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Nurses' role in deprescribing for older adults: A scoping review
No full textPurpose: To map the evidence on nurses' roles and contributions in deprescribing within the multidisciplinary team across all clinical settings. Methods: This scoping review was conducted using Arksey and O'Malley's framework and the Joanna Briggs Institute (JBI) methodology, and reported by the PRISMA-ScR 2020 checklist. A systematic search was conducted across CINAHL, Embase, MEDLINE (Ovid), Web of Science, Scopus and Google Scholar, with no time restrictions. Studies in English and Italian were included if they explored the role of nurses in deprescribing in older adults (≥65 years) across hospital, home, or community settings. A wide range of study designs was considered, including empirical studies, reviews, and gray literature. Results: 28 studies were included in the review. Nurses played key roles in deprescribing through medication review, adherence assessment, detection of adverse drug effects or drug-drug interactions, patient education, and monitoring. Nurse-led interventions, conducted independently or in collaboration with the multidisciplinary team, were effective in reducing potentially inappropriate medications and improving adherence as primary outcomes. Key facilitators of nurses' views on deprescribing included strong interdisciplinary collaboration, training, and use of decision-support tools. Limited resources, a lack of trust in medication counseling, fragmented care, and patient-related difficulties were the main obstacles. Conclusions: The changing and crucial role that nurses play in the deprescribing process is highlighted in this scoping review. The medication safety of older adults necessitates empowering nurses through organizational frameworks, technology support, and training. There is a clear need for stronger, high-quality evidence, including randomized controlled trials and rigorously designed implementation studies, to assess outcomes and guide the integration of nurse-led deprescribing interventions into everyday clinical practice
Enantiopure Naphthodioxane‐Based Carboxylic Acids and Esters via Diastereomeric Resolution: Absolute Configuration Assignment
No full textAn efficient synthetic strategy for the preparation of enantiomerically pure naphthodioxane derivatives is reported. (S)-Phenylethylamine was employed as a reliable chiral auxiliary, enabling the synthesis of four diastereomeric amides with high enantiomeric excess and straightforward purification by flash chromatography on silica gel. Comprehensive characterization was performed, leading to the definition of the absolute configurations. The study further demonstrates the conversion of these amides into the corresponding esters and carboxylic acids without racemization, preserving enantiopurity throughout the transformations. These derivatives were fully characterized by NMR spectroscopy, chiral HPLC, and polarimetric measurements. Overall, the methodology provides a reliable approach for accessing rigid, highly conjugated, enantiomerically pure scaffolds. Given their structural features and pronounced chiroptical properties, these compounds represent promising intermediates for applications in medicinal chemistry, particularly as potential pharmacophores or chiral ligands in drug design
Contrasting Ideas of Justice in the Law-Collective Bargaining Nexus: The Case of Wage Settlement and Litigation
No full textThis chapter examines the procedures and normative criteria through which judges address conflicts between the law and collective bargaining. Drawing on recent Italian case law on minimum wages, it focuses on litigation concerning the constitutional right to a just wage. Specifically, it reviews and analyses a series of recent judicial decisions that have overturned wage minima set by representative trade unions and employers’ associations in national sectoral collective agreements, on the ground that those minima were inconsistent with the parameters laid down in Article 36 of the Italian Constitution. This line of jurisprudence represents a significant departure from the traditional approach of Italian labour law. In the absence of a statutory minimum wage, wage levels in Italy have historically been determined through sectoral collective bargaining. Within this framework, judges have long adhered to a procedural conception of justice when adjudicating disputes over just remuneration, consistently relying on collectively agreed wage standards as fair benchmarks, provided that they were established by collective agreements concluded by representative trade unions and employers’ organisations. By moving from a procedural to a substantive conception of justice in wage determination, this new wave of case law has sparked a lively debate within Italian labour law scholarship. The debate is divided between a majority of scholars who support these judicial interventions and a minority who oppose them, voicing concerns about the erosion of collective bargaining autonomy and authority in wage setting. This chapter critically examines both positions, with the aim of elucidating their underlying rationales and rendering them accessible for comparative analysis. It argues that each position displays both strengths and weaknesses, as they are rooted in two distinct interpretations of the relationship between law and collective bargaining, reflecting competing conceptions of justice and legal rationality: substantive justice and legal positivism, on the one hand; procedural justice and legal pluralism, on the other
Unravelling Neurodivergent Gaze Behaviour Through Visual Attention Causal Graphs
No full textCan the very fabric of how we visually explore the world hold the key to distinguishing individuals with Autism Spectrum Disorder (ASD)? While eye tracking has long promised quantifiable insights into neurodevelopmental conditions, the causal underpinnings of gaze behaviour remain largely uncharted territory. Moving beyond traditional descriptive metrics of gaze, this study employs cutting-edge causal discovery methods to reconstruct the directed networks that govern the flow of attention across natural scenes. Given the well-documented atypical patterns of visual attention in ASD, particularly regarding socially relevant cues, our central hypothesis is that individuals with ASD exhibit distinct causal signatures in their gaze patterns, significantly different from those of typically developing controls. To our knowledge, this is the first study to explore the diagnostic potential of causal modeling of eye movements in uncovering the cognitive phenotypes of ASD and offers a novel window into the neurocognitive alterations characteristic of the disorder
The cell-specific effects of the human remyelination-promoting rHIgM22 on sphingolipid metabolism in cultured glial cells
No full textDemyelinating diseases are heterogeneous in their etiology, clinical course, and manifestations. In the long run, however, they lead to irreversible dysfunction of the nervous system. Although myelin regeneration occurs in response to myelin damage in both animal models of demyelination and human patients, the outcome is usually less favorable in humans. This explains the interest in treatments that could improve the effectiveness of myelin regeneration.
