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Carl Wernicke described the disease bearing his name in 1881 and reported three cases characterized by the presence of mental confusion, ataxia, and ophthalmoplegia. Wernicke’s disease is mainly observed in alcoholic patients, due to decreased vitamin intake as a consequence of an unbalanced diet, and a reduction of absorption due to the effects of alcohol. Likewise, inadequate vitamin intake is prevalent in older patients. Wernicke’s encephalopathy due to inappropriate total parenteral nutrition (TPN) occurs infrequently; recently, there is an increase in the literature concerning Wernicke’s encephalopathy in patients after general and bariatric surgeries. We present two cases of Wernicke’s encephalopathy after oncologic gastrointestinal surgery by failure to administer vitamin B1 during TPN; to our knowledge, these are the first two cases of Wernicke’s encephalopathy after colorectal surgery for cancer. In our opinion, timely diagnosis and treatment are mandatory to avoid nonfunctional recovery and consequent malpractice legal actions as well as an increase in the health-care costs correlated with the prolonged hospital stay and with the nonfunctional recovery.

In Italy, both parents have parental responsibility, so they have the power to give or withhold consent to medical procedures on their children.

The risk-delimiting tools available to insurance companies are therefore substantial and it is also possible to argue that a margin of uncertainty is a natural component of the insurance contract.

The aim of this article is to provide an analysis of the main issues related to the application of predictive medicine by analysing the most significant ethical implications.

The increase in the number of people who choose to have medical procedures done to improve their appearance may be due to changed social and cultural factors in modern society, as well to the ease of access and affordable costs of these cosmetic treatments.

In Italy, both parents have parental responsibility; as a general principle they have the power to give or withhold consent to medical procedures on their children, including consent for blood transfusion; however these rights are not absolute and exist only to promote the welfare of children.

Non-therapeutic body modification interventions are permitted within the limits of the use of one’s own body that can be specified in the legal system. The authors take into consideration Italian regulation on tattooing and piercing, in particular in relation to adolescents.

Dental treatments, as well as simple anatomical and functional repair work, can also be for aesthetic purposes. This is because the anatomical area concerned, i.e. the oral cavity, has a great power of attraction. Aesthetic treatments in general – in particular dental treatments – have been on the rise in recent years, and this has also meant an increase in claims due to patient dissatisfaction with the results obtained. Numerous laws have been introduced that emphasise the need for comprehensive prior information in order to acquire valid consent. This has resulted in the elimination of the distinction between the obligation of means and obligation of result, with achievement of the normally expected result required in any case.

Responsibility means responding to the damaging consequences of technical work and in this binding perspective the general principles of guilt in genetic diagnostics and related activities are not different from any other medical performance.

This study originated from events that occurred in 2014 in an Italian hospital, where the embryos of a couple, obtained by means of homologous insemination, were mistakenly implanted into the uterus of another woman who, along with her husband, underwent the same treatment.

Phishing is a common social engineering attack aimed to steal personal information. Universities attract phishing attacks because: (1) they store employees and students sensitive data; (2) they save confidential documents; and (3) their infrastructures often lack security. In this paper, we showcase a phishing assessment at the University of Redacted aimed to identify the people, and the features of such people, that are more susceptible to phishing attacks. We delivered phishing emails to 1.508 subjects in three separate batches, collecting a clickrate equal to 30%, 11% and 13%, respectively. We considered several features (i.e., age, gender, role, working/studying field, email template) in univariate and multivariate analyses and found that students are more susceptible to phishing attacks than professors or technical/administrative staff, and that emails designed through a spearphishing approach receive a highest clickrate. We believe this work provides the foundations for setting up an effective educational campaign to prevent phishing attacks not only at the University of Redacted, but in any other university

As part of the Snowmass'21 community planning excercise, the Advanced Accelerator Concepts (AAC) community proposed future linear colliders with center-of-mass energies up to 15 TeV and luminosities up to 50 × 1034 cm-2 s-1 in a compact footprint. In addition to being compact, these machines must also be energy efficient. We identify two challenges that must be addressed in the design of these machines. First, the Beam Delivery System (BDS) must not add significant length to the accelerator complex. Second, beam parameters must be chosen to mitigate beamstrahlung effects and maximize the luminosity-per-power of the machine. In this paper, we review advances in plasma lens technology that will help to reduce the length of the BDS system and we detail new Particle-in-Cell simulation studies that will provide insight into beamstrahlung mitigation techniques. We apply our analysis to both e + e - and γγ colliders. The challenges and solutions described in this paper are considered independently. A unified, self-consistent concept for a BDS system for a 15 TeV linear collider will be the subject of future work.

