Archivio istituzionale della ricerca - Università dell'Insubria
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Souveraineté et religions à l’âge des droits de l’Homme Conférences des années 2021-2022, 2022-2023, 2023-2024
No full textEn adoptant une approche interdisciplinaire, orientée vers la philosophie politique, la philosophie du droit, l’histoire des idées, la science politique, la sociologie des religions et la théorie des relations internationales, ces conférences se sont efforcées d’examiner le rapport entre la souveraineté et les religions à travers le prisme des droits de l’Homme, avec une attention spécifique au contexte européen contemporain et aux traditions religieuses
The "Idiopathic Scoliosis Graphical Representation of Worsening Trend of Natural History" (IS-GROWTH) communication tool provides a reliable prediction useful to manage long-term treatment during growth. 2025 SOSORT award winner
Get PDFPurpose: Effective communication with patients regarding long-term conservative treatment for idiopathic scoliosis necessitates an understanding of its natural history. Existing predictive models have limitations in this regard. Our study aimed to develop and evaluate the reliability and utility of the Idiopathic Scoliosis Graphical Representation Of Worsening Trend of Natural History (IS-GROWTH) communication tool. Methods: IS-GROWTH development and validation involved consecutive untreated patients with radiographs taken at and prior to the first consultation. To construct the model, we calculated the minimum and maximum progression of patients grouped by 10° Cobb angle range and growth phases. IS-GROWTH is developed for each patient, incorporating the expected progression of each growth phase into the preceding one. For temporal validation, we included patients whose data were obtained after the development of IS-GROWTH, comparing IS-GROWTH predictions with natural history. We calculated the percentage of correct predictions and applied the chi-square test. We also examined the distribution of natural history within IS-GROWTH. Finally, we piloted the tool's usefulness for communication with patients among a group of physicians using it for several years. Results: To develop IS-GROWTH, we analysed 3,184 radiographs from 1,818 participants, spanning from infancy to adolescence. For validation, we included 552 patients and found an accuracy of 95% (95% Confidence Interval, 93-97%) after adjusting for the 5° radiographic measurement error. Nineteen physicians (7.3±5.8 years’ experience) reported using IS-GROWTH in 30% of their patients (range 5-95%) and found it most useful during follow-up (84%) to motivate patients (79%). Conclusion: IS-GROWTH is reliable and useful. We now regularly use it to deepen our understanding of individual natural history and enhance communication with patients
Preliminary Validation of a Cursive Handwriting Reconstruction Algorithm from a Sensorized Ink Pen
No full textLack of handwriting automatization in childhood can cause difficulties within and outside the school context. Therefore, the objective quantification of the handwriting performance is key. A Smart Ink Pen (SIP) used on paper demonstrated its validity in characterizing primary school children's handwriting process, although missing information on the handwriting product. To overcome this limitation, a trace reconstruction algorithm was developed, based on the force and IMU signals measured by the SIP. A total of 353 words "uno", written in cursive from the BVSCO-3 battery by 50 Italian students of the 5th grade of primary school, was reconstructed. The quality of the reconstructions was validated through an Optical Character Recognition (OCR) algorithm (Google Vision), using the scans of the actual traces as a reference. The character recognition rates were 81.02% and 59.49%, the character error rates 21.48% and 47.65%, for scans and reconstructions, respectively. A deeper analysis revealed that 15% of the reconstructions were read in the opposite direction by the OCR algorithm, likely due to a non sufficient sampling rate for the last portion of the words. A characterization of the differences between the good, bad and opposite reconstructions allowed to identify some directions of improvement. An increase of the SIP sampling rate, a better modeling of the thickness of the trace, a finer estimation of the relative distance between the IMU sensor and the tip and the reconstruction of the tip trajectory during in-air movements could improve the trace reconstruction algorithm. In addition, the possibility to leverage transfer learning approaches on the OCR algorithm using the reconstructed traces for additional training could further improve the performances in terms of character recognition rate. However, the preliminary results obtained are promising and highlight the possibility of reconstructing handwriting traces while maintaining the naturalness of the gesture.Clinical relevance- This contribution establishes the possibility of reconstructing handwritten traces from the kinematic and force signals recorded by an ecological sensorized ink pen
Complessità e imprevedibilità nell’impresa responsabile: una prospettiva temporale
No full textIl paper si pone l’obiettivo di analizzare la complessità ambientale
alla luce della crescente interdipendenza tra impresa e ambiente e
della difficoltà di gestire l'imprevedibilità. Il lavoro evidenzia come
il coinvolgimento degli stakeholder sia alla base della creazione di
valore condiviso e permette di gestire la complessità. La ricerca
esamina la relazione tra complessità, responsabilità sociale
d’impresa e creazione di valore condiviso. L’analisi fornisce delle
riflessioni di tipo teorico ed affronta lo studio di un caso pratico. Lo
studio evidenzia come la creazione di valore condiviso sia utile per
rendere comprensibile la complessità e aiuti a dominarla. Evidenzia
inoltre il ruolo della comunicazione con particolare attenzione al
territorio di riferimento. Trattandosi di un conceptual paper presenta
tutti i limiti di un approccio basato sull’analisi della letteratura
esistente. Lo studio offre un contributo ai manager per affrontare il
problema della crescente interdipendenza tra impresa e ambiente,
nella gestione dell’imprevedibile e soprattutto nella riduzione del
grado di complessità. Il lavoro considera la creazione di valore
condiviso legato alla complessità e alla imprevedibilità passando
attraverso il processo di comprensione condivisa
Global age-sex-specific all-cause mortality and life expectancy estimates for 204 countries and territories and 660 subnational locations, 1950–2023: a demographic analysis for the Global Burden of Disease Study 2023
Get PDFBackground: Comprehensive, comparable, and timely estimates of demographic metrics—including life expectancy and age-specific mortality—are essential for evaluating, understanding, and addressing trends in population health. The COVID-19 pandemic highlighted the importance of timely and all-cause mortality estimates for being able to respond to changing trends in health outcomes, showing a strong need for demographic analysis tools that can produce all-cause mortality estimates more rapidly with more readily available all-age vital registration (VR) data. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) is an ongoing research effort that quantifies human health by estimating a range of epidemiological quantities of interest across time, age, sex, location, cause, and risk. This study—part of the latest GBD release, GBD 2023—aims to provide new and updated estimates of all-cause mortality and life expectancy for 1950 to 2023 using a novel statistical model that accounts for complex correlation structures in demographic data across age and time.
