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Therapeutical approach of tricuspid regurgitation and right heart failure
No full text: Significant tricuspid regurgitation (TR) is a relatively common condition, affecting approximately 4 % of the elderly population. However, there are currently no clear guidelines for its medical management due to a lack of sufficient data in the literature. This review examines the pathophysiology of TR, categorizes its etiologies, and evaluates therapeutic options, both pharmacological and non-pharmacological, to optimize intervention timing and hemodynamic management. Based on the etiology and severity of TR, we suggest a gradual, stage-based algorithm for diuretic therapy titration and a management approach derived from common clinical practices
Indagini e udienza preliminare
No full textLe disposizioni "speciali" del d.lgs. n. 231 del 2001 in materia di indagini preliminari e di regole di giudizio dell'udienza preliminare sono analizzate tutte in chiave critica, soprattutto alla luce delle problematiche lasciate aperte dal d.lgs. 10 ottobre 2022 n. 150 (così detta "legge Cartabia") e successivi interventi di correzione/integrazione; particolare attenzione è dedicata ai profili di (sospetta incostituzionalità) di talune norme
[18F]FDG PET/CT of FUO/IUO in special populations
No full text: 18F fluorodeoxyglucose ([18F]FDG) positron emission tomography/computed tomography (PET/CT) has established itself as a fundamental non invasive diagnostic technique in the investigation of patients with fever (FUO) and inflammation of unknown origin (IUO). These conditions are for definition challenging due to potential wide underlying causes, including inflammatory disease, infectious disease, malignancies and miscellanea. Sometimes no diagnosis is reached. Data about the diagnostic performances of [18F]FDG PET/CT in special populations, such as pediatrics, end-stage renal disease, HIV and intensive care unit (ICU) patients, are preliminary and heterogeneous. Our review aims to describe the role of [18F]FDG PET/CT imaging in these specific populations and focus on the potential clinical impact on diagnosis and patient management. Findings presented in the literature demonstrated a good diagnostic yield of FDG PET/CT in the study of these patients affected by FUO/IUO with performances similar to adult general populations. A positive PET scan is often contributory and, in some cases, even essential to diagnosis, whereas a negative scan may be equally important as it excludes focal disease and predicts a favourable prognosis. Further studies with larger populations would be desirable
Sex differences in schizophrenia spectrum disorders: insights from the DiAPAson study using a data-driven approach
No full textPurpose Schizophrenia Spectrum Disorders (SSD) display notable sex differences: males have an earlier onset and more severe negative symptoms, while females exhibit affective symptoms, better verbal abilities, and a more favourable prognosis. Despite extensive research, areas such as time perception and positivity remain underexplored, and machine learning has not yet been adequately utilised. This study aims to address these gaps by examining sex differences in a sample of Italian patients with SSD using a data-driven approach. Methods As part of the DiAPAson project, 619 Italian patients with SSD (198 females; 421 males) were assessed using standardised clinical tools. Data on socio-demographics, clinical characteristics, symptom severity, functioning, positivity, quality of life (QoL), and time perspective were collected. Descriptive and regression analyses were conducted. Principal Component Analysis (PCA) and the Gaussian Mixture Model (GMM) was used to define data-driven clusters. A leave-one-group-out validation was performed. Results Males were more likely to be single (p < 0.001) and less educated (p = 0.006), while females smoked more tobacco (p = 0.011). Males were more frequently prescribed antipsychotics (p = 0.022) and exhibited more severe psychiatric (p = 0.004) and negative symptoms (p = 0.013). They also had a less negative perception of past events (p = 0.047) and a better view of their psychological condition (p = 0.004). Females showed better interpersonal functioning (p = 0.008). PCA and GMM revealed two main clusters with significant sex differences (p = 0.027). Conclusion This study identifies sex differences in SSD, suggesting tailored treatments such as enhancing interpersonal skills for females and maintaining positive self-assessment for males. Using machine learning, we highlight distinct SSD phenotypes, emphasising the need for sex-specific interventions to improve outcomes and QoL. Our findings stress the importance of a multifaceted, interdisciplinary approach to address sex-based disparities in SSD. Trial registration ISRCTN registry ID ISRCTN21141466
In-situ testing of the out-of-plane flexural behavior of hollow block masonry walls retrofitted with steel fiber reinforced mortar coating
No full textThe present work focuses on the discussion of the experimental results of three monotonic and quasi-static reverse cyclic tests performed to assess the out-of-plane behavior of hollow clay block masonry walls strengthened with coating. The latter consisted of a single 30 mm thick layer of mortar applied on the outer surface of masonry and reinforced with short (32 mm long) high strength steel fibers randomly spread within the mortar matrix. Compared to traditional laboratory tests, the ones conducted herein can replicate the actual boundary conditions occurring in actual structures as the test walls are part of a full-scale building tested in previous research. The test results provided insights into the stiffness, ductility, flexural and energy dissipation capacity of the walls. Additionally, considerations regarding equivalent viscous damping were also reported. Finally, using a classical arch thrust resisting model, an analytical evaluation of the out-of-plane flexural resistance of the unstrengthened walls was conducted to assess the potential out-of-plane strength improvement achieved through a coating of steel fiber reinforced mortar
Dal consiglio di amministrazione alla performance sociale: Come la qualità del consiglio di amministrazione promuove la performance sociale in risposta a feedback di performance negativi e positivi
No full textSkeletonization-Based Adversarial Perturbations on Large Vision Language Model’s Mathematical Text Recognition
No full textThis work explores the visual capabilities and limitations of foundation models by introducing a novel adversarial attack method utilizing skeletonization to reduce the search space effectively. Our approach specifically targets images containing text, particularly mathematical formula images, which are more challenging due to their LaTeX conversion and intricate structure. We conduct a detailed evaluation of both character and semantic changes between original and adversarially perturbed outputs to provide insights into the models' visual interpretation and reasoning abilities. The effectiveness of our method is further demonstrated through its application to ChatGPT, which shows its practical implications in real-world scenarios