Abstract Background Mindfulness practice has gained interest in the management of Chronic Migraine associated with Medication Overuse Headache (CM-MOH). Mindfulness is characterized by present-moment self-awareness and relies on attention control and emotion regulation, improving headache-related pain management. Mindfulness modulates the Default Mode Network (DMN), Salience Network (SN), and Fronto-Parietal Network (FPN) functional connectivity. However, the neural mechanisms underlying headache-related pain management with mindfulness are still unclear. In this study, we tested neurofunctional changes after mindfulness practice added to pharmacological treatment as usual in CM-MOH patients. Methods The present study is a longitudinal phase-III single-blind Randomized Controlled Trial (MIND-CM study; NCT03671681). Patients had a diagnosis of CM-MOH, no history of neurological and severe psychiatric comorbidities, and were attending our specialty headache centre. Patients were divided in Treatment as Usual (TaU) and mindfulness added to TaU (TaU + MIND) groups. Patients underwent a neuroimaging and clinical assessment before the treatment and after one year. Longitudinal comparisons of DMN, SN, and FPN connectivity were performed between groups and correlated with clinical changes. Vertex-wise analysis was performed to assess cortical thickness changes. Results 177 CM-MOH patients were randomized to either TaU group or TaU + MIND group. Thirty-four patients, divided in 17 TaU and 17 TaU + MIND, completed the neuroimaging follow-up. At the follow-up, both groups showed an improvement in most clinical variables, whereas only TaU + MIND patients showed a significant headache frequency reduction (p = 0.028). After one year, TaU + MIND patients showed greater SN functional connectivity with the left posterior insula (p-FWE = 0.007) and sensorimotor cortex (p-FWE = 0.026). In TaU + MIND patients only, greater SN-insular connectivity was associated with improved depression scores (r = -0.51, p = 0.038). A longitudinal increase in cortical thickness was observed in the insular cluster in these patients (p = 0.015). Increased anterior cingulate cortex thickness was also reported in TaU + MIND group (p-FWE = 0.02). Conclusions Increased SN-insular connectivity might modulate chronic pain perception and the management of negative emotions. Enhanced SN-sensorimotor connectivity could reflect improved body-awareness of painful sensations. Expanded cingulate cortex thickness might sustain improved cognitive processing of nociceptive information. Our findings unveil the therapeutic potential of mindfulness and the underlying neural mechanisms in CM-MOH patients. Trial Registration Name of Registry; MIND-CM study; Registration Number ClinicalTrials.gov identifier: NCT0367168; Registration Date: 14/09/2018

