719 research outputs found

    Italia napoleonica. Dizionario critico

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    Pensato sul modello dei grandi dizionari storico-critici, come strumento, quindi, insieme di conoscenza e di studio il volume, che è il primo lavoro di questo tipo espressamente dedicato all'Italia nell'età napoleonica 1796-1815, presenta oltre un centinaio di voci, tra maggiori e minori,una Bibliografia di riferimento, e un Lemmario. Il curatore, accanto ad una Nota illustrativa dei criteri e degli obiettiivi dell'opera, ha anche firmato (pp. 309-325) la voce "Luoghi di Memoria

    Una educazione mediterranea

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    Napoléon grandit et mûrit une vision de la politique, des stratégies militaires dans un horizon propre à la civilisation méditerranéenne qui l’amènera à se confronter à une tradition historique qui a innervé la culture de l’Occident européen. L’esprit indépendantiste de la Corse se solidarise avec l’expérience révolutionnaire qui l’amènera à élaborer une conception et un sentiment nationaux liés à une France pleinement modernisée et capable de mener une politique impériale

    Obesity can influence children’s and adolescents’ airway hyperresponsiveness differently

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    BACKGROUND: Literature is still arguing about a possible relationship between airway hyperresponsiveness (AHR) and body mass index (BMI). This study aimed at evaluating the influence of BMI on AHR and pulmonary function in children and adolescents that performed a methacholine test for suggestive asthma symptoms. METHODS: 799 consecutive children/adolescents (535 M; mean age: 15 ± 3 yrs; median FEV(1)% predicted: 101.94% [93.46-111.95] and FEV(1)/FVC predicted: 91.07 [86.17-95.38]), were considered and divided into underweight, normal, overweight and obese. Different AHR levels were considered as moderate/severe (PD(20) ≤ 400 μg) and borderline (PD(20) > 400 μg). RESULTS: 536 children/adolescents resulted hyperreactive with a median PD(20) of 366 μg [IQR:168–1010.5]; 317 patients were affected by moderate/severe AHR, whereas 219 showed borderline hyperresponsiveness. Obese subjects aged > 13 years showed a lower (p = 0.026) median PD(20) (187μg [IQR:110–519]) compared to overweight (377 μg [IQR:204–774]) and normal-weight individuals’ values (370.5 μg [IQR:189–877]). On the contrary, median PD(20) observed in obese children aged ≤ 13 years (761 μg [IQR:731–1212]) was higher (p = 0.052) compared to normal-weight children’s PD20 (193 μg [IQR:81–542]) and to obese adolescents’ values (aged > 13 years) (p = 0.019). Obesity was a significant AHR risk factor (OR:2.853[1.037-7.855]; p = 0.042) in moderate/severe AHR adolescents. Females showed a higher AHR risk (OR:1.696[1.046-2.751] p = 0.032) compared to males. A significant relationship was found between BMI and functional parameters (FEV(1), FVC, FEV(1)/FVC) only in hyperreactive females. CONCLUSIONS: Obesity seems to influence AHR negatively in female but not in male adolescents and children. In fact, AHR is higher in obese teenagers, in particular in those with moderate/severe hyperresponsiveness, and may be mediated by obesity-associated changes in baseline lung function

    Evidence for the formation of comet 67P/Churyumov-Gerasimenko through gravitational collapse of a bound clump of pebbles

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    The processes that led to the formation of the planetary bodies in the Solar System are still not fully understood. Using the results obtained with the comprehensive suite of instruments on-board ESA’s Rosetta mission, we present evidence that comet 67P/Churyumov-Gerasimenko likely formed through the gentle gravitational collapse of a bound clump of mm-sized dust aggregates (“pebbles”), intermixed with microscopic ice particles. This formation scenario leads to a cometary make-up that is simultaneously compatible with the global porosity, homogeneity, tensile strength, thermal inertia, vertical temperature profiles, sizes and porosities of emitted dust, and the steep increase in water-vapour production rate with decreasing heliocentric distance, measured by the instruments on-board the Rosetta spacecraft and the Philae lander. Our findings suggest that the pebbles observed to be abundant in protoplanetary discs around young stars provide the building material for comets and other minor bodies

    Rationale and design of an independent randomised controlled trial evaluating the effectiveness of aripiprazole or haloperidol in combination with clozapine for treatment-resistant schizophrenia

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    <p>Abstract</p> <p>Background</p> <p>One third to two thirds of people with schizophrenia have persistent psychotic symptoms despite clozapine treatment. Under real-world circumstances, the need to provide effective therapeutic interventions to patients who do not have an optimal response to clozapine has been cited as the most common reason for simultaneously prescribing a second antipsychotic drug in combination treatment strategies. In a clinical area where the pressing need of providing therapeutic answers has progressively increased the occurrence of antipsychotic polypharmacy, despite the lack of robust evidence of its efficacy, we sought to implement a pre-planned protocol where two alternative therapeutic answers are systematically provided and evaluated within the context of a pragmatic, multicentre, independent randomised study.</p> <p>Methods/Design</p> <p>The principal clinical question to be answered by the present project is the relative efficacy and tolerability of combination treatment with clozapine plus aripiprazole compared with combination treatment with clozapine plus haloperidol in patients with an incomplete response to treatment with clozapine over an appropriate period of time. This project is a prospective, multicentre, randomized, parallel-group, superiority trial that follow patients over a period of 12 months. Withdrawal from allocated treatment within 3 months is the primary outcome.</p> <p>Discussion</p> <p>The implementation of the protocol presented here shows that it is possible to create a network of community psychiatric services that accept the idea of using their everyday clinical practice to produce randomised knowledge. The employed pragmatic attitude allowed to randomly allocate more than 100 individuals, which means that this study is the largest antipsychotic combination trial conducted so far in Western countries. We expect that the current project, by generating evidence on whether it is clinically useful to combine clozapine with aripiprazole rather than with haloperidol, provides physicians with a solid evidence base to be directly applied in the routine care of patients with schizophrenia.</p> <p>Trial Registration</p> <p><b>Clincaltrials.gov Identifier</b>: NCT00395915</p

