (A.P.); (F.S.); (E.C.); (E.P.); (S.D.); (A.C.); (S.L.); (S.Z.); (D.T.); (I.P.); (D.P.); (G.C.); (M.G.C.)
| | - Elisa Cantone
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria, S.P. Monserrato-Sestu km 0,700, 09042 Cagliari, Italy; (A.P.); (F.S.); (E.C.); (E.P.); (S.D.); (A.C.); (S.L.); (S.Z.); (D.T.); (I.P.); (D.P.); (G.C.); (M.G.C.)
| | - Elisa Pintus
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria, S.P. Monserrato-Sestu km 0,700, 09042 Cagliari, Italy; (A.P.); (F.S.); (E.C.); (E.P.); (S.D.); (A.C.); (S.L.); (S.Z.); (D.T.); (I.P.); (D.P.); (G.C.); (M.G.C.)
| | - Silvia D’Oca
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria, S.P. Monserrato-Sestu km 0,700, 09042 Cagliari, Italy; (A.P.); (F.S.); (E.C.); (E.P.); (S.D.); (A.C.); (S.L.); (S.Z.); (D.T.); (I.P.); (D.P.); (G.C.); (M.G.C.)
| | - Alessio Casula
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria, S.P. Monserrato-Sestu km 0,700, 09042 Cagliari, Italy; (A.P.); (F.S.); (E.C.); (E.P.); (S.D.); (A.C.); (S.L.); (S.Z.); (D.T.); (I.P.); (D.P.); (G.C.); (M.G.C.)
| | - Sara Littarru
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria, S.P. Monserrato-Sestu km 0,700, 09042 Cagliari, Italy; (A.P.); (F.S.); (E.C.); (E.P.); (S.D.); (A.C.); (S.L.); (S.Z.); (D.T.); (I.P.); (D.P.); (G.C.); (M.G.C.)
| | - Sara Zucca
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria, S.P. Monserrato-Sestu km 0,700, 09042 Cagliari, Italy; (A.P.); (F.S.); (E.C.); (E.P.); (S.D.); (A.C.); (S.L.); (S.Z.); (D.T.); (I.P.); (D.P.); (G.C.); (M.G.C.)
| | - Davide Tumolillo
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria, S.P. Monserrato-Sestu km 0,700, 09042 Cagliari, Italy; (A.P.); (F.S.); (E.C.); (E.P.); (S.D.); (A.C.); (S.L.); (S.Z.); (D.T.); (I.P.); (D.P.); (G.C.); (M.G.C.)
| | - Irene Pinna
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria, S.P. Monserrato-Sestu km 0,700, 09042 Cagliari, Italy; (A.P.); (F.S.); (E.C.); (E.P.); (S.D.); (A.C.); (S.L.); (S.Z.); (D.T.); (I.P.); (D.P.); (G.C.); (M.G.C.)
| | - Diego Primavera
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria, S.P. Monserrato-Sestu km 0,700, 09042 Cagliari, Italy; (A.P.); (F.S.); (E.C.); (E.P.); (S.D.); (A.C.); (S.L.); (S.Z.); (D.T.); (I.P.); (D.P.); (G.C.); (M.G.C.)
| | - Giulia Cossu
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria, S.P. Monserrato-Sestu km 0,700, 09042 Cagliari, Italy; (A.P.); (F.S.); (E.C.); (E.P.); (S.D.); (A.C.); (S.L.); (S.Z.); (D.T.); (I.P.); (D.P.); (G.C.); (M.G.C.)
| | - Antonio Egidio Nardi
- Institute of Psychiatry, Federal University of Rio de Janeiro, Rua Visconde de Piraja 407/702, Rio de Janeiro 21941-972, Brazil;
| | - Goce Kalcev
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria, S.P. Monserrato-Sestu km 0,700, 09042 Cagliari, Italy; (A.P.); (F.S.); (E.C.); (E.P.); (S.D.); (A.C.); (S.L.); (S.Z.); (D.T.); (I.P.); (D.P.); (G.C.); (M.G.C.)
| | - Mauro Giovanni Carta
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria, S.P. Monserrato-Sestu km 0,700, 09042 Cagliari, Italy; (A.P.); (F.S.); (E.C.); (E.P.); (S.D.); (A.C.); (S.L.); (S.Z.); (D.T.); (I.P.); (D.P.); (G.C.); (M.G.C.)
