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In his Lectures on the History of Philosophy, Hegel develops a subtle analysis of Megarian paradoxes: the Liar, the Veiled Man and the Sorites. In this paper, we focus on Hegel's interpretation of ...

With the onset of the COVID-19 pandemic, physicians have had concerns related to the impact of the pandemic on their practice of medicine. Our objective was to evaluate physician questions and concerns related to the COVID-19 pandemic by studying physician calls made to a medico-legal telephone helpline, and explore associations between the pattern of these calls and the temporal progression of the pandemic.We conducted a descriptive study of calls related to the COVID-19 pandemic to the Canadian Medical Protective Association (CMPA) from Jan. 1, 2020, to June 30, 2021. Using content analysis, we classified calls into themes. Using a Poisson regression model, we tested for associations between the weekly numbers of physician calls related to COVID-19 and national rates of COVID-19 cases and deaths.We analyzed 3810 COVID-19-related calls. The highest call volume was observed during the pandemic's early months and was widely distributed across the country. Call volume correlated with rates of SARS-CoV-2 infection during the pandemic's first wave (We observed high volumes of physician calls to a medico-legal helpline during the first 18 months of the COVID-19 pandemic in Canada. Our data provide insight into the questions and concerns of Canadian physicians, and serve as a contemporaneous account of the adaptability and resilience of physicians during this challenging time.

HIV-exposed infected (HEI) and uninfected (HEU) children represent the two possible outcomes of maternal HIV infection. Modifications of the intestinal microbiome have been linked to clinical vulnerability in both settings, yet whether HEI and HEU differ in terms of gut impairment and peripheral inflammation/activation is unknown.We performed a cross-sectional, pilot study on fecal and plasma microbiome as well as plasma markers of gut damage, microbial translocation, inflammation and immune activation in HIV-infected and uninfected children born from an HIV-infected mother.Fecal and plasma microbiome were determined by means of 16S rDNA amplification with subsequent qPCR quantification. Plasma markers were quantified via ELISA.Forty-seven HEI and 33 HEU children were consecutively enrolled. The two groups displayed differences in fecal beta-diversity and relative abundance, yet similar microbiome profiles in plasma as well as comparable gut damage and microbial translocation. In contrast, monocyte activation (sCD14) and systemic inflammation (IL-6) were significantly higher in HEI than HEU.In the setting of perinatal HIV infection, enduring immune activation and inflammation do not appear to be linked to alterations within the gut. Given that markers of activation and inflammation are independent predictors of HIV disease progression, future studies are needed to understand the underlying mechanisms of such processes and elaborate adjuvant therapies to reduce the clinical risk in individuals with perinatal HIV infection.

