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Background: Gender-based violence against women and its lethal outcome, femicide, represent important issues around the world. Although governments have passed specific laws, official data on gender-related violence and femicide are often absent and/or incomplete, difficult to access, rarely updated, contested and underestimated due to stigma, victim blaming or issues of legal interpretation. Femicide is an intentional killing in which a woman is murdered by an individual for misogyny and gender-related reasons. The most common type is in fact intimate femicide, which occurs when the murdered woman and the aggressor have an intimate, family, cohabitation or similar relationship. Case series: We analyzed 15 cases of femicide for which crime scene investigation and autopsy were carried out. For each case, a psychological autopsy was carried out and the means used to determine the individual's death were analysed. The circumstances in which the murder occurred were also examined. Discussion: Overkilling was evidenced in all cases analyzed. Over-killing in forensic medicine is known as a specific type of homicide in which the number of injuries inflicted far exceeds the number of injuries required to kill the victim. Therefore, the medico-legal management of the cases examined is complicated due to the multiple lesions present on the corpse on the victims which make difficult: 1) the reconstruction of the dynamics of the crime 2) the number of blows inflicted 3) the analysis of the fatal blow 4) the imputability of the offender.
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Homicidio , Humanos , Homicidio/estadística & datos numéricos , Femenino , Adulto , Persona de Mediana Edad , Adulto Joven , Autopsia , Violencia de Género , Anciano , Adolescente , Medicina LegalRESUMEN
OBJECTIVES: To assess the evolution of continuing medical education/continuous professional development (CME/CPD) in European Radiology with a particular focus on on-site (live educational events, LEE) vs remote (electronic learning materials, ELM) participation and the impact of the COVID-19 pandemic. METHODS: Results related to CME/CPD of surveys conducted by the Accreditation Council of Imaging (ACI) between 2017 and 2020 are summarized. Additional insights from the survey conducted in spring 2023, exploring online education trends since the start of the COVID-19 pandemic, are presented. Finally, the results of the surveys are correlated with the total number of CME/CPD applications received annually from 2018 to 2022. RESULTS: Pre-pandemic, 90% of European radiologists supported mandatory CME and unified CME/CPD-system. A trend among younger radiologists towards ELM was observed. Only 20% of employers fully endorsed CME/CPD. In 2020, LEE attendance dropped significantly (95.5-33%), with a simultaneous surge (33-58%) in time spent on ELM. Post-pandemic, the majority (52%) of LEE attendees participated in 1-5 events, whereas the majority (38%) of attendees of live-streamed events participated in 6-20 meetings. Content remains a priority of respondents in all formats: 79% for online, 75% for on-site, and 74% for on-demand. While the assessed quality of LEE remained at the same level (no change (36%) or good/very good (48%)), a considerably higher percentage of respondents noticed the quality of live-streamed events was good/very good (83%). CONCLUSION: The majority of European radiologists support mandatory CME and a unified CME/CPD system. Despite the post-pandemic resurgence in LEE, ELM and hybrid events are predicted to gain further prominence. CRITICAL RELEVANCE STATEMENT: The CME/CPD system dynamically adapts to evolving professional, technical, and environmental circumstances, with human interaction gaining heightened significance post-COVID-19. KEY POINTS: Professionals expressed a desire to return to on-site participation, highlighting its desirability for social interaction. Electronic learning materials are poised for continued growth, particularly among younger generations. Professionals expressed a desire towards a unified CME/CPD system in Europe.
