Freedom Within Convention: A Cooperative Analysis of the Zhuangzi and A Thousand Plateaus

The Zhuangzi, a foundational text in Classical Chinese philosophy, presents a notion of ideal humanity that involves a seemingly paradoxical relationship between a liberated existence and the barriers that restrict it. To achieve ideal humanity, one must confront the boundaries and attachments that have coalesced into a web of socio-physical conventions and developed dominion over human thought and action. This paper aims at shedding some light on this tension by offering a comparative analysis of the Zhuangzi and A Thousand Plateaus by Gilles Deleuze and Felix Guattari in terms of their conceptions of ideal humanity. While an abundance of time and different philosophical traditions separate these two texts, they share a relational ontology and similar concerns regarding the meaning and praxis of human freedom. These similarities allow for a cooperative understanding of ideal humanity in both texts without ideologically reducing them nor losing sight of the distinct and unique essence of each work. While the Zhuangzi provides a comprehensive reflection on the variability of constraints and conventions that delimit human freedom, A Thousand Plateaus illuminates the nature of this freedom using particular embodiments of the ideal person. Throughout the comparative analysis of both works, I will offer a framework for grasping the paradox of detached existence within a world of lively entanglements

BIPMIN: A Gamified Framework for Process Modeling Education

Business Process Modeling is a skill that is becoming sought after for computer engineers, with Business Process Modeling Notation (BPMN) being one example of the tools used in modeling activities. Students of the Master of Computer Engineering course at Politecnico di Torino learn about BPMN in dedicated courses but often underperform on BPMN-related exercises due to difficulties understanding how to model processes. In recent years, there has been a surge of studies that employ gamification (using game elements in non-recreative contexts to obtain benefits) as a tool in Computer Engineering education to increase students’ engagement with the learning process. This study aims to use the principles of gamification to design a supplementary learning tool for the teaching of information systems technology. In particular, to improve student understanding and use of BPMN diagrams. This study also analyzes the usability and motivation of the participants in using different game elements in increasing student motivation and performance. As part of the study, a prototype web application was developed, which implemented three different designs, each incorporating different game elements relating to either progress, competition, or rewards. An evaluation was then conducted on the prototype to evaluate the performance of the practitioners in performing BPMN modeling tasks with the gamified tool, the usability of the proposed mechanics and the enjoyment of the individual game mechanics that were implemented. With the usage of the gamified tool, the users of the experimental sample were able to complete BPMN modeling tasks with performances compatible with estimates made through expert judgement (i.e., gamification had no negative effect on performance), and were motivated to check the correctness of their models many times during the task execution. The system was evaluated as highly usable (85.8 System Usability Score); the most enjoyed game elements were rewards, levels, progress bars and aesthetics

Differential diagnosis in children with autistic symptoms and subthreshold ADOS total score: An observational study

Background: Children with autism spectrum disorder (ASD) share some symptoms with children with other neurodevelopmental disorders (ie, intellectual disability or communication disorders or language disorders). These similarities can make difficult to obtain an accurate diagnosis, which is essential to give targeted treatments to the patients. We aim to verify in our study if children with autistic traits who undergo to Autism Diagnostic Observation Schedule had specific clinical diagnosis. Patients and Methods: We selected 73 children tested with ADOS-G or ADOS-2, for the presence of autistic symptoms. The whole sample did not reach the cut-off of ADOS and did not receive the ASD diagnosis, according to DSM-5. Results: Results of this study showed that in order of frequency and early diagnosis, communication disorders (CD), mild intellectual disability (mID) and the attention deficit hyperactivity disorders (ADHD) represent the most common final clinical diagnosis in children with autistic traits. Conclusion: Our results showed as the CD was the common diagnosis of these children and that often associated with younger age. Moreover, analyses of ADOS domains and the difference of individual items between groups did not show the capacity to differentiate between different neurodevelopmental disorders in terms of differential diagnosis, and this confirms the need for integrating multiple sources of information during the diagnostic process

Tracking dynamics of magma migration in open-conduit systems

Open-conduit volcanic systems are typically characterized by unsealed volcanic conduits feeding permanent or quasi-permanent volcanic activity. This persistent activity limits our ability to read changes in the monitored parameters, making the assessment of possible eruptive crises more difficult. We show how an integrated approach to monitoring can solve this problem, opening a new way to data interpretation. The increasing rate of explosive transients, tremor amplitude, thermal emissions of ejected tephra, and rise of the very-long- period (VLP) seismic source towards the surface are interpreted as indicating an upward migration of the magma column in response to an increased magma input rate. During the 2014 flank eruption of Stromboli, this magma input pre- ceded the effusive eruption by several months. When the new lateral effusive vent opened on the Sciara del Fuoco slope, the effusion was accompanied by a large ground deflation, a deepening of the VLP seismic source, and the cessation of summit explosive activity. Such observations suggest the drainage of a superficial magma reservoir confined between the crater terrace and the effusive vent. We show how this model successfully reproduces the measured rate of effusion, the observed rate of ground deflation, and the deepening of the VLP seismic source. This study also demonstrates the ability of the geophysical network to detect superficial magma recharge within an open-conduit system and to track magma drainage during the effusive crisis, with a great impact on hazard assessment

