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Spontaneous coronary artery dissection (SCAD) is an under-recognized cause of acute coronary syndrome that predominantly affects women in adulthood and is the leading cause of acute myocardial infarction in pregnancy. The most common clinical presentation is ST-segment elevation myocardial infarction (STEMI) or non-STEMI, followed by cardiogenic shock (∼2%), sudden cardiac death (0.8% in autopsy series), cardiac arrest, ventricular arrhythmias (∼5%), and Takotsubo syndrome. The prevalence of SCAD in the general population is largely uncertain due to underdiagnosis. Oral contraceptives, post-menopausal therapy, and infertility treatments are recognized associated factors. The pathological substrates (fibromuscular dysplasia) and triggers (especially emotional stress) are commonly present in affected women. The few cases with a precise genetic aetiology occur in the context of syndromic and non-syndromic connective tissue diseases. The only true certainty in SCAD is the overwhelming prevalence in women. The first event as well as the recurrence (up to 30%, which varies depending on the definition) is largely unpredictable. The treatment strategy is highly individualized and requires extensive additional study in order to optimize outcomes and prevent major adverse cardiovascular events in affected individuals. We have known about SCAD for nearly a century, but we still do not know how best to prevent, diagnose, and treat it, making SCAD a highly important and unmet clinical need.

The development of micellar catalysis offers a sustainable alternative to organic solvents, and represents an environmental milestone in organic synthesis. Here, the first Michael addition of masked acetaldehyde under neutral, cationic and anionic micellar catalysis is reported, affording the products in high yields and enantiomeric excess, despite the use of water as solvent.

Nel ricercare nuovi approcci allo studio del diritto in sintonia con la natura, risultano di interesse alcune recenti proposte rivolte al passaggio dall'analisi «economica» all'analisi «ecologica» del diritto. Se la crisi climatica e ambientale è stata inizialmente approfondita dai pubblicisti, da qualche tempo ormai gli obiettivi ecologici sono penetrati anche nel diritto privato. In particolare, si tenterà di verificare se il contratto nella sua nuova veste «sostenibile» possa rappresentare uno strumento adeguato per invertire la rotta o se sia preferibile una «sostenibilità con lo Stato»., BioLaw Journal - Rivista di BioDiritto, N. 2 (2023)

Il saggio è incentrato sulla principale terminologia greca del latte e mira a sottolineare al contempo le implicazioni storico-culturali sul versante antropologico e fisiologico della lattazione e dell'allattamento, soprattutto nel rapporto tra madre e figlio, o tra nutrice e lattante. Sono presenti riferimenti agli usi alimentari e terapeutici.

Cu/SiO2 catalysts prepared by a deposition-decomposition (DD) method using ammonium hydroxide are currently among the most promising catalysts for oxalates hydrogenation to ethylene glycol (EG). Here, a Cu/SiO2 catalyst prepared by the DD method was pre-reduced at a) 200–350 °C in 100% H2, and 2) 200 °C in a 50% H2/N2 mixture. Then, it was tested at 200 °C, and 25 barg, while EG yields were optimized, with H2-GHSV and H2/DMO ratios in the ranges 1000–4000 h−1 and 30–200 mol/mol. The calcined catalyst presents an XRD amorphous Cu phyllosilicate phase. After pre-reduction in pure H2 at 200–250 °C (Tred), the Cu metallic surface area increased from 6 to 12 m2/gcat and slightly decreased at 350 °C. Simultaneously, the silanol's band, measured by DRIFT experiments, increased with Tred. The highest ethylene glycol yield (91%) was achieved after pre-reduction at 200 °C in pure hydrogen, working with an H2-GHSV and H2/DMO of 1050 h−1 and 68 mol/mol, respectively. The catalyst was stable for more than 36 h after a 20 h induction period. Catalyst characterization results as a function of Tred confirm that mixed-valence copper nanoparticles favor the EG selective formation, while side reactions leading to ethanol and 1,2-butanediol are related to exposed acidic and basic sites due to decreased Cu/support interactions.

The meat of snails can be considered a high-quality food for the human diet and demand is already increasing across Europe. Due to the bioaccumulation of trace elements in their tissues, land snails can be a significant tool also for environmental pollution evaluation. In this study, 28 mineral elements (Ag, Al, As, B, Ba, Be, Bi, Cd, Co, Cr, Cu, Fe, Hg, K, Li, Na, Mg, Mn, Mo, Ni, Pb, Sb, Se, Sr, Ti, Tl, V, Zn) in both the edible part and the shell of edible land snails commercially available in Southern Italy belonging to Cernuella virgata, Helix aperta, Theba pisana species were investigated by ICP-MS and direct mercury analyser. The concentration of trace elements was variable among the samples. The variability demonstrates the close connection among the type of snail, the geographical origin, and the habitat in which the species grows. The edible part of the snails analysed in this study was found to be a good source of macro-nutrients. Toxic elements were detected in some samples, especially in shells; nevertheless, the values fell within the safety limits. Further investigations and monitoring of mineral contents in edible land snails are suggested both for human health and environmental pollution evaluation.

Lo studio prende in considerazione l’alto numero di occorrenze del termine ὁδός e di alcuni suoi composti (tra cui ad esempio δίοδος e περίοδος) presenti nel Corpus ippocratico, e in particolare in un gruppo di trattati (Generazione/Natura del bambino; libro IV delle Malattie; libro I delle Malattie delle donne; Ghiandole) che presentano comuni caratteristiche dal punto di vista teorico, lessicale e delle forme dell’espressione del pensiero medico scientifico. L’uso di detta terminologia per definire le “vie del corpo umano” e i fluidi che vi scorrono (in primo luogo sangue e sperma) sembra rimandare ad una concezione dell’anatomia e della fisiologia umana comune ai trattati considerati.

International audience

Il saggio indaga in una prospettiva storico-linguistica e antropologica la natura del rapporto di cuginanza nella civiltà greca, proponendo confronti con la terminologia e la relativa concezione nel mondo latino. Al centro dell'indagine, condotta principalmente per un pubblico di non specialisti, c'è un ragionamento sulle occorrenze più antiche del termine greco "anepsiòs", esaminate nel loro contesto specifico all'interno, soprattutto, dei poemi omerici. Emerge la particolare natura del rapporto di cuginanza (termine attestato in greco nella forma anepsiòtes) secondo i Greci, che ne fa, specie nel caso di cugini primi, una fattispecie di parenti legati da uno stretto reciproco legame che implica solidarietà e partecipazione affettiva, morale e giuridica, e ciò in nome non solo della comune partecipazione alle vicende di uno stesso ghènos, ma anche di precisi interessi economici e giuridici che pertengono al relativo patrimonio familiare.