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Objective: The combination of femininity and inequality is an increasingly studied in the field of social medicine, even more if the girls or women in question experience conditions of disability or neurodivergence. The onset of menstruation, menarche, constitutes a significant and transformative event in women's lives comprising a true and proper watershed in mental and reproductive health and sexual welfare. The onset of menstruation has a profound effect not just for girls but, in the case of disabled girls, for the whole family. In this scoping review, we have researched the literature in studies which consider the issue of menstruation and autism. The works in scientific literature have been selected which, in the last 5 years, investigated the issue of menstrua-tion for autistic girls and/or women. Results: Selected studies, although few in number, have all equally evidenced the total lack of in-depth understanding of this theme, notwithstanding the fact that females, girls and women with autism would benefit from specialized services if these existed. Families, girls and women involved, moreover, although not experiencing menstruation per se in a negative light, note a deterioration in their condition particularly in respect of sensorial perception and the intensification of anxious depressive instances. This work highlights the need to deepen the aspects concerning the period in autistic girls/women, up to now the question appears to have been little studied, investigated in an uneven way. We propose a social medical program to improve sexual-affective knowledge and body awareness in autistic people.
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Trastorno Autístico , Menstruación , Humanos , Femenino , Trastorno Autístico/psicología , Menstruación/psicología , Ciclo Menstrual/fisiología , Menarquia/psicologíaRESUMEN
Abstract: Autism spectrum disorders (ASDs) belong to the category of neurodevelopmental disorders. ASD emerges in early childhood and involves deficits in communication, language, behavioural inflexibility and fixity, and sensorial neurodivergent perception. ASDs have a biological pathogenesis related to genetic and epigenetic factors. Additionally, research has shown that starting from childhood, autistic persons could find emotional regulation challenging during communication with caregivers. The importance of emotional co-regulation has always been under-lined in psychology, starting with Freud who introduced the concept of the Compassionate Other. Emotional difficulties are grasped immediately and almost instinctively by parents, who try to modulate their approach to the child's needs from the very beginning. This paper seeks to highlight the importance of emotional co-regulation as a wake-up call-in developmental trajectories that present peculiarities or anomalies. It also emphasizes the significance of emotional co-regulation as a useful tool for intervening in the dysfun-ctionality of such trajectories. This intervention aims to directly involve parents in treatment, as seen in Cooperative parent-mediated therapy. This approach is crucial for facilitating the evolution of the cognitive framework while utilizing this target. This article aims to review the most recent literature on co-regulation after explaining the theoretical framework that gave rise to this concept. It's now well established the importance of adopting a develop-mental approach that starts from the bodily dimension as the basis for the relationship with caregivers, pairs, and unfamiliar people. It is from this basis that starts the affective, emotional, and cognitive construction of the internal and external world of the child. This scoping review takes into account the most recent evidence on co-regulation and autism, emphasizing the importance of this process in diagnostic and therapeutic settings.
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Trastorno del Espectro Autista , Preescolar , Humanos , Trastorno del Espectro Autista/terapia , Comunicación , Emociones , Lenguaje , PadresRESUMEN
Extramedullary (EM) colonization is a rare complication of acute myeloid leukemia (AML), occurring in about 10% of patients, but the processes underlying tissue invasion are not entirely characterized. Through the application of RNAseq technology, we examined the transcriptome profile of 13 AMLs, 9 of whom presented an EM localization. Our analysis revealed significant deregulation within the extracellular matrix (ECM)-receptor interaction and focal-adhesion pathways, specifically in the EM sites. The transcription factor TWIST1, which is known to impact on cancer invasion by dysregulating epithelial-mesenchymal-transition (EMT) processes, was significantly upregulated in EM-AML. To test the functional impact of TWIST1 overexpression, we treated OCI-AML3s with TWIST1-siRNA or metformin, a drug known to inhibit tumor progression in cancer models. After 48 h, we showed downregulation of TWIST1, and of the EMT-related genes FN1 and SNAI2. This was associated with significant impairment of migration and invasion processes by Boyden chamber assays. Our study shed light on the molecular mechanisms associated with EM tissue invasion in AML, and on the ability of metformin to interfere with key players of this process. TWIST1 may configure as candidate marker of EM-AML progression, and inhibition of EMT-pathways may represent an innovative therapeutic intervention to prevent or treat this complication.