Objetivo: relato de estudo imuno-hematológico, tendo por finalidade compartilhar experiência de identificação de anticorpo IgG dirigido a antígeno de alta frequência (Anti-Kna) e suas implicações transfusionais. Descrição: Paciente de 68 anos, feminino, brasileira, diagnosticado com tumor intracraniano. Em 14/03/2024 foram realizados testes pré-transfusionais que apresentaram os seguintes resultados: tipagem sangüínea A Rh(D) positivo; teste de antiglobulina direto (TAD) negativo; pesquisa de anticorpos irregulares (PAI) positiva em gel LISS Coombs / gel IgG / gel NaCl, este último mais fracamente reativo; identificação do(s) anticorpo(s) sérico(s): anticorpo Indeterminado (reativo com quase todas as células do painel); autocontrole negativo em gel LISS + autocrioaglutinina indeterminada (método em tubo / 4°C). Outros testes realizados mostraram triagem em gel LISS positiva mesmos após tratamento sérico com DTT0,01M; inibição com pool de plasma para descarte de Anti-CH/Rg: triagem positiva, descartado anti-Ch/Rg; PAI positiva com hemácias tratadas com DTT0,2M, antígeno resistente; pesquisa de subclasse de IgG (indireta): IgG1 1:1 Neg. / IgG3 1:1 Neg. A paciente não possuía histórico transfusional em nosso serviço. Iniciando seu tratamento em 14/03/2024 apresentou o fenótipo: C-, Cw-, c+, E+, e-; K-, k+, Kp(a-b+); Jk(a+b-); M+, N-, S-, s+; Fy(a-b+); Le(a+ b-); Lu(a-b+); P1+. Encaminhamos a amostra ao laboratório de referência para a realização de estudos sorológicos e moleculares. As técnicas moleculares utilizadas (PCR multiplex), demonstraram KN*2 . Fenótipo deduzido do genótipo: Kn(a-b+). O soro foi testado com painel de hemácias raras, no qual não apresentou reatividade com uma hemácia Kn(a-). Como resultado final, liberado pelo laboratório de referência, o anticorpo em questão foi caracterizado como anti-Kna, Conclusão: anticorpo sérico anti-Kna. De 19/04/24 a 28/05/24 a paciente recebeu cinco unidades de concentrado de hemácias, todas com prova de compatibilidade negativa em gel LISS Coombs, sendo quatro C- e- K- e uma unidade C- e+ K-. Não apresentou reação transfusional, assim como elevação em testes de perfil hemolítico, com adequado incremento transfusional confirmando os dados existentes na literatura a respeito do Anti-Kna, bem como a pesquisa para subclasse de IgG que também informava não se tratar de IgG1 e/ou IgG3, portanto anticorpo sem significado clínico transfusional.

In this work, we report the investigation of the effect of exposure of apple trees to the bioeffector wood distillate (WD), a plant biostimulant used for improving the nutritional profiling of crop plants. We measured the effect by evaluating the biochemical and nutritional profile of both pulps and skin of fruits. WD (0.2 %, v/v) was applied once a week by foliar application, from May 2023 until September 2023. The results indicate that the WD-treated apples have a significant increase in several analyzed parameters (i.e., phenols, flavonoids, tannins, total antioxidant power, sugars, pectin, free amino acids, and mineral element content), especially in the pulp. These data were also confirmed by NMR and LC-ESI-MS techniques. This study pointed out that WD could be a handy tool for the cultivation of fruit trees.

The aim of this research was to compare the level of digital competence of future pedagogical staff (students of pedagogical faculties) in Italy and Poland. The research was conducted using original measurement tools and knowledge tests. The triangulation of techniques and research tools made possible the determination of the level of knowledge of the positive and negative features of the development of the information society, as well as the proficiency and frequency of use of the most popular websites and software. The research was conducted in the first half of 2022 using stratified sampling in both countries (N = 1209, IT = 604, PL = 605). Based on the data collected, it was noted that: (1) Pre-service teachers most often use software such as word processors and presentation creation tools; (2) This group very rarely uses software to create web pages, create visual material, or edit video; (3) The least problematic software that students use are word processors and multimedia presentations; (4) Among the typical ICT mediated activities that cause problems are: searching for and installing freeware (PL), installing and configuring parental control software (PL, IT), creating websites (PL, IT), searching for freely licensed images, and identifying plagiarism (PL); (5) Polish students have more theoretical knowledge about e-risks and the possibilities of the digital world than their Italian counterparts; (6) In most domains, the Italian future teachers rate their competences higher; (7) 53.81% of the respondents in IT and 38.68% in PL received lower results in competence tests, and handling ICT in selected areas causes problems for these students; (8) Both in PL and IT the frequency of ICT use and its seamless integration are predictors for assessing the effectiveness of ICT use in education.

“Click” cycloadditions offer effective pathways for the modifications of supramolecular structures, polymers, and nanomaterials. These reactions include bioorthogonal mechanisms that do not interfere with the biological processes, providing a type of chemistry to operate directly in living environments, such as cells and animals. As a result, the “click” cycloadditions represent highly and selective tools for tailoring the properties of nanomedicine scaffolds, expanding the efficacy of multiple therapeutic strategies. We focused this minireview on the bioorthogonal cycloadditions, presenting an insight into the strategies to modify nanostructured biomedical scaffolds inside living systems. We organized the contributions according to the three main mechanisms of “click” cycloadditions: strain-promoted sydnone-alkyne, tetrazine ligation, and strain-promoted [3+2] azido-alkyne.