Background: The Lombardy region, in Northern Italy, suffered a major outbreak of Coronavirus disease 2019 (COVID-19) at the end of February 2020. The health system was rapidly overwhelmed by the pandemic. It became evident that patients suffering from time-sensitive medical emergencies like stroke, cerebral hemorrhage, trauma and acute myocardial infarction required timely, effective and safe pathways to be treated. The problem was addressed by a regional decree that created a hub-and-spoke system for time-sensitive medical emergencies. Methods: We report the re-organizational changes adopted at a hub hospital (despite having already destined to COVID-19 patients most resources), and the number of emergent procedures for medical emergencies on the first 30-day of activity. These data were compared with the hospital activity in the same period of the previous year. Results: Organizational changes were implemented in few hours. Dedicated pathways for non-COVID-19 patients affected by a medical emergency were set up in the emergency department, in the labs and in the operating theater. Ten intensive beds were implemented from a high-dependency unit; two operating rooms were reserved 24 h/day to neurosurgical or trauma emergencies. The number of emergent procedures was not different from that of the previous year, no admission refusal, no treatment delay and no viral transmission to the treated patients were recorded. No viral transmission to health care workers was observed. Conclusions: Re-organization of a hospital in order to adopt a hub-and-spoke model resulted feasible and allowed to face acute coronary syndrome and other time-sensitive medical emergencies timely and safely.

Attraverso una ricerca etnografica basata sulla partecipazione alla pratica pellegrinale dell’acchianata, l’articolo racconta la devozione a Santa Rosalia di alcuni mauriziani induisti residenti a Palermo. Il saggio integra la letteratura esistente sulla partecipazione dei gruppi migranti al culto di Santa Rosalia presentando le specificità delle pratiche rituali dei devoti induisti mauriziani a partire dalle caratteristiche del loro contesto di partenza. I soggetti della ricerca includono la santa, divinità del territorio di arrivo, nella logica e nelle dinamiche del culto alle divinità femminili induiste, sulla base delle analogie tra la tradizione cultuale palermitana e le esperienze religiose della società postcoloniale mauriziana. La Santuzza e la sua montagna sacra sono adottate come mediatrici divine dei nuovi problemi e desideri connessi alla mobilità: i soggetti migranti incorporano gesti e simboli rituali cattolici nel loro dialogo votivo con Santa Rosalia, stabiliscono una connessione affettiva e spirituale con la città di Palermo attraverso lo spazio sacro di Monte Pellegrino, e rivendicano il diritto devozionale al miracolo per facilitare processi quali l’apprendimento della lingua italiana e l’aspirazione a una maggiore mobilità sociale. Il rapporto con Santa Rosalia entra nell’intimità dei devoti, fornendo loro uno spazio creativo di costruzione di nuove forme di appartenenza transnazionale e allo stesso tempo un’interfaccia privilegiata con la nuova città e i suoi abitanti. Through a participatory ethnography of the acchianata pilgrimage, the article examines Hindu Mauritians’ devotion to Santa Rosalia (‘a Santuzza’) in Palermo. The essay contributes to the existing literature on the participation of migrant group in the worship of Santa Rosalia by presenting the specificities of Hindu Mauritians’ ritual practices based on the features of their departure context. The research subjects position their worship of the patron saint – as the deity of their arrival city – alongside their devotion to Hindu female goddesses, by drawing analogies between local devotional practices and the religious experiences of postcolonial Mauritius. The Santuzza and her sacred mountain (Monte Pellegrino) are adopted as divine mediators of the problems and desires arising from their mobility. Migrant subjects incorporate Catholic ritual gestures and symbols in their votive dialogue with Santa Rosalia, establishing an emotional and spiritual connection with the city of Palermo through the sacred space of Monte Pellegrino, while demanding miracles from her deity to facilitate processes such as learning the Italian language and aspiring for greater social mobility. The intimate relationship with Santa Rosalia provides her devotees with a creative space for the construction of new forms of transnational belonging and a privileged interface with the new city and its inhabitants.

Non-intoxicating Cannabis sativa L. (i.e., hemp) is increasingly used for industrial, cosmetic and food applications. Despite the fact that the EU has not yet established a regulatory framework on hazardous compounds (i.e., toxic inorganic elements), the monitoring of cannabis products is of paramount importance to safeguard consumers, also in view of the species propensity to accumulate toxic metals from the environment. The aim of this work was to assess the compliance with Law n. 242/2016 and the safety of hemp inflorescences from different varieties and Italian regions by monitoring the main cannabinoids and trace elements. All samples complied with the Italian law due to a THC content

Retinal pigment epithelium (RPE) are specialized multifunctional cells indispensable for maintenance of vision. Dysfunction and death of the RPE cells is implicated in the genesis and progression of age-related macular degeneration (AMD). Oxidative stress and resulting cellular damage plays a critical mechanistic role in AMD pathogenesis. Oxidized low-density lipoprotein (oxLDL), derived from LDL in a pro-oxidative environment, is found adjacent to the RPE as part of drusen, extracellular deposits that are a characteristic clinical feature of AMD. OxLDL is cytotoxic and oxLDL-induced oxidative damage may contribute to functional impairment of the RPE. Therefore, knowledge of how the RPE respond to oxLDL exposure is important to understand the mechanisms underlying RPE dysfunction and death associated with AMD. The objective of this study was to characterize alterations in the RPE proteome triggered by exposure to non-cytotoxic levels of oxLDL. Protein identification and quantification were performed with a high -resolution LC-MS/MS-based proteomics workflow. In total, out of the