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Leucemia Mieloide Aguda , Metformina , Humanos , Línea Celular Tumoral , Transición Epitelial-Mesenquimal/genética , Leucemia Mieloide Aguda/genética , Leucemia Mieloide Aguda/patología , ARN Interferente Pequeño , Invasividad Neoplásica/patología , Regulación Neoplásica de la Expresión GénicaRESUMEN
Background: The problem concerning the activation of the measure of Compulsory Health Treatment (CHT) for subjects suffering from Eating Disorders (ED) represents a legal paradox that places health professionals in the position of frequently doubting the real usefulness of the measure within the hospital context. This issue is mainly related to anorexia nervosa, which puts the subject in a higher life-threatening situation than other EDs. Method and materials: To outline the current state of the art, the most recent national and international scientific publications concerning informed consent and CHT in EDs were searched. In addition, Italian rulings in various degrees of judgement were evaluated with the suggestion of a possible resolution of these issues. Results: The analysis of the literature showed that although a multitude of psychometric instruments has been created to identify the ability to give informed consent, there are still not all the elements necessary to identify the actual degree of disease awareness of ED subjects. An important factor could be the exploration of the person's interception, which has been seen to be very high in individuals with AN who are known not to experience the sensation of hunger. At present, reviews of the bibliography and judgments have shown that the measurement of CHT remains crucial if it is intended as a life-saving treatment. However, it is evident that in terms of BMI, CHT is not a definitive intervention and therefore the adoption of this practice is necessary with extreme caution taking into account the person's actual ability to consent. Conclusions: Future studies will have the task of determining the psychic factors necessary to better understand the state of the person in his or her physical and mental wholeness, giving due weight to these characteristics and orienting knowledge in a practical sense to more profitable direct treatment for individuals with ED.
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Anorexia Nerviosa , Trastornos de Alimentación y de la Ingestión de Alimentos , Masculino , Femenino , Humanos , Consentimiento Informado , Trastornos de Alimentación y de la Ingestión de Alimentos/terapia , Anorexia Nerviosa/terapia , ItaliaRESUMEN
Cervical cancer (CC) is the fourth leading cause of death in women worldwide and despite the introduction of screening programs about 30% of patients presents advanced disease at diagnosis and 30-50% of them relapse in the first 5-years after treatment. According to FIGO staging system 2018, stage IB3-IVA are classified as locally advanced cervical cancer (LACC); its correct therapeutic choice remains still controversial and includes neoadjuvant chemo-radiotherapy, external beam radiotherapy, brachytherapy, hysterectomy or a combination of these modalities. In this review we focus on the most appropriated therapeutic options for LACC and imaging protocols used for its correct follow-up. We explore the imaging findings after radiotherapy and surgery and discuss the role of imaging in evaluating the response rate to treatment, selecting patients for salvage surgery and evaluating recurrence of disease. We also introduce and evaluate the advances of the emerging imaging techniques mainly represented by spectroscopy, PET-MRI, and radiomics which have improved diagnostic accuracy and are approaching to future direction.
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BACKGROUND: We evaluated clinical features and risk factors for mortality in patients with haematological malignancies and COVID-19. METHODS: Retrospective, case-control (1:3) study in hospitalized patients with COVID-19. Cases were patients with haematological malignancies and COVID-19, controls had COVID-19 without haematological malignancies. Patients were matched for sex, age and time of hospitalization. RESULTS: Overall, 66 cases and 198 controls were included in the study. Cases had higher prior corticosteroid use, infection rates, thrombocytopenia and neutropenia and more likely received corticosteroids and antibiotics than controls. Cases had higher respiratory deterioration than controls (78.7% vs 65.5%, p = 0.04). Notably, 29% of cases developed respiratory worsening > 10 days after hospital admission, compared to only 5% in controls. Intensive Care Unit admission and mortality were higher in cases than in controls (27% vs 8%, p = 0.002, and 35% vs 10%, p < 0.001). At multivariable analysis, having haematological malignancy [OR4.76, p < 0.001], chronic corticosteroid therapy [OR3.65, p = 0.004], prior infections [OR57.7, p = 0.006], thrombocytopenia [OR3.03, p < 0.001] and neutropenia [OR31.1, p = 0.001], low albumin levels [OR3.1, p = 0.001] and ≥ 10 days from hospital admission to respiratory worsening [OR3.3, p = 0.002] were independently associated with mortality. In cases, neutropenia [OR3.1, p < 0.001], prior infections [OR7.7, p < 0.001], ≥ 10 days to respiratory worsening [OR4.1, p < 0.001], multiple myeloma [OR1.5, p = 0.044], the variation of the CT lung score during hospitalization [OR2.6, p = 0.006] and active treatment [OR 4.4, p < 0.001] all were associated with a worse outcome. CONCLUSION: An underlying haematological malignancy was associated with a worse clinical outcome in COVID-19 patients. A prolonged clinical monitoring is needed, since respiratory worsening may occur later during hospitalization.