Abstract Objective The resting‐state functional connectome has not been extensively investigated in amyotrophic lateral sclerosis (ALS) spectrum disease, in particular in relationship with patients' genetic status. Methods Here we studied the network‐to‐network connectivity of 19 ALS patients carrying the C9orf72 hexanucleotide repeat expansion (C9orf72+), 19 ALS patients not affected by C9orf72 mutation (C9orf72−), and 19 ALS‐mimic patients (ALSm) well‐matched for demographic and clinical variables. Results When compared with ALSm, we observed greater connectivity of the default mode and frontoparietal networks with the visual network for C9orf72+ patients (P = 0.001). Moreover, the whole‐connectome showed greater node degree (P

Currently available data show mixed results as to whether the processing of emotional information has the same characteristics in the native (L1) as in the second language (L2) of bilinguals. We conducted a functional magnetic resonance imaging (fMRI) experiment to shed light on the neurocognitive mechanisms underlying bilinguals’ emotional processing in L1 and L2 during an emotional interference task (i.e., the Emotional Stroop Task – EST). Our sample comprised proficient Italian-English bilinguals who learned their L2 during childhood mainly in instructional rather than immersive contexts. In spite of no detectable behavioural effects, we found stronger brain activations for L1 versus L2 emotional words in sectors of the posteromedial cortex involved in attention modulation, episodic memory, and affective processing. While fMRI findings are consistent with the hypothesis of a stronger emotional resonance when processing words in a native language, our overall pattern of results points to the different sensitivity of behavioural and hemodynamic responses to emotional information in the two languages of bilingual speakers.

L’innovazione didattica rientra tra le azioni che i sistemi di Higher Education sono chiamati ad implementare per continuare a svolgere il ruolo di agenzie che guidano il cambiamento. È un’iniziativa che all’Università di Padova ormai da circa otto anni è declinata in percorsi diversi, uno dei quali è il percorso per change agent (CA), i quali hanno la funzione di generare cambiamento all’interno dei loro contesti. La finalità di questa ricerca, a carattere qualitativo, è di conoscere quali cambiamenti hanno sperimentato i docenti coinvolti sia nei processi di insegnamento/apprendimento sia come CA nei loro dipartimenti di afferenza. I risultati mostrano che ci sia stato un cambiamento significativo in termini di prospettive e pratica didattica, ma ulteriori sforzi sono da compiere per svolgere una funzione efficace come CA.

The article looks at global, regional, national and local dimensions in a diverse setting of the interplay of governmental, university and civil society partners. Higher education (HE) is called to support the recent discussions on the importance of adult learning and education (ALE) within lifelong learning. Therefore, during the Adult Education Academy (AEA) on international and comparative studies which met in 2024 at University of Würzburg for the 11th year as a study opportunity for PhD and Master students as well as practitioners, the authors agreed to contribute this paper to examine thematic areas related to global policy recommendations that strengthen the relationship between HE and ALE in different forms. Findings should lead to a better understanding of ALE enabling the acquisition of skills for personal fulfilment and social enlightenment. Le istituzioni di Higher education promuovono l’apprendimento e l’educazione degli adulti: esempi, esperienze, aspettative. L’articolo esamina le dimensioni globale, regionale, nazionale e locale in un contesto diversificato di interazione tra partner governativi, universitari e della società civile. L’HE è chiamata a supportare il recente dibattito sull’importanza dell’apprendimento e dell’educazione degli adulti (EA). Pertanto, durante l’Adult Education Academy (AEA) sugli studi internazionali e comparativi, riunitasi nel 2024 all’Università di Wurzburg come opportunità di studio per dottorandi, studenti e professionisti, gli autori hanno concordato di contribuire alla stesura di questo articolo con la finalità di esaminare temi relativi alle raccomandazioni delle politiche globali che rafforzano il rapporto tra HE e AE. I risultati dovrebbero portare a un migliore riconoscimento dell’AE come mezzo per l’acquisizione di competenze utili alla realizzazione personale e alla crescita sociale.