Applications of Ketogenic Diets in Patients with Headache: Clinical Recommendations

Headaches are among the most prevalent and disabling neurologic disorders and there are several unmet needs as current pharmacological options are inadequate in treating patients with chronic headache, and a growing interest focuses on nutritional approaches as non-pharmacological treatments. Among these, the largest body of evidence supports the use of the ketogenic diet (KD). Exactly 100 years ago, KD was first used to treat drug-resistant epilepsy, but subsequent applications of this diet also involved other neurological disorders. Evidence of KD effectiveness in migraine emerged in 1928, but in the last several year's different groups of researchers and clinicians began utilizing this therapeutic option to treat patients with drug-resistant migraine, cluster headache, and/or headache comorbid with metabolic syndrome. Here we describe the existing evidence supporting the potential benefits of KDs in the management of headaches, explore the potential mechanisms of action involved in the efficacy in-depth, and synthesize results of working meetings of an Italian panel of experts on this topic. The aim of the working group was to create a clinical recommendation on indications and optimal clinical practice to treat patients with headaches using KDs. The results we present here are designed to advance the knowledge and application of KDs in the treatment of headaches

Clinical validation of 13-Gene DNA methylation analysis from oral brushing: a non invasive sampling procedure for early detection of oral squamous cell carcinoma. A multicentric study

1. Introduction In a recent study our research group described a non-invasive sampling procedure based on DNA methylation analysis of a set of 13 genes with a high level of accuracy (sensitivity 96.6%, specificity 100%) in the detection of squamous cell carcinoma of the oral cavity (OSCC) [1]. The purpose of the present study was to test the diagnostic performance of this non invasive sampling procedure in an italian multicentric study. 2. Materials and Methods Oral brushing specimens were collected in ten different italian units of oral medicine. Each oral medicine unit collected blindly 10 brushing specimens from patients affected by OSCC and an equal number of age and sex-matched healthy controls. 13-gene DNA methylation analysis was performed and each sample was considered positive or negative in relation to a predefined cut-off value. 3. Results 181 out of 200 planned specimens were analyzed. DNA could not be amplified in 4 cases (2.2%). 86/93 (92.5%) specimens derived from OSCC patients were detected as positive and 70/84 (83.3%) specimens derived from healthy donors showed a negative score. 4. Conclusions Data from multicentric study confirmed a high level of sensitivity of our procedure whereas level of specificity is slightly lower if compared to our previous study. These data suggest that our procedure may be proposed as a first level diagnostic test with the aim to avoid a diagnostic delay in Oral Squamous Cell Carcinoma. Conflicts of Interest: As a possible conflict of interest, L. Morandi and D.B.G. submitted a patent (the applicant is the University of Bologna) in November 2016 to the National Institute of 398 Industrial Property; however, we believe that this is a natural step of translational research (bench-to-bedside) 399 and guarantee that the scientific results are true. The remaining authors declare that they have no competing 400 interest

Prevalence of resistance-associated substitutions to NS3, NS5A and NS5B inhibitors at DAA-failure in hepatitis C virus in Italy from 2015 to 2019

: Despite the high efficacy of direct-acting antivirals (DAAs), the selection of resistance-associated substitutions (RASs) after virological failure of hepatitis C virus (HCV) DAAs can impair the cure of chronic HCV. The aim of the study was to characterize RASs after virological failure of DAAs in Italy over the years. Within the Italian network VIRONET-C, the change in prevalence of NS3/4A-NS5A-NS5B RASs was retrospectively evaluated in patients who failed a DAA regimen over the years 2015-2019. NS3, NS5A and NS5B Sanger sequencing was performed using homemade protocols and the geno2pheno system was used to define HCV-genotype/subtype and predict drug resistance. The changes in the prevalence of RASs over time were evaluated using the chi-square test for trend. Predictors of RASs at failure were analysed by logistic regression. Among 468 HCV-infected patients, HCV genotype 1 was the most prevalent (1b in 154, 33% and 1a in 109, 23%). DAA regimens were: ledipasvir (LDV)/sofosbuvir (SOF) in 131 patients (28%), daclatasvir (DCV)/SOF in 109 (23%), ombitasvir/paritaprevir/ritonavir+dasabuvir (3D) in 89 (19%), elbasvir (EBR)/grazoprevir (GRZ) in 52 (10.5%), velpatasvir (VEL)/SOF in 53 (11%), glecaprevir (GLE)/pibrentasvir (PIB) in 27 (6%) and ombitasvir/paritaprevir/ritonavir (2D) in 7 (1.5%); ribavirin was administered in 133 (28%). The NS5A fasta sequence was available for all patients, NS5B and NS3/4A both for 93%. The prevalence of NS5A and NS3/4A RASs significantly declined from 2015 to 2019; NS5B RAS remained stable. Independent predictors of any RASs included older age and genotype 1a (vs G2 and vs G4). Notably, at least partial susceptibility to all the agents included in the GLE/PIB and VEL/SOF/Voxilaprevir (VOX) combinations was predicted in >95% of cases. As RASs remain common at the failure of DAAs, their identification could play a crucial role in optimizing re-treatment strategies. In Italy RAS prevalence has been decreasing over the years and susceptibility to the latest developed drug combinations is maintained in most cases