    Joint position statement of the International Federation of Sports Medicine (FIMS) and European Federation of Sports Medicine Associations (EFSMA) on the IOC framework on fairness, inclusion and non-discrimination based on gender identity and sex variations.

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    The IOC recently published its framework on fairness, inclusion and non-discrimination based on gender identity and sex variations. This framework is drafted mainly from a human rights perspective, with less consideration for medical/scientific issues. The framework places the onus for gender eligibility and classification entirely on the International Federations (IFs), even though most will not have the capacity to implement the framework. The position of no presumption of advantage is contrary to the 2015 IOC consensus. Implementation of the 2021 framework will be a major challenge for IFs that have already recognised the inclusion of trans and women athletes with differences of sexual development (DSD) using a scientific/medical solution. The potential consequences for sports that need to prioritise fairness or safety could be one of two extremes (1) exclusion of all transgender or DSD athletes on the grounds of advantage or (2) self-identification that essentially equates to no eligibility rules. Exclusion of all transgender or DSD athletes is contrary to the Olympic charter and unlawful in many countries. While having no gender eligibility rules, sport loses its meaning and near-universal support. Athletes should not be under pressure to undergo medical procedures or treatment to meet eligibility criteria. However, if an athlete is fully informed and consents, then it is their free choice to undergo carefully considered or necessary interventions for gender classification for sport to compete fairly and safely in their chosen gender. Free choice is a fundamental human right, but so is the right to fair and safe competition

    Influence of Antisynthetase Antibodies Specificities on Antisynthetase Syndrome Clinical Spectrum TimeCourse

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    Introduction: Increased cardiovascular (CV) morbidity and mortality is observed in inflammatory joint diseases (IJDs) such as rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis. However, the management of CV disease in these conditions is far from being well established.Areas covered: This review summarizes the main epidemiologic, pathophysiological, and clinical risk factors of CV disease associated with IJDs. Less common aspects on early diagnosis and risk stratification of the CV disease in these conditions are also discussed. In Europe, the most commonly used risk algorithm in patients with IJDs is the modified SCORE index based on the revised recommendations proposed by the EULAR task force in 2017.Expert opinion: Early identification of IJD patients at high risk of CV disease is essential. It should include the use of complementary noninvasive imaging techniques. A multidisciplinary approach aimed to improve heart-healthy habits, including strict control of classic CV risk factors is crucial. Adequate management of the underlying IJD is also of main importance since the reduction of disease activity decreases the risk of CV events. Non-steroidal anti-inflammatory drugs may have a lesser harmful effect in IJD than in the general population, due to their anti-inflammatory effects along with other potential beneficial effects.This research was partially funded by FOREUM—Foundation for Research in Rheumatolog

    The Comet Interceptor Mission

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    Here we describe the novel, multi-point Comet Interceptor mission. It is dedicated to the exploration of a little-processed long-period comet, possibly entering the inner Solar System for the first time, or to encounter an interstellar object originating at another star. The objectives of the mission are to address the following questions: What are the surface composition, shape, morphology, and structure of the target object? What is the composition of the gas and dust in the coma, its connection to the nucleus, and the nature of its interaction with the solar wind? The mission was proposed to the European Space Agency in 2018, and formally adopted by the agency in June 2022, for launch in 2029 together with the Ariel mission. Comet Interceptor will take advantage of the opportunity presented by ESA's F-Class call for fast, flexible, low-cost missions to which it was proposed. The call required a launch to a halo orbit around the Sun-Earth L2 point. The mission can take advantage of this placement to wait for the discovery of a suitable comet reachable with its minimum ΔV capability of 600 ms-1. Comet Interceptor will be unique in encountering and studying, at a nominal closest approach distance of 1000 km, a comet that represents a near-pristine sample of material from the formation of the Solar System. It will also add a capability that no previous cometary mission has had, which is to deploy two sub-probes - B1, provided by the Japanese space agency, JAXA, and B2 - that will follow different trajectories through the coma. While the main probe passes at a nominal 1000 km distance, probes B1 and B2 will follow different chords through the coma at distances of 850 km and 400 km, respectively. The result will be unique, simultaneous, spatially resolved information of the 3-dimensional properties of the target comet and its interaction with the space environment. We present the mission's science background leading to these objectives, as well as an overview of the scientific instruments, mission design, and schedule

    Understanding Factors Associated With Psychomotor Subtypes of Delirium in Older Inpatients With Dementia

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