(150 word max) We present a first-of-kind mesh-refined (MR) massively parallel Particle-In-Cell (PIC) code for kinetic plasma simulations optimized on the Frontier, Fugaku, Summit, and Perlmutter supercomputers. Major innovations, implemented in the WarpX PIC code, include: (i) a three level parallelization strategy that demonstrated performance portability and scaling on millions of A64FX cores and tens of thousands of AMD and Nvidia GPUs (ii) a groundbreaking mesh refinement capability that provides between 1.5 x to 4 x savings in computing requirements on the science case reported in this paper, (iii) an efficient load balancing strategy between multiple MR levels. The MR PIC code enabled 3D simulations of laser-matter interactions on Frontier, Fugaku, and Summit, which have so far been out of the reach of standard codes. These simulations helped remove a major limitation of compact laser-based electron accelerators, which are promising candidates for next generation high-energy physics experiments and ultra-high dose rate FLASH radiotherapy.

Electromagnetic particle-in-cell (PIC) codes are widely used to perform computer simulations of a variety of physical systems, including fusion plasmas, astrophysical plasmas, plasma wakefield particle accelerators, and secondary photon sources driven by ultra-intense lasers. In a PIC code, Maxwell's equations are solved on a grid with a numerical method of choice. This article focuses on pseudo-spectral analytical time-domain (PSATD) algorithms and presents a novel hybrid PSATD PIC scheme that combines the respective advantages of standard nodal and staggered methods. The novelty of the hybrid scheme consists in using finite-order centering of grid quantities between nodal and staggered grids, in order to combine the solution of Maxwell's equations on a staggered grid with the deposition of charges and currents and the gathering of electromagnetic forces on a nodal grid. The correctness and performance of the novel hybrid scheme are assessed by means of numerical tests that employ different classes of PSATD equations in a variety of physical scenarios, ranging from the modeling of electron-positron pair creation in vacuum to the simulation of laser-driven and particle beam-driven plasma wakefield acceleration. It is shown that the novel hybrid scheme offers significant numerical and computational advantages, compared to purely nodal or staggered methods, for all the test cases presented.

Within the framework of the recent agri-food technological advancement, the design and validation of a methodology for the water content estimation in the Carasau bread manufacturing process is herein presented. Following a thorough evaluation of the dough dielectric properties, a suitable antenna layout has been selected, pointing out the advantages in the choice of a contactless narrow-band antenna in comparison to wide-band and dual-band ones. The presented simulated results are then validated using a prototype sensor and an ad hoc measurement system to confirm the antenna ability to discriminate among doughs with different water content. In addition, an accurate analysis of possible sources of misinterpretation of the results is presented.

Abstract Background Despite hypothalamus has long being considered to be involved in the pathophysiology of cluster headache, the inconsistencies of previous neuroimaging studies and a limited understanding of the hypothalamic areas involved, impede a comprehensive interpretation of its involvement in this condition. Methods We used an automated algorithm to extract hypothalamic subunit volumes from 105 cluster headache patients (57 chronic and 48 episodic) and 59 healthy individuals; after correcting the measures for the respective intracranial volumes, we performed the relevant comparisons employing logist regression models. Only for subunits that emerged as abnormal, we calculated their correlation with the years of illness and the number of headache attacks per day, and the effects of lithium treatment. As a post-hoc approach, using the 7 T resting-state fMRI dataset from the Human Connectome Project, we investigated whether the observed abnormal subunit, comprising the paraventricular nucleus and preoptic area, shows robust functional connectivity with the mesocorticolimbic system, which is known to be modulated by oxytocin neurons in the paraventricular nucleus and that is is abnormal in chronic cluster headache patients. Results Patients with chronic (but not episodic) cluster headache, compared to control participants, present an increased volume of the anterior–superior hypothalamic subunit ipsilateral to the pain, which, remarkably, also correlates significantly with the number of daily attacks. The post-hoc approach showed that this hypothalamic area presents robust functional connectivity with the mesocorticolimbic system under physiological conditions. No evidence of the effects of lithium treatment on this abnormal subunit was found. Conclusions We identified the ipsilateral-to-the-pain antero-superior subunit, where the paraventricular nucleus and preoptic area are located, as the key hypothalamic region of the pathophysiology of chronic cluster headache. The significant correlation between the volume of this area and the number of daily attacks crucially reinforces this interpretation. The well-known roles of the paraventricular nucleus in coordinating autonomic and neuroendocrine flow in stress adaptation and modulation of trigeminovascular mechanisms offer important insights into the understanding of the pathophysiology of cluster headache.