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Perra A, Galetti A, Zaccheddu R, Locci A, Piludu F, Preti A, Primavera D, Di Natale L, Nardi AE, Kurotshka PK, Cossu G, Sancassiani F, Stella G, De Lorenzo V, Zreik T, Carta MG. A Recovery-Oriented Program for People with Bipolar Disorder through Virtual Reality-Based Cognitive Remediation: Results of a Feasibility Randomized Clinical Trial. J Clin Med 2023; 12:jcm12062142. [PMID: 36983145 PMCID: PMC10056011 DOI: 10.3390/jcm12062142] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 03/02/2023] [Accepted: 03/07/2023] [Indexed: 03/11/2023] Open
Abstract
Background: Cognitive impairment is a frequent consequence of bipolar disorder (BD) that is difficult to prevent and treat. In addition, the quality of the preliminary evidence on the treatment of BD through Cognitive Remediation (CR) with traditional methods is poor. This study aims to evaluate the feasibility of a CR intervention with fully immersive Virtual Reality (VR) as an additional treatment for BD and offers preliminary data on its efficacy. Methods: Feasibility randomized controlled cross-over clinical study, with experimental condition lasting three months, crossed between two groups. Experimental condition: CR fully immersive VR recovery-oriented program plus conventional care; Control condition: conventional care. The control group began the experimental condition after a three months period of conventional care (waiting list). After the randomization of 50 people with BD diagnosis, the final sample consists of 39 participants in the experimental condition and 25 in the control condition because of dropouts. Results: Acceptability and tolerability of the intervention were good. Compared to the waitlist group, the experimental group reported a significant improvement regarding cognitive functions (memory: p = 0.003; attention: p = 0.002, verbal fluency: p = 0.010, executive function: p = 0.003), depressive symptoms (p = 0.030), emotional awareness (p = 0.007) and biological rhythms (p = 0.029). Conclusions: The results are preliminary and cannot be considered exhaustive due to the small sample size. However, the evidence of efficacy, together with the good acceptability of the intervention, is of interest. These results suggest the need to conduct studies with larger samples that can confirm this data. Trial registration: ClinicalTrialsgov NCT05070065, registered in September 2021
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Affiliation(s)
- Alessandra Perra
- International PhD in Innovation Sciences and Technologies, University of Cagliari, 09124 Cagliari, Italy
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
- Correspondence:
| | - Alessia Galetti
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
| | - Rosanna Zaccheddu
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
| | - Aurora Locci
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
| | - Federica Piludu
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
| | - Antonio Preti
- Department of Neuroscience, University of Turin, 10125 Turin, Italy
| | - Diego Primavera
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
| | | | - Antonio Egidio Nardi
- Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro 21941-901, Brazil
| | | | - Giulia Cossu
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
| | - Federica Sancassiani
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
| | - Giusy Stella
- Department of Mental Health and Pathological Addiction, ASL 5, 00034 Rome, Italy
| | | | - Thurayya Zreik
- Mental Health Service User Association, 11072070 Beirut, Lebanon
| | - Mauro Giovanni Carta
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
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Amer SA, Abd-Ellatif EE, Hughes P, Al-Enazi HMG, AlHasan A, Amer MA, Alruhaimi AF, Elsayed M. Emotional Contagion Scale and Mental Health Status during the First Wave of COVID-19 Pandemic, National Assessment. Clin Pract Epidemiol Ment Health 2022; 18:e174501792208200. [PMID: 37274863 PMCID: PMC10156037 DOI: 10.2174/17450179-v18-e2208200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 06/08/2022] [Accepted: 06/30/2022] [Indexed: 06/07/2023]
Abstract
Background This great pandemic of COVID-19 has been a unique stressor that affected all communities in 2020. This study aims to examine the prevalence of anxiety and depression due to the COVID-19 pandemic in Saudi Arabia and to study the emotional cognition scale in the Kingdom of Saudi Arabia (KSA) in relation to the COVID-19 pandemic. Methodology A descriptive cross-sectional study was conducted on 857 inhabitants randomly selected from the 13 administrative regions of Saudi Arabia, using a validated self-administrated questionnaire comprising six sections. The collected data were summarized and analyzed. Results Among the majority of the studied participants, 377 (44.0%) were aged from 35 to less than 50 y. There were 489 (57.1%) females and 368 (42.9%) males, 616 (71.9%) Saudi nationals, 715 (83.4%) university-educated or postgraduate, 619 (72.2%) unmarried and 238 (27.8%) married, and 663 (77.4%) living in areas under partial lockdown. The resultant elevated total depression score was statistically significant (p<0.05) for the following: participants younger than 35y, females, Saudis, those with lower education levels, those who were married, students, those with work suspension during the COVID-19 pandemic, and amongst those who experienced complete lockdown. Among the majority of the studied participants, 355 (41.2%) showed mild depression, and 281(32.6) showed moderate anxiety, and were in the growth zone. In addition, the elevated total anxiety score was statistically significant (p<0.05) amongst the following; younger participants, females, Saudi nationals, those with lower educational levels, those who were unmarried, students, those with telework, and those with no curfew. Conclusion The adverse mental health effects were more prevalent among particular groups of the population, such as females, adults under 35 years old, students, those with lower educational attainments, and those suffering from chronic illnesses. Anxiety was significantly correlated with depression. The practice of preventive measures, e.g., wearing masks, and social distancing to prevent the spread of COVID-19, may have had psychological benefits during the pandemic. Summary We assessed the mental health status in Saudi Arabia during the first wave of the COVID-19 pandemic. Mild depression and moderate anxiety were prevalent problems, with many determinants and interrelations. Fear was the most infectious emotion, while happiness was the highest.