Impact of safety-related dose reductions or discontinuations on sustained virologic response in HCV-infected patients: Results from the GUARD-C Cohort

BACKGROUND: Despite the introduction of direct-acting antiviral agents for chronic hepatitis C virus (HCV) infection, peginterferon alfa/ribavirin remains relevant in many resource-constrained settings. The non-randomized GUARD-C cohort investigated baseline predictors of safety-related dose reductions or discontinuations (sr-RD) and their impact on sustained virologic response (SVR) in patients receiving peginterferon alfa/ribavirin in routine practice. METHODS: A total of 3181 HCV-mono-infected treatment-naive patients were assigned to 24 or 48 weeks of peginterferon alfa/ribavirin by their physician. Patients were categorized by time-to-first sr-RD (Week 4/12). Detailed analyses of the impact of sr-RD on SVR24 (HCV RNA <50 IU/mL) were conducted in 951 Caucasian, noncirrhotic genotype (G)1 patients assigned to peginterferon alfa-2a/ribavirin for 48 weeks. The probability of SVR24 was identified by a baseline scoring system (range: 0-9 points) on which scores of 5 to 9 and <5 represent high and low probability of SVR24, respectively. RESULTS: SVR24 rates were 46.1% (754/1634), 77.1% (279/362), 68.0% (514/756), and 51.3% (203/396), respectively, in G1, 2, 3, and 4 patients. Overall, 16.9% and 21.8% patients experienced 651 sr-RD for peginterferon alfa and ribavirin, respectively. Among Caucasian noncirrhotic G1 patients: female sex, lower body mass index, pre-existing cardiovascular/pulmonary disease, and low hematological indices were prognostic factors of sr-RD; SVR24 was lower in patients with 651 vs. no sr-RD by Week 4 (37.9% vs. 54.4%; P = 0.0046) and Week 12 (41.7% vs. 55.3%; P = 0.0016); sr-RD by Week 4/12 significantly reduced SVR24 in patients with scores <5 but not 655. CONCLUSIONS: In conclusion, sr-RD to peginterferon alfa-2a/ribavirin significantly impacts on SVR24 rates in treatment-naive G1 noncirrhotic Caucasian patients. Baseline characteristics can help select patients with a high probability of SVR24 and a low probability of sr-RD with peginterferon alfa-2a/ribavirin

Determinants of weight, psychological status, food contemplation and lifestyle changes in patients with obesity during the COVID-19 lockdown: a nationwide survey using multiple correspondence analysis

Introduction The corona virus disease 2019 (COVID-19) pandemic forced most of the Italian population into lockdown from 11 March to 18 May 2020. A nationwide survey of Italian Clinical Nutrition and Dietetic Services (Obesity Centers or OCs) was carried out to assess the impact of lockdown restrictions on the physical and mental wellbeing of patients with obesity (PWO) who had follow-up appointments postponed due to lockdown restrictions and to compare determinants of weight gain before and after the pandemic. Methods We designed a structured 77-item questionnaire covering employment status, diet, physical activity and psychological aspects, that was disseminated through follow-up calls and online between 2 May and 25 June 2020. Data were analyzed by multiple correspondence analysis (MCA) and multiple linear regression. Results A total of 1,232 PWO from 26 OCs completed the questionnaires (72% female, mean age 50.2 +/- 14.2 years; mean BMI 34.7 +/- 7.6 kg/m(2); 41% obesity class II to III). During the lockdown, 48.8% gained, 27.1% lost, while the remainder (24.1%) maintained their weight. The mean weight change was +2.3 +/- 4.8 kg (in weight gainers: +4.0 +/- 2.4 kg; +4.2% +/- 5.4%). Approximately 37% of participants experienced increased emotional difficulties, mostly fear and dissatisfaction. Sixty-one percent reduced their physical activity (PA) and 55% experienced a change in sleep quality/quantity. The lack of online contact (37.5%) with the OC during lockdown strongly correlated with weight gain (p &lt; 0.001). Using MCA, two main clusters were identified: those with unchanged or even improved lifestyles during lockdown (Cluster 1) and those with worse lifestyles during the same time (Cluster 2). The latter includes unemployed people experiencing depression, boredom, dissatisfaction and increased food contemplation and weight gain. Within Cluster 2, homemakers reported gaining weight and experiencing anger due to home confinement. Conclusions Among Italian PWO, work status, emotional dysregulation, and lack of online communication with OCs were determinants of weight gain during the lockdown period