Archivio istituzionale della ricerca - Università di Modena e Reggio Emilia

University of Modena and Reggio Emilia

Archivio istituzionale della ricerca - Università di Modena e Reggio Emilia
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    Risk factors, prenatal diagnosis, and outcome of posterior placenta accreta spectrum disorders in patients with placenta previa or low-lying placenta: A multicenter study

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    Introduction: Placenta accreta spectrum (PAS) disorders occur when the definitive placenta develops within the uterus scar area. Although classically PAS develops in the anterior wall of the uterus mainly, it can also develop in the posterior uterine wall. The aim of this study was to report the risk factors, diagnostic accuracy of prenatal imaging, and surgical outcome of pregnancies complicated by posterior PAS in women with placenta previa or low-lying. Material and Methods: Secondary analysis of a multicenter prospective study involving 16 referral hospitals in Italy (ADoPAD Study). Inclusion criteria were patients with a posterior low-lying placenta (<20 mm from the internal cervical os) or placenta previa (covering the os), aged >= 18 years undergoing ultrasound assessment at >= 26(+0) weeks of gestation. The reference standard for PAS was represented by the failure of placental separation at delivery or by pathological analysis. The primary aim was to report the risk factors associated with the occurrence of posterior PAS. The secondary aims were to evaluate the ability of prenatal ultrasound in detecting posterior PAS and to report its surgical outcome compared to posterior placental previa or low-lying with no PAS and anterior PAS, respectively, and in patients with a prenatal compared to post-natal diagnosis. Univariate and diagnostic accuracy analyses were used to analyze the data. Results: 258 patients were included in the analysis. Posterior PAS occurred in 8.1% (n = 21; 95% CI 5.4-12.1) of patients. There was a higher incidence of one or more prior CS (62% vs. 21%, p < 0.001) and myomectomy with uterine penetration (71.0% vs. 3.4%, p < 0.001) in patients with posterior PAS compared to those with no PAS. In patients with posterior PAS, placenta accreta occurred in 66.67% (14/21), increta in 23.81% (5/21), and percreta in 9.52% (2/21) of cases. Posterior PAS confirmed at birth was diagnosed prenatally by ultrasound in 62% (13/21) of cases. When comparing anterior with posterior PAS, patients with anterior PAS were more likely to have a prior CS (82% vs. 62%; p = 0.0049) and placenta percreta (54% vs. 10%; p < 0.001). Finally, the need for hysterectomy (89% vs. 48%; p < 0.001) was higher, while that of balloon tamponade insertion was lower (17% vs. 52%; p = 0.001) in patients with anterior compared to posterior PAS. Conclusions: Prior uterine surgery in patients with placenta previa or low-lying represents the commonest risk factors for posterior PAS. The diagnostic accuracy of ultrasound in detecting posterior PAS is lower in cases with posterior compared to anterior PAS. Finally, in referral centers, posterior PAS disorders were associated with a lower risk of hysterectomy compared to anterior PAS

    Suspended transport of gravel in rivers: Empirical evidence from the 2022 flood in the Misa River (Eastern Apennines, Italy)

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    In September 2022, an exceptional flood in the Misa River basin (Eastern Apennines, Italy) resulted in the unusual deposition of gravelly lobes on terraces up to 6 m higher than the riverbed. These deposits suggest that coarse bed sediments were transported in suspension rather than as bedload, as typically occurs under competent flow conditions. To verify this hypothesis, we combined field evidence-obtained from geomorphological and sedimentological surveys-with theoretical insights based on sediment transport theory. Our findings indicate that medium-sized gravels, which are part of the riverbed material, were transported in suspension within the water column. This phenomenon required specific conditions to generate the necessary shear stress and energy, including (i) a high-magnitude flood enriched with fine sediments, which increased the fluid density and viscosity, and (ii) an entrenched channel with stable banks that limited channel widening during the flood event. When these processes coincided with alluvial plain inundation by overbank flows, gravel transported in suspension was able to reach and settle on elevated surfaces, such as terraces far above the active channel. These observations highlight the potential for gravel-bed rivers to support the transport of coarse sediment in suspension under extreme flood conditions and specific geomorphological constraints on the active river channels. By demonstrating the role of sediment concentration, channel morphology and flood dynamics, our research provides new insights into sediment transport mechanisms and contributes to a broader understanding of the morphodynamic processes governing gravel-bed rivers under such exceptional conditions, with broad implications for refining flood hazard models and improving sediment transport predictions in fluvial systems

    ChatBDI: Think BDI, Talk LLM

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    This paper describes ChatBDI, a framework for extending Beliefs-Desires-Intentions (BDI) agents with the ability to communicate with humans exploiting Large Language Models (LLMs). The ChatBDI integration of BDI agents and LLMs relies on the Knowledge Query and Manipulation Language (KQML) as the intermediary language between humans and agents, and Jason - inside the JaCaMo framework - as the implementation language. The purpose of ChatBDI is not only to create brand new 'BDI speakers', but also to add communication capabilities to existing BDI agents without altering their source code. This 'chattification' serves a double purpose: by exploiting the BDI model, it provides an 'intentional brain' to LLMs, hence addressing one of their major limitations as speakers - the lack of intentionality; by exploiting the generative power of LLMs, it adds a creative and fluent 'language actuator' to BDI agents

    Intervento sperimentale: protocollo didattico, prove, materiali e risultati

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    Gender discrimination and negative consequences at work: Exploring the mediating role of the relationship with the leader

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    The paper explores the association between perceived gender discrimination (PGD) and work-related outcomes, emphasizing the mediating role of the quality of the relationship with the leader. Data were collected from two studies with employees (N = 665 and N = 562). PGD was linked to organizational outcomes through leader relationship quality, moderated by employee gender, leader gender, and gender similarity between the leader and employee. In Study 1, PGD was found to be negatively associated with support, which in turn mediated the relationship between PGD and work outcomes. In Study 2, a broader conceptualization of leader relationship quality based on Leader-Member Exchange (LMX) theory was employed, considering multiple dimensions (affect, loyalty, contribution, and respect). Results partially replicated and extended the central role of the leader in mediating the association between PGD and work outcomes, with affect and leader support emerging as key mediators. Moreovergender-based moderations emerged in both studies; in Study 1, PGD influenced leader support and work-related outcomes. In Study 2, female leaders strengthened the negative impact of PGD on job satisfaction and the positive relationship between leader support and engagement. These studies underscore the leader’s central role in connecting organizational climate with employee outcomes and highlight the critical aspects of the leader-employee relationship that influence these outcomes

    Prefazione

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    This study, adopting a perspective of critical pedagogy, investigates the epistemological and professional conditions of pedagogical discourse and educational practices. The analysis focuses on problematizing the space occupied by pedagogy in the contemporary landscape, highlighting the internal tensions of its status and outlining its positioning in relation to institutional recognition. The text is divided into two parts. The first part develops the theme of crisis in relation to pedagogical discourse and educational practices, examining its potential ramifications, legitimacy, and consequences, while shedding light on its structural dimension. Through a genealogical analysis, the research aims to reposition this crisis within a broader framework, tracing it back to processes of subjectivation and social reproduction. The second part concentrates on the submerged dimensions of pedagogy, namely those implicit, latent, or unaddressed elements that influence both educational action and the institutional recognition of pedagogical professions. Overall, the study explores the conditions of possibility for a critical rethinking of pedagogy, aimed at restoring its epistemological autonomy and its transformative role within society

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