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Affiliation(s)
- Samar A. Amer
- Department of Public Health and Community Medicine, Faculty of Medicine, Zagazig University, Zagazig 44519, Egypt
- Member at the Royal College of General Practitioners (INT), London, UK
| | - Eman Elsayed Abd-Ellatif
- Department of Public Health and Community Medicine, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | | | - Hadi Mahdi Ghazai Al-Enazi
- Nursing Specialty, Director of the Anti-Smoking Program in Al-Qassim, Ministry of Health (MOH), Saudi Arabia, SA
| | - Ahmed AlHasan
- MD, General Directorate of Medical Services, Ministry of Defense, SA
| | - Mostafa A. Amer
- Faculty of Medicine, Zagazig University, Zagazig 44519, Egypt
| | - Asma Faleh Alruhaimi
- Department of Epidemiology, General Directorate of Health Programs and Chronic Disease, MOH, SA
| | - Mohamed Elsayed
- Department of Psychiatry and Psychotherapy III, University of Ulm, Leimgrubenweg 12-14, 89075, Ulm, Germany
- Department of Psychiatry, School of Medicine and Health Science, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
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Velluzzi F, Cossu G, Fosci M, Montisci R, Zaccheddu R, Minerba L, Musu M, Pintus E, Fortin D, Romano F, Aviles Gonzalez CI, Melis P, Deledda A, Loviselli A, Carta MG. Effect of a Low-Moderate Exercise Program on Dysmetabolism in Older Adults: Results of a Randomized Controlled Trial. Nutrients 2022; 14:nu14163337. [PMID: 36014843 PMCID: PMC9413492 DOI: 10.3390/nu14163337] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 08/10/2022] [Accepted: 08/11/2022] [Indexed: 12/11/2022] Open
Abstract
Physical exercise has been shown to improve dysmetabolism in older adults, reducing cardiovascular risk, while its role in preventing dysmetabolism is less known. Moreover, most of the trials use exercise programs that are difficult to put into daily practice. The purpose of this Randomized Controlled Trial (RCT) was to evaluate the effectiveness of a 3-month moderate exercise program in improving or preventing dysmetabolism in 120 older adults, randomly selected for the exercise program (experimental group) or cultural activities (control group). None of the subjects were following a hypocaloric diet, and all of them reported healthy eating habits. Anthropometric (Body Mass Index (BMI) and Waist Circumference (WC)) and metabolic variables (fasting plasma glucose (FPG), High-Density Lipoprotein Cholesterol (HDL-C), and triglycerides (TG)) were assessed at baseline (T0) and at the end of the trial (T1). Dysmetabolism was defined by the presence of an increased WC plus at least two metabolic alterations. At T0, the two groups did not differ by sex, age, education, BMI, WC, FPG, HDL-C levels, and prevalence of dysmetabolism. The mean BMI value indicated overweight, and WC values were higher than the cut-off. At T1, a slight reduction in the number of people with dysmetabolism was found only in the experimental group. However, none of the individuals without dysmetabolism at T0 in the experimental group developed it at T1, while 11.4% developed it in the control group (p = 0.032). This study highlights that a moderate exercise program, accessible in daily practice, can prevent dysmetabolism in older adults, even while being overweight, while if dysmetabolism is already present, more prolonged combined nutritional and exercise interventions will be needed.