Methods: We used 24 025 data sources from VR, sample registration, surveys, censuses, and other sources to estimate all-cause mortality for males, females, and all sexes combined across 25 age groups in 204 countries and territories as well as 660 subnational units in 20 countries and territories, for the years 1950–2023. For the first time, we used complete birth history data for ages 5–14 years, age-specific sibling history data for ages 15–49 years, and age-specific mortality data from Health and Demographic Surveillance Systems. We developed a single statistical model that incorporates both parametric and non-parametric methods, referred to as OneMod, to produce estimates of all-cause mortality for each age-sex-location group. OneMod includes two main steps: a detailed regression analysis with a generalised linear modelling tool that accounts for age-specific covariate effects such as the Socio-demographic Index (SDI) and a population attributable fraction (PAF) for all risk factors combined; and a non-parametric analysis of residuals using a multivariate kernel regression model that smooths across age and time to adaptably follow trends in the data without overfitting. We calibrated asymptotic uncertainty estimates using Pearson residuals to produce 95% uncertainty intervals (UIs) and corresponding 1000 draws. Life expectancy was calculated from age-specific mortality rates with standard demographic methods. For each measure, 95% UIs were calculated with the 25th and 975th ordered values from a 1000-draw posterior distribution.
Findings: In 2023, 60·1 million (95% UI 59·0–61·1) deaths occurred globally, of which 4·67 million (4·59–4·75) were in children younger than 5 years. Due to considerable population growth and ageing since 1950, the number of annual deaths globally increased by 35·2% (32·2–38·4) over the 1950–2023 study period, during which the global age-standardised all-cause mortality rate declined by 66·6% (65·8–67·3). Trends in age-specific mortality rates between 2011 and 2023 varied by age group and location, with the largest decline in under-5 mortality occurring in east Asia (67·7% decrease); the largest increases in mortality for those aged 5–14 years, 25–29 years, and 30–39 years occurring in high-income North America (11·5%, 31·7%, and 49·9%, respectively); and the largest increases in mortality for those aged 15–19 years and 20–24 years occurring in Eastern Europe (53·9% and 40·1%, respectively). We also identified higher than previously estimated mortality rates in sub-Saharan Africa for all sexes combined aged 5–14 years (87·3% higher in GBD 2023 than GBD 2021 on average across countries and territories over the 1950–2021 period) and for females aged 15–29 years (61·2% higher), as well as lower than previously estimated mortality rates in sub-Saharan Africa for all sexes combined aged 50 years and older (13·2% lower), reflecting advances in our modelling approach. Global life expectancy followed three distinct trends over the study period. First, between 1950 and 2019, there were considerable improvements, from 51·2 (50·6–51·7) years for females and 47·9 (47·4–48·4) years for males in 1950 to 76·3 (76·2–76·4) years for females and 71·4 (71·3–71·5) years for males in 2019. Second, this period was followed by a decrease in life expectancy during the COVID-19 pandemic, to 74·7 (74·6–74·8) years for females and 69·3 (69·2–69·4) years for males in 2021. Finally, the world experienced a period of post-pandemic recovery in 2022 and 2023, wherein life expectancy generally returned to pre-pandemic (2019) levels in 2023 (76·3 [76·0–76·6] years for females and 71·5 [71·2–71·8] years for males). 194 (95·1%) of 204 countries and territories experienced at least partial post-pandemic recovery in age-standardised mortality rates by 2023, with 61·8% (126 of 204) recovering to or falling below pre-pandemic levels. There were several mortality trajectories during and following the pandemic across countries and territories. Long-term mortality trends also varied considerably between age groups and locations, demonstrating the diverse landscape of health outcomes globally.
