Community integration level and life satisfaction of the person with spinal cord injury: survey using CIQ-R and LiSat-9 questionnaires.

openINTRODUZIONE: la lesione midollare ha gravi conseguenze sul benessere fisico, psichico e sociale della persona, che impattano sui livelli di integrazione in comunità e di soddisfazione di vita. Il terapista occupazionale è il professionista che si occupa dell’autonomia personale nell’ambiente di vita e nel tessuto sociale dell’individuo e ha il compito di dare rilevanza a integrazione e soddisfazione di vita all’interno del progetto riabilitativo, tematiche strettamente connesse tra loro e a cui si pone minore attenzione nella pratica clinica, rispetto a recupero funzionale e pratica delle ADL. OBIETTIVO: indagare il livello di integrazione nella comunità della persona con lesione midollare e determinare il grado di soddisfazione di vita, ricercando correlazioni tra i dati acquisiti e fattori ritenuti predittivi di buoni livelli di integrazione e soddisfazione di vita, come età, genere, livello di istruzione, reddito annuo, livello lesionale, completezza della lesione, cronicità della lesione, situazione abitativa e possesso di una connessione a internet. MATERIALI E METODI: nel periodo compreso tra maggio e luglio 2023, sono stati somministrati ad un campione di 53 persone con lesione midollare in fase cronica in trattamento presso il Centro “Progetto Spilimbergo” di Spilimbergo (PN) due questionari: lo strumento Community Integration Questionnaire Revised (CIQ-R), una misura breve ed affidabile dell’integrazione nella comunità in quattro specifiche aree (domestica, sociale, della produttività e del social networking elettronico); il questionario Life Satisfaction Questionnaire (LiSat-9) che valuta la soddisfazione di vita nel suo complesso, nelle attività di vita quotidiana e nelle relazioni sociali. Sono state effettuate due revisioni della letteratura: una orientata a ricercare studi precedenti e similari a quello in oggetto, una focalizzata sul ruolo del terapista occupazionale nella pianificazione di un progetto riabilitativo volto al raggiungimento di buoni livelli di integrazione in comunità e soddisfazione di vita. RISULTATI: i dati raccolti rivelano una correlazione tra soddisfazione di vita e integrazione nelle aree di produttività e socialità; coloro che vivono soli hanno livelli di integrazione domestica maggiori rispetto a chi abita con qualcuno. I dati socio-demografici che sembrano avere una correlazione maggiore con buoni livelli di soddisfazione e integrazione sono alti livelli di istruzione, lesione midollare bassa, evento della lesione nella fascia d’età 15-54 anni, possesso di una connessione a internet e abilità nell’utilizzo di social network, posta elettronica e smartphone, emerge inoltre una maggiore predisposizione a buoni livelli di integrazione sociale per il genere maschile. CONCLUSIONI: i risultati confermano quanto dedotto dalla letteratura indagata, comprovando l’importanza della formulazione di un progetto riabilitativo determinato ad ottenere buoni livelli di integrazione e soddisfazione di vita per l’individuo con lesione midollare cronica, progetto di cui il terapista occupazionale può e deve essere promotore

Attacking DoH and ECH: Does Server Name Encryption Protect Users’ Privacy?

Privacy on the Internet has become a priority, and several efforts have been devoted to limit the leakage of personal information. Domain names, both in the TLS Client Hello and DNS traffic, are among the last pieces of information still visible to an observer in the network. The Encrypted Client Hello extension for TLS, DNS over HTTPS or over QUIC protocols aim to further increase network confidentiality by encrypting the domain names of the visited servers. In this article, we check whether an attacker able to passively observe the traffic of users could still recover the domain name of websites they visit even if names are encrypted. By relying on large-scale network traces, we show that simplistic features and off-the-shelf machine learning models are sufficient to achieve surprisingly high precision and recall when recovering encrypted domain names. We consider three attack scenarios, i.e., recovering the per-flow name, rebuilding the set of visited websites by a user, and checking which users visit a given target website. We next evaluate the efficacy of padding-based mitigation, finding that all three attacks are still effective, despite resources wasted with padding. We conclude that current proposals for domain encryption may produce a false sense of privacy, and more robust techniques should be envisioned to offer protection to end users