Summary Background Presenting symptoms of childhood cancers might mimic those of rheumatic diseases. However, the evidence available to guide differential diagnosis remains scarce. Preventing wrong or delayed diagnosis is therefore important to avoid incorrect administration of glucocorticoid or immunosuppressive therapy and worsening of prognosis. As such, we aimed to assess the prevalence and characteristics of presenting musculoskeletal manifestations in patients at cancer onset and to identify the factors that differentiate childhood malignancies with arthropathy from juvenile idiopathic arthritis. Methods We did a multicentre, cross-sectional study at 25 paediatric haemato-oncology centres and 22 paediatric rheumatology centres in Italy. We prospectively recruited patients who were younger than 16 years that were newly diagnosed with cancer or juvenile idiopathic arthritis. We excluded patients with glucocorticoid pre-treatment (>1 mg/kg per day of oral prednisone or equivalent for ≥2 consecutive weeks). We collected data for patients with a new diagnosis of cancer or juvenile idiopathic arthritis using an electronic case report form on a web-based platform powered by the Cineca Interuniversity Consortium. The primary outcome was to describe the frequency and characteristics of musculoskeletal manifestations at cancer onset; and the secondary outcome was to identify factors that could discriminate malignancies presenting with arthropathy, with or without other musculoskeletal symptoms, from juvenile idiopathic arthritis using multivariable logistic regression analysis. Findings Between May 1, 2015, and May 31, 2018, 1957 patients were eligible, of which 1277 (65%) had cancer and 680 (35%) had juvenile idiopathic arthritis. Musculoskeletal symptoms occurred in 324 (25% [95% CI 23·0–27·8]) of 1277 patients with cancer, of whom 207 had arthropathy. Patients with malignant bone tumours had the highest frequency of musculoskeletal symptoms (53 [80%] of 66), followed by patients with Langerhans histiocytosis (16 [47%] of 34), leukaemia (189 [32%] of 582), soft-tissue sarcomas (16 [24%] of 68), and neuroblastoma (21 [19%] of 109). In the 324 patients with cancer and musculoskeletal symptoms, the most common complaints were joint pain (199 [61%]), followed by limb bone pain (112 [35%]). Joint involvement had a prevalent monoarticular pattern (100 [48%] of 207) and oligoarticular pattern (86 [42%] had 2–4 joints involved and 20 [10%] had >4 joints involved), with the most frequently involved joints being the hip (88 [43%] of 207) and knee (81 [39%]). On multivariable analysis, limb bone pain was the independent variable most strongly associated with cancer (odds ratio [OR] 87·80 [95% CI 18·89–408·12]), followed by weight loss (59·88 [6·34–565·53]), thrombocytopenia (12·67 [2·40–66·92]), monoarticular involvement (11·30 [4·09–31·19]), hip involvement (3·30 [1·13–9·61]), and male sex (2·40 [1·03–5·58]). Factors independently associated with juvenile idiopathic arthritis were morning stiffness (OR 0·04 [95% CI 0·01–0·20]), joint swelling (0·03 [0·01–0·09]), and involvement of the small hand joints (0·02 [0–1·05]). Interpretation Our study provides detailed information about presenting musculoskeletal manifestations of childhood cancers and highlights the clinical and laboratory features that are most helpful in the differential diagnosis with juvenile idiopathic arthritis. Funding Associazione Lorenzo Risolo.

International audience; Commercial microalgae production with conventional suspended cultures is still facing the challenge of high operational costs related to mixing and harvesting diluted biomass. Attached culture system is an emerging technology for replacing the suspended culture systems, were the biomass grows as a biofilm on a supporting belt that is continuously rotating between the liquid and gaseous phases. Immobilized culture systems have several advantages, when compared to suspended culture systems, such as higher biomass productivity and straightforward harvesting and concentration. Ready-to-use biomass with water content between 80-90% is harvested by simple scrapping, avoiding some dewatering steps. However, additional infrastructures are required increasing material and electricity demands. This study is a comparative pond to gate life cycle assessment of the environmental impacts, energetic and materials demands between the conventional Open Raceways Ponds (ORP) and Rotating Algal Biofilm (RAB), considering large-scale production of Tetraselmis suecica. Two products were analysed: microalgae biomass at 20%-DW and algae meal (protein concentrate powder). The results were also compared with the conventional protein sources, such as soymeal and fishmeal. Considering that both systems achieve the same productivity (20 g•m-2 •d-1), the environmental impacts, measured trough a single aggregated eco-point value, were 26% and 24% higher in attaching system than ORP, per kilogram of biomass at 20%-DW and protein powder (algae meal), respectively. Both solutions offer a significant environmental improvement when compared to soymeal and fishmeal. Productivities 40% higher in RAB are required to obtain lower environmental impacts than ORP system. Electrical demands reductions up to 83% and 62% per kilogram of biomass 20%-DW and kilogram of algae meal, respectively, were reached by RAB approach. If RAB can substantiate a 50% increase in productivity on the long run, then the eco-points gains will be 20%, with reductions higher than 55% in electricity requirements and around 30% in the water consumption. The efficient energy performance of RAB, and its considerable margin of improvement make it a promising alternative to conventional open raceway systems.

The role of an actor in a social network is identified through a set of measures called centrality. Degree centrality, betweenness centrality, closeness centrality, and clustering coefficient are the most frequently used metrics to compute the node centrality. Their computational complexity in some cases makes unfeasible, when not practically impossible, their computations. For this reason, we focused on two alternative measures, WERW-Kpath and Game of Thieves, which are at the same time highly descriptive and computationally affordable. Our experiments show that a strong correlation exists between WERW-Kpath and Game of Thieves and the classical centrality measures. This may suggest the possibility of using them as useful and more economic replacements of the classical centrality measures.