OBJECTIVES/HYPOTHESIS The aim of the present study is to validate and compare four of the most widely used staging systems for juvenile angiofibroma on a homogeneous cohort of patients. STUDY DESIGN Retrospective case series. METHODS A retrospective review of patients treated with endoscopic or endoscopic-assisted surgical resection between 1999 and 2020 was carried out. Each case was classified according to the following staging systems: Andrews-Fisch (1989), Radkowski (1996), University of Pittsburgh Medical Center (2010), and Janakiram (2017). Spearman's rank correlation test and areas under the curve of receiver operator curves were used to assess the correlation between outcomes of interests (blood loss, surgical time, need for transfusion, and persistence of disease) and stage of disease. RESULTS Seventy-nine patients were included, with a median follow-up time of 25 months (range 12-127 months). Median surgical time was 217 minutes (range 52-625). Median blood loss was 500 mL (range 40-5200) and 27 patients (34.2%) required blood transfusions. Seven patients (8.9%) showed persistence of disease. All classification systems showed a similar association with blood loss, surgical time, persistence of disease, and need for transfusion. CONCLUSIONS Involvement of the infratemporal fossa and intracranial extension was identified as red flags for surgical planning and preoperative counseling, as associated with increased risk for transfusion and persistent/recurrent disease, respectively. No classification system was found to be better than the others in predicting the most important outcomes. Therefore, the simplest and most easily applicable system would be the preferred one to be used in clinical practice. LEVEL OF EVIDENCE Level 4 case series Laryngoscope, 2021.

Non-intoxicating

Ganpati. Sacred in the Making explores the celebration of the Ganesha festival in Palermo, Italy, from the point of view of a woman of Mauritian origins and the ritual community gathering at her temporary shrine. The camera is absorbed in the sacred performance as a ritual tool, conveying the sensory experience of participating in the rite. Merging into musical and sonic performances of devotion, this film is a multimodal engagement with the construction of migrant spaced spaces and the resonances of this process in the urban social fabric.

Background The incretin-based medicines GLP1 analogues (GLP1a) and dipeptidyl peptidase-4 inhibitors (DPP4i) are hypoglycaemic agents licensed for the treatment of type 2 diabetes mellitus (T2DM). Although these drugs possess comparable efficacy and low risk of hypoglycaemia, differences in terms of route of administration (subcutaneous versus oral), effect on body weight and gastrointestinal tolerabily can impact their actual use in clinical practice. This study aimed to describe the real-world utilization of incretin-based medicines in the Italian clinical practice. Methods A multi-database, population-based, descriptive, cohort study was performed using administrative data collected between 2008 and 2014 from three Italian geographic areas. Subjects aged ≥18 were selected. New users were defined as those with ≥1 dispensing of GLP1a or DPP4i during the year of interest and none in the past. Trends of cumulative annual incidence of use in the general adult population were observed. New users of GLP1a or DPP4i were respectively described in terms of demographic characteristics and use of antidiabetic drugs during 1 year before and after the first incretin dispensing. Results The overall study population included 4,943,952 subjects. A total of 7357 new users of GLP1a and 41,907 of DPP4i were identified during the study period. Incidence of use increased between 2008 (0.2‰ for both GLP1a and DPP4i) and 2011 (GLP1a = 0.6‰; DPP4i = 2.5‰) and slightly decreased thereafter. In 2014, 61% of new GLP1a users received once-daily liraglutide while 52% of new DPP4i users received metformin/DPP4i in fixed-dose. The percentage of new DPP4i users older than 65 years of age increased from 30.9 to 62.6% during the study period. Around 12% of new users had not received any antidiabetic before starting an incretin. Conclusions During the study period, DPP4i rapidly became the most prescribed incretin-based medicine, particularly among older new user. The choice of the specific incretin-based medicine at first prescription appeared to be directed towards those with higher convenience of use (e.g. oral DPP4i rather than subcutaneous GLP1a, once-daily liraglutide rather than twice-daily exenatide). The non-negligibile use of incretin-based medicines as first-line pharmacotherapy for T2DM warrants further effectiveness and safety evaluations to better define their place in therapy. Electronic supplementary material The online version of this article (10.1186/s12902-019-0334-y) contains supplementary material, which is available to authorized users.

Recently WHO has declared novel coronavirus disease 2019 (COVID-19) outbreak a pandemic. Acute respiratory syndrome seems to be the most common manifestation of COVID-19. Besides pneumonia, it has been demonstrated that SARS-CoV-2 infection affects multiple organs, including brain tissues, causing different neurological manifestations, especially acute cerebrovascular disease (ischemic and hemorrhagic stroke), impaired consciousness and skeletal muscle injury. To our knowledge, among neurological disorders associated with SARS-CoV2 infection, no Posterior Reversible Encephalopathy Syndrome (PRES) has been described yet. Herein, we report a case of a 64-year old woman with COVID19 infection who developed a PRES, and we suggest that it could be explained by the disruption of the blood brain barrier induced by the cerebrovascular endothelial dysfunction caused by SARS-CoV-2.

Enantioselective organocatalysis has quickly established itself as the third pillar of asymmetric catalysis. It is a powerful technology platform, and it has a tremendous impact in both academic and industrial settings. By focusing on pregabalin, as a case study, this Perspective aims to show how a process amenable to industry of a simple chiral molecule can be tackled in several different ways using organocatalysis.

The management of tandem extracranial internal carotid artery and intracranial large vessel occlusion during endovascular thrombectomy (EVT) for acute ischemic stroke (AIS) has been under-investigated. We sought to investigate outcomes of AIS patients with tandem occlusion (TO) treated with carotid artery stenting (CAS) compared to those not treated with CAS (no-CAS) during EVT.We performed a cohort study using data from AIS patients enrolled in the Italian Registry of Endovascular Treatment in Acute Stroke. Outcomes were 3 months' mortality, functional outcome, complete and successful recanalization, any intracranial hemorrhage, parenchymal hematoma and symptomatic intracerebral hemorrhage.Among 466 AIS patients with TO, CAS patients were 122 and no-CAS patients were 226 (118 excluded). After adjustment for unbalanced variables, CAS was associated with a lower rate of 3 months' mortality (OR 0.407, 95% CI 0.171-0.969, p = 0.042). After adjustment for pre-defined variables, CAS was associated with a lower rate of 3 months' mortality (aOR 0.430, 95% CI 0.187-0.989, p = 0.047) and a higher rate of complete recanalization (aOR 1.986, 95% CI 1.121-3.518, p = 0.019), successful recanalization (aOR 2.433, 95% CI 1.263-4.686, p = 0.008) and parenchymal hematoma (aOR 2.876, 95% CI 1.173-7.050, p = 0.021). CAS was associated with lower 3 months mortality (OR 0.373, 95% CI 0.141-0.982, p = 0.046) and higher rates of successful recanalization (OR 2.082, 95% CI 1.099-3.942, p = 0.024) after adjustment for variables associated with 3 months' mortality and successful recanalization, respectively.Among AIS patients with TO, CAS during EVT was associated with a higher rate of successful reperfusion and a lower rate of 3 months' mortality.