Prevalence and impact of polypharmacy in older patients with type 2 diabetes

Background: Polypharmacy is a prevalent condition in older adults, especially those with multiple chronic diseases, and has been largely associated with adverse outcomes, including disability, hospitalizations, and death. Aims: This systematic review focused on diabetes and aimed to investigate the prevalence and impact of polypharmacy in older adults affected by such disease. Methods: Observational (either cross-sectional or longitudinal) or experimental studies investigating the frequency and impact of polypharmacy in older adults with diabetes were identified from scientific databases and grey literature until August 2021. The prevalence and the 95% Confidence Interval (95% CI) of polypharmacy in older people with diabetes were summarized by a random-effects meta-analysis. Results: From a total of 1465 records, 9 were selected for the qualitative synthesis, and 8 for the quantitative synthesis. Most studies defined polypharmacy using a cut-off for the minimum number of medications ranging from 4 to 6 drugs/day. The pooled prevalence of polypharmacy in older people with diabetes was 64% (95% CI 45–80%). Considering studies that used the same definition of polypharmacy (i.e. ≥ 5 drugs/day), the pooled prevalence was 50% (95% CI 37–63%). The between-studies heterogeneity was high. Across the selected studies, polypharmacy seemed to negatively influence both diabetes-specific (poor glycemic control and risk of hypoglycemia) and health-related (risk of incident falls, syncope, hospitalization, and death) outcomes. Conclusion: This systematic review confirms the high prevalence of polypharmacy in older people with diabetes and its strong impact on several health-related outcomes, including mortality. These results strengthen the need to improve care strategies for management of these patients

Are Darknets All The Same? On Darknet Visibility for Security Monitoring

Darknets are sets of IP addresses that are advertised but do not host any client or server. By passively recording the incoming packets, they assist network monitoring activities. Since packets they receive are unsolicited by definition, darknets help to spot misconfigurations as well as important security events, such as the appearance and spread of botnets, DDoS attacks using spoofed IP address, etc. A number of organizations worldwide deploys darknets, ranging from a few dozens of IP addresses to large/8 networks. We here investigate how similar is the visibility of different darknets. By relying on traffic from three darknets deployed in different contintents, we evaluate their exposure in terms of observed events given their allocated IP addresses. The latter is particularly relevant considering the shortage of IPv4 addresses on the Internet. Our results suggest that some well-known facts about darknet visibility seem invariant across deployments, such as the most commonly contacted ports. However, size and location matter. We find significant differences in the observed traffic from darknets deployed in different IP ranges as well as according to the size of the IP range allocated for the monitoring

The Secretory Response of Rat Peritoneal Mast Cells on Exposure to Mineral Fibers

Background: Exposure to mineral fibers is of substantial relevance to human health. A key event in exposure is the interaction with inflammatory cells and the subsequent generation of pro-inflammatory factors. Mast cells (MCs) have been shown to interact with titanium oxide (TiO2) and asbestos fibers. In this study, we compared the response of rat peritoneal MCs challenged with the asbestos crocidolite and nanowires of TiO2 to that induced by wollastonite employed as a control fiber. Methods: Rat peritoneal MCs (RPMCs), isolated from peritoneal lavage, were incubated in the presence of mineral fibers. The quantities of secreted enzymes were evaluated together with the activity of fiber-associated enzymes. The ultrastructural morphology of fiber-interacting RPMCs was analyzed with electron microscopy. Results: Asbestos and TiO2 stimulate MC secretion. Secreted enzymes bind to fibers and exhibit higher activity. TiO2 and wollastonite bind and improve enzyme activity, but to a lesser degree than crocidolite. Conclusions: (1) Mineral fibers are able to stimulate the mast cell secretory process by both active (during membrane interaction) and/or passive (during membrane penetration) interaction; (2) fibers can be found to be associated with secreted enzymes\u2014this process appears to create long-lasting pro-inflammatory environments and may represent the active contribution of MCs in maintaining the inflammatory process; (3) MCs and their enzymes should be considered as a therapeutic target in the pathogenesis of asbestos-induced lung inflammation; and (4) MCs can contribute to the inflammatory effect associated with selected engineered nanomaterials, such as TiO2 nanoparticles

Psychologising meritocracy: A historical account of its many guises

Measured by psychologists, conceived in critical terms, popularised as satire, and exploited by politicians, meritocracy is a dilemmatic concept that has changed its meanings throughout history. Social psychologists have conceptualised and operationalised meritocracy both as an ideology that justifies inequality and as a justice principle based on equity. These two conceptualisations express opposing ideas about the merit of meritocracy and are both freighted ideologically. We document how this dilemma of meritocracy’s merit developed from meritocracy’s inception as a critical concept among UK sociologists in the 1950s to its operationalisation by U.S. and Canadian social psychologists at the end of the 20th century. We highlight the ways in which meritocracy was originally utilised, in part, to critique the measurement of merit via IQ tests, but ironically became a construct that, through its psychologisation, also required measurement. Through the operationalisation of meritocracy, social psychologists obscured the possibility of critiquing meritocracy and missed the opportunity to offer alternatives to a system that has been legitimised by their own work. A social psychology of meritocracy should take into consideration the ideological debate around its meaning and value and the implications of its measurement and study