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COVID-19 , Neoplasias Hematológicas , Neutropenia , Trombocitopenia , Corticoesteroides/uso terapéutico , Albúminas , Antibacterianos , COVID-19/epidemiología , Estudios de Casos y Controles , Neoplasias Hematológicas/complicaciones , Humanos , Neutropenia/complicaciones , Estudios Retrospectivos , SARS-CoV-2 , Trombocitopenia/complicacionesRESUMEN
A first-principles scaling law, based on turbulent transport considerations, and a multimachine database of density limit discharges from the ASDEX Upgrade, JET, and TCV tokamaks, show that the increase of the boundary turbulent transport with the plasma collisionality sets the maximum density achievable in tokamaks. This scaling law shows a strong dependence on the heating power, therefore predicting for ITER a significantly larger safety margin than the Greenwald empirical scaling [Greenwald et al., Nucl. Fusion, 28, 2199 (1988)NUFUAU0029-551510.1088/0029-5515/28/12/009] in case of unintentional high-to-low confinement transition.
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Kambo is the name of a natural substance derived from the glandular secretions of the amphibian Phyllomedusa bicolor, a species native to regions in South America. The communities living in these areas administer the substance generally transdermally during rituals for religious-purifying purposes, producing small skin burns. The scientific literature has reported some cases of intoxication following the use of Kambo but this aspect is still poorly understood. In fact, no shared therapy protocols exist for these events nor any real legislation on Kambo. The purpose of this work was to examine all cases of acute intoxication resulting from the administration of Kambo and published over the last 10 years, illustrating clinical signs, laboratory findings, instrumental tests, and therapy. The several cases identified in our review confirm that acute Kambo intoxication can occur, with serious and life-threatening effects. We developed a protocol aimed at the early diagnosis of cases of suspected acute intoxication by creating a treatment algorithm. The study aims to investigate the pathophysiology of these events in humans, proposing a protocol for the diagnosis and treatment of these cases that can be used by healthcare professionals.
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Past studies have shown that disease threat increases people's hostility towards immigrants. However, in our survey (N = 9571) conducted in five advanced Asian economies during the outbreak of COVID-19, we found that COVID-19 vulnerability was positively associated with support for immigration. Drawing on insight from policy feedback theories, we propose that the positive association is caused by the presence of widespread border crossing restrictions, which have changed the meaning and cost implications of COVID-19. As the outbreak expands, the pandemic has become not just a threat to people's health but also a barrier to globalization. Consequently, people who are worried about the disease may see globalization processes, including migration, as signs of pandemic relief. We find supportive evidence in our analysis. First, the positive association between COVID-19 vulnerability and support for immigration is more salient among respondents who considered restrictions on international travel to be stringent. Second, the positive association between COVID-19 vulnerability and immigration attitude was mediated by perceived economic threat from the pandemic and contribution by immigrants towards the containment of the pandemic. These findings suggest that disease control measures adopted at the global level may alter certain widely accepted effects of disease threat on immigration attitudes.