Since the beginning of the Sophoclean drama OT, King Oedipus, in his attempt to contrast the plague that afflicts Thebes, has to confront the traditional influence of the Delphic oracles and the opinion of the local seer, Tiresias, who is demanding to interpret the words of the God Apollo. In this sense, the Sophoclean drama seems to set into the Attic scene the main traits of its contemporary public debate (second half of the 5th Century BC) about power and fallibility of both oracles and their human interpreters, the so-called manteis. This paper aims by means of a detailed analysis of the dramatic discourse to investigate the positions expressed by the different characters involved in the discussion (from Oedipus and Jocasta to Tiresias, Creon, and the Chorus) concerning the status and the epistemic value of the mantic art (mantikè téchne) with a peculiar focus on the following question: does the mantic art stand scepticism (particularly by Jocasta)?

BackgroundClinical trials and observational studies have demonstrated the benefit of thrombectomy up to 16 or 24 hours after the patient was last known to be well. This study aimed to evaluate the outcome of stroke patients treated beyond 24 hours from onset.MethodsWe analyzed the outcome of 34 stroke patients (mean age 70.7±12.3 years; median National Institutes of Health Stroke Scale (NIHSS) score 13) treated with endovascular thrombectomy beyond 24 hours from onset who were recruited in the Italian Registry of Endovascular Thrombectomy in Acute Stroke. Selection criteria for patients were: pre-stroke modified Rankin scale (mRS) score of ≤2, non-contrast CT Alberta Stroke Program Early CT score of ≥6, good collaterals on single phase CT angiography (CTA) or multiphase CTA, and CT perfusion mismatch with an infarct core size ≤50% of the total hypoperfusion extent or involving less than one-third of the extent of the middle cerebral artery territory evaluated by visual inspection. The primary outcome measure was functional independence assessed by the mRS at 90 days after onset. Safety outcomes were 90 day mortality and the occurrence of symptomatic intracranial hemorrhage (sICH).ResultsSuccessful recanalization (Thrombolysis in Cerebral Infarction score of 2b or 3) was present in 76.5% of patients. Three month functional independence (mRS score 0–2) was observed in 41.1% of patients. The case fatality rate was 26.5%. and the incidence of sICH was 8.8%.ConclusionsThese findings suggest that, in a real world setting, very late endovascular therapy is feasible in appropriately selected patients.

Il sapere si divide in discipline separate, specialiste di un frammento unico della sua totalità. Fare ricerca vuol dire diventare specialisti del frammento di conoscenza che si sceglie di approfondire. Ma separare così la conoscenza in compartimenti stagni impedisce di averne una visione di insieme; ne spezza l’unità, ne cancella la complessità. Cercando di sapere sempre di più su sempre di meno si arriverà a sapere tutto su niente, come ritiene lo scienziato Konrad Lorenz. Lo scritto si presenta come un cammino, il quale, guidato da pensatori quali Edgar Morin, José Ortega y Gasset ed Isabelle Stengers, vuole mostrare i concetti della conoscenza e le discipline stesse non più come monadi chiuse in se stesse ma come nomadi in cammino tra i saperi. Per riscoprire il valore, possibile e realizzabile, di una conoscenza trans-disciplinare. Currently knowledge is divided into separate disciplines. Doing research means becoming a specialist in a chosen fragment of knowledge. But separating knowledge into sealed compartments impedes us from having an integrative view; it breaks its unity, it dissolves its complexity. The scientist Konrad Lorenz believes that if we try to know more and more about less and less, we will know everything about nothing. This article intends to be a path, led by the philosophers Edgar Morin, José Ortega y Gasset and Isabelle Stengers, to show concepts and disciplines no longer as closed monads, but as nomads walking through knowledge landscapes. The aim is to rediscover the possible and achievable value of trans-disciplinary knowledge., PELORO, V. 7, N. 1 (2022)

BACKGROUND: In the arboriculture sector, some activities are still manually performed by forestry workers, which result consequently exposed to a high risk of developing muscle skeletal disorders. The Italian Compensation Authority reported an increase of work-related tendinopathies and carpal tunnel syndrome in loggers, but screening protocols are not available yet. OBJECTIVES: The objectives were: a) to evaluate the prevalence of tendinopathies and carpal tunnel syndrome in a sample of loggers and b) identify a sound screening approach. METHODS: 41 loggers and 41 paired control workers were recruited for a total of 164 hands. The protocol included 1) demographic data; 2) medical history; 3) identification of CTS symptoms through a questionnaire and a hand-chart; 4) upper limbs clinical examination; 5) Raynaud’s diseases questionnaire; 6) wrists ultrasound; 7) NCS of the distal median nerve. RESULTS: The prevalence of tendinopathies was statistically significant only in the non-dominant hand (75, 5% in the exposed group and 53, 6% in the non-exposed group). The prevalence of CTS was 32, 2% in the exposed group and 15, 5% in the non-exposed group. The questionnaire had a sensitivity of 56, 7% and a specificity of 75%. The hand-chart had a sensitivity of 30% and a specificity of 92%. The clinical examination had sensitivity of 30% and specificity of 80%. The ultrasound had a sensitivity of 70% and a specificity of 56%. CONCLUSIONS: Loggers are a population at risk of occupational hand and wrist disorders. The hand-chart could be considered, together with the questionnaire, as the best secondary prevention tool to diagnose CTS.

Occupational logging activities expose workers to a wide range of risk factors, such as lifting heavy loads, prolonged, awkward positioning of the lower back, repetitive movements, and insufficient work pauses. Body posture has an important impact on the level of physiological load. The present study involved a group of 40 loggers in the province of Enna (Sicily, Italy) with the aim of defining the impact of logging activities on the workers’ physiological strain during the three primary work tasks of felling, delimbing, and bucking. The Zephyr Bioharness measurement system was used to record trunk posture and heart rate data during work tasks. The NASA TLX questionnaire was used to explore workers’ effort perception of the work tasks. Based on our results, the most demanding work task was tree felling, which requires a higher level of cardiac cost and longer periods spent in awkward trunk postures. The perceived physiological workload was consistently underestimated, especially by the more experienced loggers. Lastly, as the weight of the chainsaw increased, the cardiac load increased.