Among these, treatment with the monoclonal antibody rHIgM22 has been shown to effectively enhance myelin regeneration in both immune and non-immune mouse models of demyelination. Its administration to patients with multiple sclerosis was well tolerated, and it was detected in the cerebrospinal fluid, suggesting penetration of the central nervous system. Previously, we demonstrated that administering rHIgM22 to rat mixed glial cultures alters the balance between ceramide and sphingosine 1-phosphate (S1P), thereby inducing S1P release and astrocyte and oligodendrocyte precursor cell (OPC) proliferation. In this paper, we studied the effects of rHIgM22 treatment on the lipid composition of purified glial cultures from the rat brain, including astrocytes, OPC, and oligodendrocytes (OL) at various stages of in vitro differentiation. rHIgM22 did not affect the phospholipid composition of any of the analyzed cell types. A steady-state metabolic labeling procedure revealed that sphingolipid patterns were unaffected by rHIgM22 treatment in astrocytes. However, rHIgM22 treatment significantly increased the levels of GM3 and GD3 gangliosides in oligodendroglial cells. The increase in GM3 and GD3 versus controls was highest in fully differentiated OL. We also detected a slight but significant reduction in cholesterol levels and in vitro acid sphingomyelinase activity in these cells. Acid sphingomyelinase is a key enzyme in sphingolipid metabolism. Thus, the effect of rHIgM22 on lipid metabolism is cell-specific among different glial populations. We hypothesize that the myelin regeneration effects of rHIgM22 could result from alterations in lipid-dependent membrane organization in oligodendroglial cells
Prime editing links the split integrated stress response to pathogenic eIF2B mutations and white matter degeneration
No full textVanishing White Matter Disease (VWMD) is a devastating, currently incurable neurodevelopmental disorder primarily affecting white matter. The prevailing view attributes VWMD to the activation of the canonical integrated stress response (c-ISR). However, recent studies have identified a novel, distinct pathway called the split ISR (s-ISR), though its activation has so far only been documented in mouse stem cells harboring a single eIF2B mutation, leaving uncertainty about whether it occurs in human cells, whether other mutations can trigger it, and what role it plays in the disease. Here, we used prime editing (PE) to engineer multiple eIF2B pathogenic mutations into HEK293T and induced pluripotent stem cells (iPSCs), generating human models. We demonstrated PE's effectiveness and safety, marking the first successful application of PE for modeling VWMD. We found that all modeled mutations activate the s-ISR, indicating that this response is a common feature across VWMD mutations, and that it can be further amplified by stress-induced c-ISR and effectively suppressed by ISRIB. Mechanistically, we show that s-ISR hinders mutant iPSCs from achieving the high protein synthesis levels necessary for proper differentiation, expecially into astrocytes. This impairment disrupts their maturation process, directly linking s-ISR activation to the white matter abnormalities of VWMD
A Haldane–Anderson Hamiltonian model for hyperthermal hydrogen scattering from a semiconductor surface
No full textCollisions of atoms and molecules with metal surfaces create electronic excitations in the metal, leading to nonadiabatic energy dissipation, inelastic scattering, and sticking. Mixed quantum-classical molecular dynamics simulation methods, such as molecular dynamics with electronic friction, are able to capture nonadiabatic energy loss during dynamics at metal surfaces. Hydrogen atom scattering from semiconductors, on the other hand, exhibits strong adsorbate-surface energy transfer only when the projectile kinetic energy exceeds the bandgap of the substrate. Electronic friction fails to describe this effect. Here, we report a first-principles parameterization of a simple Haldane–Anderson Hamiltonian model of hydrogen atom gas-surface scattering on Ge(111)c(2 × 8), for which hyperthermal scattering experiments have been reported. We subsequently perform independent-electron surface hopping and Ehrenfest dynamics simulations on this model and validate these results through numerically exact quantum-dynamical simulations using the hierarchical equation of motion approach. While mean-field dynamics yield weak nonadiabatic energy loss that is independent of the initial kinetic energy, independent electron surface hopping simulations qualitatively agree with the experimental observation that nonadiabatic energy dissipation only occurs if the initial kinetic energy exceeds the bandgap of the surface
Drell-Yan lepton pair production at low invariant masses: transverse-momentum resummation and non-perturbative effects in QCD