Social Network Analysis (SNA) studies groups of individuals and can be applied in a lot of areas such us organizational studies, psychology, economics, information science and criminology. One of the most important results of SNA has been the definition of a set of centrality measures (e.g., degree, closeness, betweenness, or clustering coefficient) which can be used to identify the most influential people with respect to their network of relationships. The main problem with computing centrality metrics on social networks is the typical big size of the data. From the computational point of view, SNA represents social networks as graphs composed of a set of nodes connected by another set of edges on which the metrics of interest are computed. To overcome the problem of big data, some computationally-light alternatives to the standard measures, such as Game of Thieves or WERW-Kpath, can be studied. In this regard, one of my main research activities was to analyze the correlation among standard and nonstandard centrality measures on network models and real-world networks. The centrality metrics can greatly contribute to intelligence and criminal investigations allowing to identify, within a covert network, the most central members in terms of connections or information flow. Covert networks are terrorist or criminal networks which are built from the criminal relationships among members of criminal organizations. One of the most renowned criminal organizations is the Sicilian Mafia. The focal point of my research work was the creation of two real-world criminal networks from the judicial documents of an anti-mafia operation called Montagna conducted by a specialized anti-mafia police unit of the Italian Carabinieri in Messina (i.e., the third largest city on the island of Sicily). One network includes meetings and the other one records telephone calls among suspected criminals of two Sicilian Mafia families. This dataset is unique and it might represent a valuable resource for better understanding complex criminal phenomena from a quantitative standpoint. Different SNA approaches have been used on these Montagna networks to describe their structure and functioning, to predict missing links, to identify leaders or to evaluate police interventions aimed at dismantling and disrupting the networks. Graph distances have been used to find a network model able to properly mime the structure of a Mafia network and to quantify the impact of incomplete data not only on Mafia networks such as the Montagna ones but also on terrorist and street gangs networks. The two simple Montagna networks have been finally used to build a multilayer network trying to obtain a more nuanced understanding of the network structure and of the strategic position of nodes in the network.

Purpose. To describe ecthyma gangrenosum (EG) characteristics and complications in a large multicenter pediatric retrospective collection of children with malignancies or bone marrow failure syndromes. Methods. EG episodes diagnosed in the period 2009-2019 were identified by a retrospective review of clinical charts at centers belonging to the Italian Pediatric Hematology Oncology Association. Results. EG occurred in 38 children (male/female 16/22; median age 5.2 years) with hematological malignancy (33), allogeneic stem cell transplantation (2) or relapsed/refractory solid tumor (3). The involved sites were: perineal region (19), limbs (10), trunk (6), head and the iliac crest (3). Bacteremia was present in 22 patients. Overall, the germs isolated were Pseudomonas aeruginosa (34), Stenotrophomonas maltophilia (3) and Escherichia Coli (1); 31% of them were MDR. All patients received antibacterial treatment while surgery was performed in 24 patients (63.1%). Predisposing underlying conditions for EG were: severe neutropenia (97.3%), corticosteroid treatment (71%), iatrogenic diabetes (23.7%). All patients recovered, but EG recurred in 5 patients. Nine patients (24%) showed sequelae (deep scars, with muscle atrophy in 2). Four patients (10.5%) died, 1 due to relapse of EG with KPC co-infection, 3 due to the underlying disease. Conclusions. EG requires early recognition and a proper and timely treatment to obtain the recovery and to avoid larger necrotic evolution. The occurrence of scarring sequelae might affect the quality of life of patients.

Complementary feeding (CF) is a pivotal phase of the individual’s growth, during which children develops their future dietary habits. To date, only few studies investigated and compared weaning modalities between different geographical areas. The aim of this article is to describe the current Italian practice for CF in healthy term infants among different areas (North, Center, South) of Italy. Two different multiple-choice questionnaires were produced and sent to 665 Italian primary care pediatricians (PCP) and 2023 families with children under 1 year of age. As emerged from our investigation, in Italy CF is usually started between the 5th and 6th month of life. The preferred approach (chosen by 77% of families) involves the use of home-cooked liquid or semi-liquid ailments, or industrial baby foods. A new CF modality is emerging, consisting of traditional complementary foods with adult food tastings (10% of families). Approximately 91% of pediatricians give written dietary suggestions, and 83% of families follow their advice. We found significantly divergent weaning habits among different areas of Italy. PCP have a key role in guiding parents during the introduction of new foods in their infant’s diet and should take this as an opportunity to educate the whole family to healthy dietary habits.