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COVID-19 , Emigración e Inmigración , Asia , Demografía , Retroalimentación , Humanos , Pandemias , Dinámica Poblacional , Política PúblicaRESUMEN
The ecological roles of the species in the food web are studied through the Ecopath with Ecosim modelling approach. In this modelling approach, the food web is described by means of functional groups, each representing a species, a life stage of a species, or a group of species with similar trophic, ecological and physiological features. Links between the groups are formally described by a set of linear equations, informed with ecological and fishing data. Here, the data input collected to implement 3 Ecopath models in the Northern Ionian Sea (Central Mediterranean Sea) from 1995 to 2015 are reported. This dataset applied to study the ecological roles of the demersal Chondrichthyes in the study area could be useful to explore different fishing management scenarios. A large dataset of over 300 taxa is shown detailing the ecological inputs, such as Biomass (kg km-2), Production and Consumption rates (y-1), Diet information (weight in %), and fishing data represented by Landings and Discards (t km-2 y-1). In particular, the fishery data described the catches of trawls, longlines, passive nets, other gears and purse seine. In addition, a description of the aggregation method of the species is shown.
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The East Asian experience in tackling COVID-19 has been highly praised, but this high-level generalisation neglects variation in pandemic response measures adopted across countries as well as the socio-political factors that shaped them. This paper compares the early pandemic response in Singapore and Hong Kong, two Asian city-states of similar sizes, a shared history of SARS, and advanced medical systems. Although both were able to contain the virus, they did so using two very different approaches. Drawing upon data from a cross-national, probability sample Internet survey conducted in May 2020 as well as media and mobility data, we argue that the different approaches were the result of the relative strength of civil society vs. the state at the outset of the outbreak. In protest-ridden Hong Kong, low governmental trust bolstered civil society, which focused on self-mobilisation and community mutual-help. In Singapore, a state-led response model that marginalised civil society brought early success but failed to stem an outbreak among its segregated migrant population. Our findings show that an active civil society is pivotal to effective outbreak response and that trust in government may not have been as important as a factor in these contexts.
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COVID-19 , Política , COVID-19/epidemiología , COVID-19/prevención & control , Hong Kong/epidemiología , Humanos , Singapur/epidemiologíaRESUMEN
Previous studies on the connection between climate and plague were mostly conducted without considering the influence of large-scale atmospheric circulations and long-term historical observations. The current study seeks to reveal the sophisticated role of climatic control on plague by investigating the combined effect of North Atlantic Oscillation (NAO) and temperature on plague outbreaks in Europe from 1347 to 1760 CE. Moving correlation analysis is applied to explore the non-linear relationship between NAO and plague transmission over time. Also, we apply the cross-correlation function to identify the role of temperature in mediating the NAO-plague connection and the lead-lag relationship in between. Our statistical results show that the pathway from climate change to plague incidence is distinctive in its spatial, temporal, and non-linear patterns. The multi-decadal temperature change exerted a 15-22 years lagged impact on the NAO-plague correlation in different European regions. The NAO-plague correlation in Atlantic-Central Europe primarily remained positive, while the correlation in Mediterranean Europe switched between positive and negative alternately. The modulating effect of temperature over the NAO-plague correlation increases exponentially with the magnitude of the temperature anomaly, but the effect is negligible between 0.3 and -0.3 °C anomaly. Our findings show that a lagged influence from the temperature extremes dominantly controls the correlation between NAO and plague incidence. A forecast from our study suggests that large-scale plague outbreaks are unlikely to happen in Europe if NAO remains at its current positive phase during the earth's future warming.
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We investigate the time evolution of the mean location and variance of a charged particle subject to random collisions that are Poisson distributed. The particle moves on a plane and is subject to a magnetic field applied perpendicular to the plane, so it is constrained to move in circles in the absence of collisions. We develop a procedure that yields analytic expressions of the mean and variance. These results are valid for arbitrary times after the start of the walk, including early on when, on average, less than one collision is expected. As an example of their applicability, we use these expressions to model experimental results and simulations of suprathermal ions propagating in a turbulent plasma in TORPEX (the TORoidal Plasma EXperiment).