Il saggio rappresenta la prosecuzione delle ultime ricerche di Claude Calame, grecista di fama mondiale: dopo il Prometeo genetista (Sellerio, Palermo 2016, ed. or. Paris 2011), adesso lo studioso svizzero propone una riflessione sui rapporti tra l’essere umano e il suo ambiente, maturata sulla base del serrato confronto tra l’idea originaria, greca, di physis e la nozione di ‘natura’ per come essa si è sviluppata a partire dal pensiero illuministico e deterministico. Dei cinque capitoli in cui il saggio è complessivamente strutturato, il primo (dal titolo En Grèce ancienne : l’homme et son milieu) ricostruisce con accuratezza storico-filologica e acume critico il concetto greco di physis, rappresentandolo come un processo dinamico, non inscrivibile nei limiti dell’idea moderna di ‘natura’, vista al contrario sempre di più come il luogo dell’oggettivazione e dello sfruttamento, da parte dell’uomo, dell’ambiente che lo circonda. Il capitolo II (titolo: Des philosophes des Lumières aux anthropologues modernes) prosegue sulla linea del primo, in quanto l’Autore vi ripercorre la storia della nascita in età moderna, dall’Illuminismo sino agli antropologi contemporanei di scuola strutturalista, del concetto di ‘cultura’ come contrapposto alla natura-oggetto. Il capitolo III (intitolato Au-delà des déterminismes anthropologiques : perméabilités) propone una riflessione fondante di una nuova concezione del rapporto tra uomo e ambiente, e natura e cultura, che si basi sull’idea di interrelazione e di permeabilità tra quelli che sinora sono stati intesi come due ambiti distinti. Nel corso del capitolo IV (titolo: L’homme et son environnement : relations interactives) si pongono le basi per ripensare l’idea di natura nei termini del concetto antico di physis. In conseguenza del complessivo ripensamento (insieme storico, filologico e epistemologico) dell’intera questione ambientale, nel quinto e ultimo capitolo (Pour une construction écosocialiste de l’homme et de son milieu) l’A. argomenta la necessità di ‘ricostruire’ il rapporto tra uomo e ambiente in termini alternativi rispetto al sistema tradizionale, realizzando sul piano culturale e politico l’auspicata transizione ecosocialista e ecopoietica. The essay represents the continuation of the latest research by Claude Calame, a world-famous Greek scholar: after the geneticist Prometheus (Sellerio, Palermo 2016, or. Paris 2011), now the Swiss scholar proposes a reflection on the relationship between human beings and its environment, matured on the basis of the close comparison between the original Greek idea of ​​physis and the notion of 'nature' as it developed from Enlightenment and deterministic thought. Of the five chapters in which the essay is structured as a whole, the first (entitled En Grèce ancienne: l'homme et son milieu) reconstructs the Greek concept of physis with historical-philological accuracy and critical acumen, representing it as a dynamic, non-inscribable process within the limits of the modern idea of ​​'nature', seen on the contrary more and more as the place of objectification and exploitation by man of the environment that surrounds him. Chapter II (title: Des philosophes des Lumières aux anthropologues modernes) continues on the line of the first, as the author traces the history of birth in the modern age, from the Enlightenment to the contemporary anthropologists of the structuralist school, of the concept of ' culture 'as opposed to nature-object. Chapter III (entitled Au-delà des déterminismes anthropologiques: perméabilités) proposes a fundamental reflection of a new conception of the relationship between man and environment, and nature and culture, which is based on the idea of ​​interrelation and permeability between those that have hitherto been were intended as two distinct areas. During chapter IV (title: L'homme et son environnement: relations interactives) the foundations are laid for rethinking the idea of ​​nature in terms of the ancient concept of physis. As a result of the overall rethinking (both historical, philological and epistemological) of the entire environmental question, in the fifth and last chapter (Pour une construction écosocialiste de l'homme et de son milieu) the A. argues the need to 'reconstruct' the relationship between man and the environment in alternative terms to the traditional system, achieving the desired ecosocialist and ecopoietic transition on a cultural and political level.

Lower-than-normal platelet counts are a hallmark of the acquired autoimmune illness known as immune thrombocytopenia, which can affect both adults and children. Immune thrombocytopenia patients’ care has evolved significantly in recent years, but the disease’s diagnosis has not, and it is still only clinically achievable with the elimination of other causes of thrombocytopenia. The lack of a valid biomarker or gold-standard diagnostic test, despite ongoing efforts to find one, adds to the high rate of disease misdiagnosis. However, in recent years, several studies have helped to elucidate a number of features of the disease’s etiology, highlighting how the platelet loss is not only caused by an increase in peripheral platelet destruction but also involves a number of humoral and cellular immune system effectors. This made it possible to identify the role of immune-activating substances such cytokines and chemokines, complement, non-coding genetic material, the microbiome, and gene mutations. Furthermore, platelet and megakaryocyte immaturity indices have been emphasized as new disease markers, and prognostic signs and responses to particular types of therapy have been suggested. Our review’s goal was to compile information from the literature on novel immune thrombocytopenia biomarkers, markers that will help us improve the management of these patients.

Introduction: Correct tip positioning is a critical aspect in central vascular access devices insertion. The verification of positioning at the cavo-atrial junction is usually performed by intracavitary electrocardiography. Recently, echocardiographic techniques were proposed, including the direct visualization of the catheter or the visualization of a saline/air bolus (i.e. “bubble test”). As for the latter, a push-to-bubbles delay time below 2 s was proposed to indicate a correct positioning of the catheter tip. The aim of this study was to measure the variations of the push-to-bubbles time at increasing distance from the cavo-atrial junction, to verify if a cut-off of 1–2 s correspond to a well-positioned catheter. Methods: We performed a prospective study including patients with clinical indication of positioning a peripherally inserted central catheter. The catheter tip was positioned at the cavo-atrial junction (P0) via intracavitary electrocardiography, and the push-to-bubbles delay time was measured. The catheter was then retracted 5 cm (P1) and 10 cm (P2), and the test was repeated at this positioning. Push-to-bubbles time measurements were performed off-line by analyzing an audio/video recording which included the echography screen and the voice signal of the operator. Results: Forty-nine patients were included. The average push-to-bubble time when the catheter tip was in the reference position was 0.41 ± 0.21 s. Retraction of the PICC catheter of 5 and 10 cm determined a significant increase of the push-to-bubbles time: mean time difference was +0.34 (95% IC 0.25–0.43, p Conclusion: The push-to-bubbles time is very low when the catheter tip is at the cavo-atrial junction. This delay increases progressively with increasing distance from the target. Push-to-bubbles delay time above 1 s might indicate a catheter not close to the cavo-atrial junction.