Interpretation: This analysis identified several key differences in mortality trends from previous estimates, including higher rates of adolescent mortality, higher rates of young adult mortality in females, and lower rates of mortality in older age groups in much of sub-Saharan Africa. The findings also highlight stark differences across countries and territories in the timing and scale of changes in all-cause mortality trends during and following the COVID-19 pandemic (2020–23). Our estimates of evolving trends in mortality and life expectancy across locations, ages, sexes, and SDI levels in recent years as well as over the entire 1950–2023 study period provide crucial information for governments, policy makers, and the public to ensure that health-care systems, economies, and societies are prepared to address the world's health needs, particularly in populations with higher rates of mortality than previously known. The estimates from this study provide a robust framework for GBD and a valuable foundation for policy development, implementation, and evaluation around the world
Board Cultural Diversity and ESG Disclosure: Unveiling the Mediating Power of CSR Committees in Family Firms
No full textThis study examines the impact of board cultural diversity on ESG disclosure in family firms, exploring the mediating role of the CSR committee. Using a sample of 298 listed European non-financial family firms (2013–2022) and 2SLS models, we demonstrate that cultural diversity is positively associated with ESG disclosure, and the presence of a CSR committee mediates this relationship. Additionally, family ownership, family presence on the board, and CEO ownership are found to be negatively correlated with ESG disclosure. The results confirm the effectiveness of the CSR committee as a cognitive-institutional mechanism that channels the board's cognitive resources into more structured sustainability practices. Findings provide policy guidance for enhancing ESG disclosure in family firms via board diversity and CSR committees
Clinical characteristics, therapy and outcome of bloodstream infections caused by vancomycin-resistant enterococci: a multicentre clinical experience
No full textObjectives: Bloodstream infections (BSIs) due to vancomycin-resistant Enterococcus spp. (VRE) are considered a predictor of mortality among frail patients. The aim of this study was to evaluate the risk factors associated with 30 day mortality and relapse of infection in enterococcal BSI caused by VRE and to evaluate the impact of antibiotic regimens in targeted therapy. Methods: We conducted a retrospective study of consecutive hospitalized patients in six teaching hospitals from August 2016 to August 2022 in Italy. All adult patients with a documented VRE BSI were included. Results: We enrolled 517 consecutive hospitalized patients with VRE BSI; of these BSIs 496 (96.5%) were caused by Enterococcus faecium and 26 (5.1%) by Enterococcus faecalis. The most frequently used antibiotics as backbone were linezolid (48.1%) and daptomycin (43.7%). Overall, the 30 day mortality was 32.1%. Upon Cox regression analysis, the risk factor independently associated with 30 day mortality was Charlson comorbidity index >3 points (P < 0.001), whereas a Pitt score <4 points (P = 0.031), surgery for source control of infection (P = 0.016) and time to targeted therapy <24 h (P = 0.006) were associated with survival. After propensity score adjustment, a daptomycin-based regimen (P = 0.003) was associated with 30 day survival. Conclusions: VRE BSI is an important cause of mortality in frail/critically ill patients. Our data highlighted the role of daptomycin as backbone agent for the treatment of enterococcal BSI caused by vancomycin-resistant strains
Addiction and chronic skin diseases: A Pan-European study on prevalence, associations and patient impact
Get PDFBackground: Chronic skin diseases such as psoriasis (PSO), atopic dermatitis (AD) and hidradenitis suppurativa (HS) are frequently associated with psychological distress, potentially promoting maladaptive coping mechanisms including addictive behaviours. Despite evidence of higher addiction rates among dermatology patients, comprehensive multicenter data across Europe are lacking. Objectives: To estimate the prevalence and patterns of addictive behaviours among patients with chronic skin diseases in European tertiary dermatology centres and explore associated sociodemographic and clinical factors. Methods: This multicentre cross-sectional study recruited adult patients with PSO, AD, HS, alopecia areata (AA), urticaria, or vitiligo from dermatology departments in 20 European countries. Participants completed a standardized questionnaire assessing sociodemographics, disease characteristics, and addictive behaviours (smoking, alcohol use, drug use, gambling, internet addiction, and eating disorders). Descriptive analyses and multivariate logistic regression were performed. Results: Among 3585 participants (median age 43 years; 51.1% female), the prevalence of addictive behaviours was notable: smoking (25.7%), pathological gambling (4.5%), hazardous drinking (8.8%), alcohol dependence (2.5%), drug use disorders (5.3%), eating disorders (1.8%), and internet addiction (29.7%). Smoking was most common among PSO and HS patients (48.6%), and gambling among AA and vitiligo patients (8.2%). Significant associations included male sex, younger age, single status, higher Dermatology Life Quality Index (DLQI) scores, and regional variation. Discussion: Addictive behaviours are prevalent in dermatology patients and are associated with both sociodemographic and disease-related factors. The DLQI was positively correlated with multiple addictions, suggesting that reduced quality of life may contribute to maladaptive coping. However, due to the absence of a control group, the tertiary care setting, limited center distribution, and unknown response rate, generalizability is restricted. Conclusion: Addiction screening and supportive mental health strategies should be integrated into dermatologic care, particularly for high-risk patients. Population-based studies with control groups are needed to confirm these findings