Pruritus in chronic plaque psoriasis: a questionnaire-based study on 230 Italian patients

In the past, several textbooks defined psoriasis as a non-pruritic dermatosis, but the most recent data in the literature emphasizes the high frequency of pruritus in psoriasis and its impact on the quality of life of patients with psoriasis.Aim of this study was to explore the sensory and affective dimensions of pruritus as well as to assess the impact of itch on quality of life and to evaluate the influence of lifestyles, habits, and various anti-pruritic therapies on pruritus in a large group of psoriatic subjects. The structured Yosipovitch itch questionnaire was given to 240 psoriatic patients. 230 patients returned a complete and detailed questionnaire. Pruritus was referred to by 80% of the patients. Psoriasis area and severity index (PASI) was significantly higher in itching-patients (P=0.04). In half of the patients, itching appeared daily, particularly in the evening. Significant aggravating factors of pruritus were stress, skin dryness, hot water, sweating, elevated ambient temperature, exercise, abundant meals, bad moods, lying position, and contact with clothes. Cold water is the only factor that showed to significantly relieve the pruritus. Anti-pruritic therapies had limited effect.Pruritus is a common, bothersome, and poorly responsive symptom in patients with psoriasis.</p

Metabolic reprogramming identifies the most aggressive lesions at early phases of hepatic carcinogenesis

Metabolic changes are associated with cancer, but whether they are just bystander effects of deregulated oncogenic signaling pathways or characterize early phases of tumorigenesis remains unclear. Here we show in a rat model of hepatocarcinogenesis that early preneoplastic foci and nodules that progress towards hepatocellular carcinoma (HCC) are characterized both by inhibition of oxidative phosphorylation (OXPHOS) and by enhanced glucose utilization to fuel the pentose phosphate pathway (PPP). These changes respectively require increased expression of the mitochondrial chaperone TRAP1 and of the transcription factor NRF2 that induces the expression of the rate-limiting PPP enzyme glucose-6-phosphate dehydrogenase (G6PD), following miR-1 inhibition. Such metabolic rewiring exclusively identifies a subset of aggressive cytokeratin-19 positive preneoplastic hepatocytes and not slowly growing lesions. No such metabolic changes were observed during non-neoplastic liver regeneration occurring after two/third partial hepatectomy. TRAP1 silencing inhibited the colony forming ability of HCC cells while NRF2 silencing decreased G6PD expression and concomitantly increased miR-1; conversely, transfection with miR-1 mimic abolished G6PD expression. Finally, in human HCC patients increased G6PD expression levels correlates with grading, metastasis and poor prognosis. Our results demonstrate that the metabolic deregulation orchestrated by TRAP1 and NRF2 is an early event restricted to the more aggressive preneoplastic lesions

Presepsin levels and COVID-19 severity: a systematic review and meta-analysis

Plasmatic presepsin (PSP) is a novel biomarker reported to be useful for sepsis diagnosis and prognosis. During the pandemic, only few studies highlighted a possible correlation between PSP and COVID-19 severity, but results remain inconsistent. The present study aims to establish the correlation between PSP and COVID-19 severity. English-language papers assessing a correlation between COVID-19 and PSP from MEDLINE, PubMed, Google Scholar, Cochrane Library, MeSH, LitCovid NLM, EMBASE, CINAHL Plus and the World Health Organization (WHO) website, published from January 2020 were considered with no publication date limitations. Two independent reviewers performed data abstraction and quality assessment, and one reviewer resolved inconsistencies. The protocol was registered on PROSPERO (CRD42022325971).Fifteen articles met our eligibility criteria. The aggregate study population included 1373 COVID-19 patients who had undergone a PSP assessment. The random-effect meta-analysis was performed in 7 out of 15 selected studies, considering only those reporting the mean PSP levels in low- and high-severity cases (n = 707).The results showed that the pooled mean difference of PSP levels between high- and low-severity COVID-19 patients was 441.70&nbsp;pg/ml (95%CI: 150.40-732.99&nbsp;pg/ml).Our data show that presepsin is a promising biomarker that can express COVID-19 severity