Nonlinear processes involving frequency-mixing of light fields set the basis for ultrafast coherent spectroscopy of collective modes in solids. In certain semimetals and semiconductors, generation of coherent phonon modes can occur by a displacive force on the lattice at the difference-frequency mixing of a laser pulse excitation on the electronic system. Here, as a low-frequency counterpart of this process, we demonstrate that coherent phonon excitations can be induced by the sum-frequency components of an intense terahertz light field, coupled to intraband electronic transitions. This nonlinear process leads to charge-coupled coherent dynamics of Raman-active phonon modes in the strongly correlated metal V2O3. Our results show an alternative up-conversion pathway for the optical control of Raman-active modes in solids mediated by terahertz-driven electronic excitation., Communications Physics, 5

NaOsO3 has recently attracted significant attention for the strong coupling between its electronic band structure and magnetic ordering. Here, we used time-resolved magnetic x-ray diffraction to determine the timescale of the photoinduced antiferromagnetic dynamics in NaOsO3. Our measurements are consistent with a sub-100 fs melting of the antiferromagnetic long-range order that occurs significantly faster than the lattice dynamics as monitored by the transient change in intensity of selected Bragg structural reflections, which instead show a decrease of intensity on a timescale of several ps.

Flow diversion changed the approach to complex intracranial aneurysms, leading to a widespread use and a rapid technological evolution. Indeed, indications continued to expand, including ruptured intracranial aneurysms in selected cases. Recently, new devices have been designed specifically to target smaller vessels. Therefore, we conducted a multicenter study to evaluate clinical outcome, complications, and occlusion rate of patients with ruptured aneurysms treated with new generation low profile Silk Vista Baby (SVB) flow diverter stent (FD).We performed a retrospective observational study on consecutive patients who underwent treatment with SVB for ruptured aneurysms at 12 Italian centers. Primary end point was favorable clinical outcome rate, defined as modified ranking score (mRS) of 0-2 at the 3 months. Secondary outcomes were complication rate, aneurysm re-rupture, and complete aneurysm occlusion at last radiological follow-up.Twenty-five patients were included; at 3 months' follow-up, 19 patients (79.1%) had favorable clinical outcome (mRS 0-2). Three patients (12.5%) died during follow-up. In-stent thrombosis occurred in two cases (8.3%), managed with glycoprotein IIb/IIIA and intra-stent angioplasty, without clinical consequences. In 18 (85.7%) patients, complete occlusion at 3 months was demonstrated. No rebleeding occurred during follow-up. Presentation with unfavorable World Federation of Neurosurgical Societies grading system (WFNS) and posterior circulation location were both significantly correlated with unfavorable clinical outcome (p = 0.005 and p = 0.02).Our data suggests that low profile FD treatment of ruptured intracranial aneurysms located distally of the circle of Willis is feasible. New generation low profile FD may represent an alternative option in carefully selected cases.

Introduction: Scalp arteriovenous fistulas (AVF) following hair transplantation are rare; few single case reports have been described. Therapeutic options include open surgery, percutaneous and transarterial endovascular embolization; in recent years these latter have gained favour because of their minimally invasive approach also concerning post-treatment cutaneous appearance. Case presentation: A 29 y/o male after 3 months from a hair transplantation procedure began to notice a little pulsatile mass beneath the skin of the forehead. Subsequent diagnostic imaging (CTA and angiography) showed the presence of a scalp frontoparietal AVF with a single superficial temporal artery (STA) feeder and a superficial subcutaneous veins drainage. After a few months a sudden worsening of symptoms was reported. Endovascular treatment was performed in general anaesthesia, with right femoral arterial access, ECA catheterization, superselective STA microcatheterization right at fistula point and embolization with platinum detachable coils. No procedural complications occurred. Patient was discharged on the 4th day, asymptomatic. Clinical symptoms resolved promptly after just 3–4 weeks. A control angiogram after 6 months showed complete disappearance of the fistula. Conclusions Hair transplantation procedures are associated with a low risk profile, and scalp AVF is a very rare complication; both endovascular interventions and open surgery are safe and effective in treating this complication. A complete preliminary angiographic study is needed; if vascular anatomy is favourable, a transarterial approach can be performed. Coiling occlusion compared to glue embolization avoids cutaneous discoloration and/or subcutaneous mass among the fistulous point. In this case this technique was proven to be safe and effective.

Synergistic catalysis offers the unique possibility of simultaneous activation of both the nucleophile and the electrophile in a reaction. A requirement for this strategy is the stability of the active species towards the reaction conditions and the two concerted catalytic cycles. Since the beginning of the century, aminocatalysis has been established as a platform for the stereoselective activation of carbonyl compounds through HOMO-raising or LUMO-lowering. The burgeoning era of aminocatalysis has been driven by a deep understanding of these activation and stereoinduction modes, thanks to the introduction of versatile and privileged chiral amines. The aim of this review is to cover recent developments in synergistic strategies involving aminocatalysis in combination with organo-, metal-, photo-, and electro-catalysis, focusing on the evolution of privileged aminocatalysts architectures.

Complessivamente 12 sono i saggi che compongono questa raccolta dedicata alla riflessione antica e moderna sulla crescita e sviluppo delle forme di vita. Ogni saggio rappresenta un vero e proprio viaggio che attraversa diverse regioni del sapere: i classici antichi, greci e latini, sono in effetti quantitativamente predominanti, e questo a ragione dei prevalenti interessi scientifici dei curatori, i quali però si sono ben guardati dall’isolare il ‘classico’ nella sua idiosincratica prospettiva ante litteram, ma hanno cercato e trovato la collaborazione con altri settori della ricerca scientifica. Il che si traduce nella partecipazione al progetto editoriale e scientifico anche di antropologi del mondo antico, di biologi e genetisti, di filosofi e storici del pensiero filosofico e scientifico. Altogether 12 are the essays that make up this collection dedicated to ancient and modern reflection on the growth and development of forms of life. Each essay represents a real journey that crosses different regions of knowledge: the ancient Greek and Latin classics are in quantitatively predominant effects, and this due to the prevalent ones scientific interests of the curators, who, however, have been careful not to isolate the 'classic' in its idiosyncratic perspective ante litteram, but have sought and found collaboration with other sectors of scientific research. This translates into the participation in the editorial and scientific project of anthropologists of the ancient world, biologists and geneticists, of philosophers and historians of philosophical and scientific thought.