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Affiliation(s)
- Fernanda Velluzzi
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
- Correspondence:
| | - Giulia Cossu
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
| | - Michele Fosci
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
| | - Roberta Montisci
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
| | - Rosanna Zaccheddu
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
| | - Luigi Minerba
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
| | - Mario Musu
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
| | - Elisa Pintus
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
| | - Dario Fortin
- Department of Psychology and Cognitive Science, University of Trento, 38123 Trento, Italy
| | - Ferdinando Romano
- Department of Public Health and Infectious Diseases, Unitelma Sapienza University, 00185 Rome, Italy
| | - Cesar Ivan Aviles Gonzalez
- Departamento de Facultad de Ciencias de la Salud, Universidad Popular del Cesar, Valledupar 200002, Colombia
| | - Paola Melis
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
| | - Andrea Deledda
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
| | - Andrea Loviselli
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
| | - Mauro Giovanni Carta
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
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Carta MG, Aviles Gonzalez CI, Minerba L, Pau M, Musu M, Velluzzi F, Ferreli C, Pintus E, Machado S, Romano F, Vacca V, Preti A, Cossu G, Atzori L. Exercise in Older Adults to Prevent Depressive Symptoms at the Time of Covid-19: Results of a Randomized Controlled Trial with Follow-Up. Clin Pract Epidemiol Ment Health 2022; 18:e174501792112231. [PMID: 37274849 PMCID: PMC10156046 DOI: 10.2174/17450179-v18-e2112231] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 10/18/2021] [Accepted: 11/19/2021] [Indexed: 06/07/2023]
Abstract
Background This study aimed to verify, through a randomized controlled trial, whether a medium-intensity mixing/aerobic/anaerobic exercise (accessible to older adults even with mild chronic diseases) can effectively counteract depressive episodes. A characteristic of the trial was that the follow-up coincided (unscheduled) with the lockdown due to Covid-19. Methods Participants (N=120) were randomized into an intervention group, performing physical exercise, and a control group. Participants, aged 65 years and older, belonged to both genders, living at home, and cleared a medical examination, were evaluated with a screening tool to detect depressive episodes, the PHQ9, at pre-treatment, end of the trial (12-week), and follow-up (48-week). Results A decrease in the frequency of depressive episodes after the trial (T1) was found in both groups; however, a statistically significant difference was observed only in the control group (p=0.0039). From T1 to follow-up (conducted during the lockdown), the frequency of depressive episodes increased in the control group, reaching a frequency equal to the time of study entry (p=0.788). In the experimental group, the frequency of depressive episodes did not change at the end of the trial but reached a statistically significant difference compared to the start of the study (p = 0.004) and was higher than the control group (p=0.028). Conclusion Moderate-intensity physical exercise can be conducted safely, benefitting older adults even suffering from mild chronic disorders. Physical exercise seems to guarantee a long-term preventive effect towards depressive symptoms, especially in serious stressful situations such as the lockdown due to the Covid-19 pandemic. Clinical Trial Registration Number NCT03858114
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Affiliation(s)
- Mauro Giovanni Carta
- Department Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Cesar Ivan Aviles Gonzalez
- Azienda Ospedaliero Universitaria di Cagliari, Cagliari, Italy
- Universidad del Cesar, Valledupar, Colombia
| | - Luigi Minerba
- Department Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Massimiliano Pau
- Dipartimento di Ingegneria Meccanica, Chimica e dei Materiali, Università degli Studi di Cagliari, Cagliari, Italy
| | - Mario Musu
- Department Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Fernanda Velluzzi
- Department Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Caterina Ferreli
- Department Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Elisa Pintus
- Department Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Sergio Machado
- Department of Sports and Methods Techniques, Federal University of Santa Maria (UFSM), Brazil
- Laboratory of Physical Activity Neuroscience, Neurodiversity Institute, Queimados-RJ, Brazil
| | - Ferdinando Romano
- Department of Public Health and Infectious Diseases, Università Roma Sapienza, Roma, Italy
| | - Veronica Vacca
- Department Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Antonio Preti
- Department of Medical Sciences and Public Health, University of Turin, Turin, Italy
| | - Giulia Cossu
- Department Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Laura Atzori
- Department Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
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