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Humans possess limited knowledge on what generated cultural dynamics to strengthen human resilience to overcome climate-induced stresses. Although the highly developed mental ability of humans could have enabled significant human resilience in history, no study has empirically explained or has even scientifically confirmed how and when such dynamics arose. To fill the current research gap, this study therefore explores the associations among climatic conditions, the evolutional dynamics of human thinkers and their thoughts, and human ecological-socioeconomic conditions in the past 2500 years in Europe. Results from quantitative modellings and causal analyses confirm that climatic-ecological stresses led to human ecological-socioeconomic crises, and thereby dramatically increased twice of the thinkers' number and their thoughts' impact across different philosophies in truth, knowledge, and ethics for adaptation at multi-decadal to centennial temporal scales, especially in spirituality oriented mentality. The process of the stress-generated cultural dynamics displays some similarities with the stress-induced mutagenesis in organism evolution. Ultimately, climatic-ecological stresses prompt the escalation in the number of thinkers and impacts of their thoughts and flourishing of philosophy. Such stress-regenerated cultural dynamics imply that the current climate change threat may stimulate another thriving phase of cultural selection and lift humans to the next homeostatic plateau of civilization. Findings also extend the cognate scope of psychological, sociological, and civilization studies.
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Adaptación Fisiológica , Cambio Climático , Aclimatación , Europa (Continente) , HumanosRESUMEN
We designed and built a diagnostic based on a cathodoluminescent screen for the detection of turbulent plasma structures with high spatial resolution. The screen is coated with a low threshold energy cathodoluminescent powder that emits light when exposed to a plasma. The emitted light is imaged with a fast frame camera combined with an image intensifier and an optical bandpass filter. The diagnostic is used to study turbulent structures and seeded blobs. The results are analyzed with pattern recognition algorithms to track the turbulent structures and study their evolution in time.
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Septic pulmonary embolism (SPE) is an uncommon disease in which a microorganism- containing thrombus causes an inflammatory reaction and a mechanical obstruction in the vascular system of the lungs. Usually it is associated with tricuspid valve vegetation, septic thrombophlebitis or infected venous catheters. We present a rare and fatal case of massive septic pulmonary thromboembolism occurred in a diabetic woman, who complained in previous days dyspnoea, abdominal pain and nausea. Autopsy findings showed evidence of an erosive cystitis, while lungs examination showed total occlusion of pulmonary circulation system due to thrombo-embolic clots. In literature cases report about an association between septic pulmonary thromboembolism and erosive cystitis haven't been reported. So, we here show the first reported fatal case of a septic pulmonary thromboembolism as a lethal evolution of an erosive cystitis.
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Cistitis/complicaciones , Angiopatías Diabéticas , Embolia Pulmonar/etiología , Anciano de 80 o más Años , Autopsia , Cistitis/patología , Resultado Fatal , Femenino , Medicina Legal , Humanos , Inflamación , Embolia Pulmonar/mortalidad , Embolia Pulmonar/patología , Enfermedades Vasculares/complicacionesRESUMEN
Scanning electron microscopy is a technique that provides high-resolution images at the micro- and nano-scale. The combination of scanning electron microscopy and energy dispersive X-ray spectroscopy analysis is developing fast for application in forensic science. In this work, we report a case of work-related traumatic death of a 50-year-old man. The autopsy showed cranial fractures with cerebral haemorrhage. It was more difficult to understand the accident dynamics because the body had been shifted from the accident site to mask what had really taken place. Scanning electron microscopy/energy dispersive X-ray spectroscopy was used to identify the material of the impacting tool and to establish the possible legal responsibility of the employer. In this study, we demonstrate that scanning electron microscopy/energy dispersive X-ray spectroscopy is a useful forensic tool for the analysis of biological samples. Further, for studying the lacerations on the corpse from doubtful blunt tools, scanning electron microscopy/energy dispersive X-ray spectroscopy can assist in demonstrating that the scene has been falsified, as it was in this case.