Dopo un inquadramento terminologico atto a presentare le più comuni radici che esprimono in greco antico i concetti di crescita e di sviluppo del vivente, l’attenzione è rivolta alle modalità con cui in testi di varia natura e datazione (da Omero sino al Corpus ippocratico) si descrive la crescita dell’essere umano a partire dal costante confronto con il mondo vegetale, in modo che dal configurarsi delle teorie possano risaltare le più o meno implicite mentalità. Attraverso il massiccio ricorso al ragionamento analogico, le fonti considerate permettono di farsi un’idea non solo del processo di crescita in sé, ma anche del ruolo assegnato nella cultura e nel pensiero della Grecia antica alla madre nel suo rapporto con la prole. After a terminological framework aimed at presenting the most common roots that express the concepts of growth and development of the living being in ancient Greek, the attention is turned to the ways in which texts of various kinds and dating (from Homer to the Hippocratic Corpus) the growth of the human being is described starting from the constant confrontation with the vegetable world, so that the more or less implicit mentalities can emerge from the configuration of the theories. Through the massive use of analogical reasoning, the sources considered allow us to get an idea not only of the growth process itself, but also of the role assigned in the culture and thought of ancient Greece to the mother in her relationship with the offspring.

Background: Little is known about the comparative risk of death with atypical or conventional antipsychotics (APs) among persons with cardiovascular or cerebrovascular disease (CCD). Research design and methods: A cohort study was conducted using five Italian claims databases. New atypical AP users with CCD aged ≥65 (reference) were matched to new conventional AP users. Mortality per 100 person-years (PYs) and hazard ratios (HR), estimated using Cox models, were reported. Incidence and risk of death were estimated for persons having drug–drug interactions. Outcome occurrence was evaluated 180 days after AP initiation. Results: Overall 24,711 and 27,051 elderly new conventional and atypical AP users were identified. The mortality rate was 51.3 and 38.5 deaths per 100 PYs for conventional and atypical AP users. Mortality risk was 1.33 (95%CI: 1.27–1.39) for conventional APs. There was no increased mortality risk with single drug–drug interactions (DDIs) vs. no DDI. AP users with ≥1 DDI had a 29% higher mortality risk compared to no DDI in the first 90 days of treatment (HR: 1.29 (95% CI: 1.00–1.67)). Conclusions: Conventional APs had a higher risk of death than atypical APs among elderly persons with CCD. Having ≥1 DDI was associated with an increased risk of death.

Two strategies for protecting body image against the negative effects of exposure to idealized media images have been proposed: (1) using labels to alert viewers to digital retouching, (2) limiting digital retouching. This study investigated the effects digitally modified vs.unmodified images and the use of labels on those images (disclaimer/retouch-free] vs. unlabeled) on appearance satisfaction and mood. Trait upwards appearance comparison, media ideal internalization, media similarity, and body appreciation were explored as moderators. Participants (n = 614, women, 18-30 years) viewed the same ten images of female figures (both thin ideal and size/shape diverse images) across four conditions: (1) unmodified, unlabelled, (2) unmodified, labelled, (3) modified, labelled, and (4) modified, unlabelled images. Exposure to unmodified images was shown to be less harmful than exposure to modified images. Neither label type was associated with more positive outcomes compared to their counterpart unlabelled conditions. State appearance comparison was highest in the two labelled conditions. Trait upwards appearance comparison and media ideal internalization to some extent moderated effects on negative mood. Findings provide additional evidence that disclaimer labels on digitally modified images are not helpful for body image, while images that depart from the thin-ideal can contribute to promoting positive body image.

Background and objective To describe our single-center experience in the treatment of cavernous internal carotid artery (ICA) acute bleeding with flow diverter stent (FDS), as a single endovascular procedure or combined with an endoscopic endonasal approach. Methods We analyze a case series of 5 patients with cavernous ICA acute bleeding, i.e., 3 iatrogenic, 1 post-traumatic, and 1 erosive neoplastic. After an immediate nasal packing to temporarily bleeding control, patients underwent digital subtraction angiography (DSA) to identify the site of the ICA injury. A concomitant balloon occlusion test (BOT) was performed, to exclude post-occlusive ischemic neurological damage. An FDS was placed with parallel intravenous infusion of abciximab in 3 cases and tirofiban in 2 cases. In two patients, an innovative “sandwich technique” combining the endovascular reconstruction with an extracranial intrasphenoidal cavernous ICA resurfacing with autologous flaps or grafts by endoscopic endonasal approach was performed. Results No patient had periprocedural ischemic-hemorrhagic complications. All patients had a regular clinical evolution, without general complications or new onset of focal neurological deficits. No further bleeding occurred in 3 patients, while 2 cases experienced a mild rebleeding in a period ranging from 5 to 15 days after the endovascular procedure. In these two cases, we proceeded with an endoscopic endonasal procedure to resurface the exposed ICA wall in the sphenoid sinus. Conclusions Although the treatment of choice for cavernous ICA acute bleeding remains the occlusion of the injured vessel, in cases of poor hemodynamic compensation at the BTO, the endovascular FDS emergency placement can be effective. A combined endoscopic endonasal technique to support the extracranial side of the vessel using autologous flaps or grafts can be performed to prevent the risk of rebleeding.

Since December 2019, a novel Severe Acute Respiratory Syndrome coronavirus 2 from China has rapidly spread worldwide. Although respiratory involvement is the mainstay of coronavirus disease 2019 (COVID-19), systemic involvement has recently drawn more attention. In particular, a number of recent articles have shed light on the nervous system as one of the possible targets. At our institution, we observed 15 patients with acute brain vascular manifestations; most interesting, we had a higher prevalence of the posterior circulation acute impairment. In our series, 7 patients had acute posterior cerebral injury: 1, hemorrhagic posterior reversible encephalopathy syndrome; 5, posterior circulation ischemic stroke; and 1, parieto-occipital hemorrhagic stroke. On the basis of our evidence and previous basic science reports, we believe a common etiopathogenetic thread may connect ischemic/hemorrhagic events of the posterior circulation and posterior reversible encephalopathy syndrome in the setting of COVID-19.

Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the infectious agent responsible for coronavirus disease 2019 (COVID-19). Respiratory and gastrointestinal manifestations of SARS-CoV-2 are well described, less defined is the clinical neurological spectrum of COVID-19. We reported a case of COVID-19 patient with acute monophasic Guillain-Barré syndrome (GBS), and a literature review on the SARS-CoV-2 and GBS etiological correlation. Case Description A 68 years-old man presented to the emergency department with symptoms of acute progressive symmetric ascending flaccid tetraparesis. Oropharyngeal swab for SARS-CoV-2 tested positive. Neurological examination showed bifacial nerve palsy and distal muscular weakness of lower limbs. The cerebrospinal fluid assessment showed an albuminocytologic dissociation. Electrophysiological studies showed delayed distal latencies and absent F waves in early course. A diagnosis of Acute Inflammatory Demyelinating Polyradiculoneuropathy (AIDP) subtype of GBS was then made. Conclusions Neurological manifestations of COVID-19 are still under study. The case we described of GBS in COVID-19 patient adds to those already reported in the literature, in support of SARS-CoV-2 triggers GBS. COVID-19 associated neurological clinic should probably be seen not as a corollary of classic respiratory and gastrointestinal symptoms, but as SARS-CoV-2-related standalone clinical entities. To date, it is essential for all Specialists, clinicians and surgeons, to direct attention towards the study of this virus, to better clarify the spectrum of its neurological manifestations.

Intravitreal anti-vascular endothelial growth factor (VEGF) drugs aflibercept and ranibizumab are used in neovascular retinal diseases but may be associated with non-ocular haemorrhage. Our objective was to compare the risk of non-ocular haemorrhage with intravitreal aflibercept versus intravitreal ranibizumab and with individual intravitreal anti-VEGFs versus intravitreal dexamethasone. A retrospective cohort study was conducted using four Italian claims databases, covering 18 million inhabitants from 2011 to 2016. Incident aflibercept users were matched 1:4 to incident ranibizumab users. The outcome was incident non-ocular haemorrhage requiring hospitalisation. Incidence per 1000 person-years (PYs) was estimated. Patients were followed for 180 days using an intention-to-treat (ITT) approach. An as-treated (AT) approach was also employed, using grace periods of 60 or 90 days. Analyses were repeated for aflibercept versus dexamethasone and ranibizumab versus dexamethasone. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated using Cox proportional hazards models. We identified incident users of intravitreal ranibizumab (n = 21,766), aflibercept (n = 3150) and dexamethasone (n = 3900). The incidence of haemorrhage was four events per 1000 PYs for each drug. Aflibercept was not associated with increased risk versus ranibizumab at 180 days (HR 0.97 [95% CI 0.37–2.56]). Results were consistent in the AT analysis (HR 1.19 [95% CI 0.52–2.75]). No increased risk was found for aflibercept and ranibizumab at 180 days versus dexamethasone (HR 0.70 [95% CI 0.30–2.60] and HR 0.67 [95% CI 0.33–1.38], respectively). No association was identified between intravitreal aflibercept and non-ocular haemorrhage versus ranibizumab. A comparable risk for these intravitreal anti-VEGFs and intravitreal dexamethasone was observed.

Most advertisements contain thin-ideal imagery enhanced by digital modification. The deleterious effects on body image and eating disorder risk of exposure to such images have been well documented. One of the proposed macro-level solutions to mitigate these effects has been the use of labels on images, primarily disclaimer labels. A growing number of studies have explored the usefulness of such labels in protecting body image against the detrimental effects of media exposure; however, findings have been divergent.The current study aimed to conduct a systematic review and meta-analysis of the existing literature investigating the effects of including labels on media images on body image.The systematic review identified n = 22 studies that were included in a narrative review, n = 18 were included in the meta-analysis. Overall, findings provided little support for the use of disclaimer or warning labels as a means of protecting against the detrimental effects of media exposure on body image. Furthermore, findings suggested that such labels might increase state appearance comparison when exposed to media images.These findings are especially concerning in light of recent legislative efforts to mitigate media effects through the use of labels on imagery, as well as industry initiatives based on image labeling. Additional research examining alternative strategies for universal prevention of body image and eating concerns is warranted.La mayoría de las imágenes de los anuncios publicitarios presentan una figura ideal delgada que ha sido retocada digitalmente. Los efectos nocivos en la imagen corporal y el riesgo de trastorno alimentario por la exposición a dichas imágenes han sido bien documentados. Una de las soluciones a gran escala que se han propuesto para mitigar estos efectos ha sido el uso de etiquetas en las imágenes, básicamente etiquetas de exención de responsabilidad. Un número creciente de estudios ha explorado la utilidad de dichas etiquetas para proteger la imagen corporal contra los efectos perjudiciales de la exposición a los medios de comunicación; sin embargo, los hallazgos han sido divergentes. El presente estudio tuvo como objetivo realizar una revisión sistemática y un meta-análisis de la literatura existente que investiga los efectos de incluir estas etiquetas en las imágenes sobre imagen corporal en los medios de comunicación. La revisión sistemática identificó n = 22 estudios que se incluyeron en una revisión narrativa, n = 18 se incluyeron en el meta-análisis. En general, los hallazgos proporcionaron poco soporte para el uso de descargos de responsabilidad o etiquetas de advertencia como un medio de protección contra los efectos perjudiciales de la exposición de los medios en la imagen corporal. Además, las investigaciones han demostrado que dichas etiquetas pueden aumentar la comparación al ser expuestas a las imágenes mediáticas. Estos hallazgos son especialmente preocupantes a la luz de los recientes esfuerzos legislativos para mitigar los efectos de los medios mediante el uso de etiquetas en las imágenes, así como las iniciativas de la industria basadas en el etiquetado de imágenes. Se justifica una investigación adicional que examine las estrategias alternativas para la prevención universal de la imagen corporal y las preocupaciones alimentarias.