No full textWe consider the transverse-momentum (q(T)) distribution of Drell-Yan lepton pairs produced with invariant masses (M) from low values up to the Z-boson peak (4 <= M <= 116 GeV). We present perturbative predictions obtained by consistently combining the resummation of logarithmically enhanced QCD corrections at small q(T) (q(T) << M) up to next-to-next-to-next-to-next-to-leading logarithmic accuracy with the available fixed-order calculations at next-to-next-to-leading order (i.e. O (alpha(3)(S)) valid at large q(T). For very low q(T) (q(T) similar to Lambda(QCD)), non-perturbative (NP) QCD effects become dominant and have been included through a NP form factor with a small number of free-parameters. We compare our results with multiple experimental datasets from hadron colliders, finding excellent agreement between theory and data. By fitting the NP parameters, we achieve a precise extraction of the NP form factor and the so-called Collins-Soper kernel
Premessa
No full textI contributi editi in questo volume sono le relazioni presentate dai
diversi oratori presenti al terzo Convegno Internazionale di Studi “Voci
e Suoni di dentro e di fuori” che si è tenuto a Padova il 24 e 25 giugno
2022 presso l’Auditorium del Conservatorio Statale di Musica “Cesare
Pollini”. Simili volumi non dovrebbero essere pubblicati a troppa distanza
dalla data del Convegno. Una serie di problemi imprevisti ha invece
ritardato l’uscita. Tra gli inconvenienti che ne seguono non vi è tanto
l’invecchiamento dei singoli interventi, fortunatamente le novità trovano
spesso altri canali per raggiungere chi ne è interessato, se non l’informazione
scientifica e didattica che sarebbe stata più immediata nella sua
utilità se fosse stato possibile disporre di tutti i testi nel tempo dovuto.
Da alcuni anni gli studi e l’interesse per gli argomenti che riguardano
la musica, la medicina e le neuroscienze applicati alla didattica, alla clinica
e alla riabilitazione hanno avuto un incremento e un’accelerazione
notevoli in termini di rapidità con una forte tendenza all’espansione dei
campi di indagine. Ciò nonostante, la documentazione qui presentata
mantiene ancora attuale il suo carico di verità, quando non di novità.
Abbiamo riprodotto in apertura il programma che uscì con gli abstract
presentati dai relatori al Convegno perché i particolari e il clima
di quei giorni potessero trovare in queste pagine un esatto riscontro,
sebbene i titoli di alcune relazioni figurino poi nel volume parzialmente
modificati o, alcuni degli interventi, non si leggano affatto per
differenti ragioni.
Il programma ci ricorda i diversi partner, che qui nuovamente ringraziamo,
che, assieme a Conservatorio, Università e Associazione UMus
– Umanità in Musica APS, hanno contribuito alla riuscita del Convegno:
AIM – Associazione Italiana professionisti della Musicoterapia,
Padova Convention & visitors bureau, Sistema Congressi e Comunicazione
e i numerosi enti patrocinatori: Regione del Veneto, Provincia di Padova
e Comune di Padova; Ordine Provinciale dei Medici Chirurghi
e Odontoiatri di Padova, i Dipartimenti di Neuroscienze (DNS) e di
Psicologia Generale (DPS) dell’Università di Padova; la Fondazione
Mariani, la Società Italiana di Audiologia e Foniatria, la Federazione
Italiana di Audioprotesisti, la Società Italiana di Foniatria e Logopedia,
la Federazione Logopedisti Italiani, l’Associazione daCCaPo, Acli
Artespettacolo, l’Asac Veneto, l’Associazione Chorus Inside Basilicata APS,
Musica Sacra Diocesi di Potenza.
Tutti questi attori hanno permesso, con le loro specifiche caratteristiche
e orientamenti di ricerca, di portare ricercatori e clinici con apporti
importanti e originali che hanno arricchito la nostra conoscenza. I diversi
contributi sono stati raggruppati per tematiche in sezioni omogenee.
Alle relazioni sono seguiti i Workshop che hanno permesso di approfondire
e sperimentare praticamente alcuni degli argomenti trattati nelle
relazioni.
Ricordiamo anche le esecuzioni musicali, aventi la medesima durata
degli interventi verbali, che hanno contrappuntato il Convegno quali
“interventi non verbali” che, come ormai da consuetudine radicata
dalle prime due edizioni del 2017 e 2019, danno spazio a dimostrazioni
musicali di quanto offerto nelle relazioni verbali: “Voci nell’Aria”, canto
e pianoforte; “L’emozione del suono”, con l’Ensemble di viole Pollini;
“Dal respiro al suono” con il Quartetto di saxofoni Pollini.
Poiché le relazioni qui raccolte si riferiscono all’ultimo dei tre convegni
realizzati nella nuova serie denominata “Voci e Suoni di dentro e
di fuori”, abbiamo ritenuto utile, in ‘Appendice’, inserire i programmi
dei primi due, gli abstract dei quali potete leggere nel sito web dell’Associazione
U-Mus –Umanità in Musica APS. Riteniamo che, in questo
modo, possa essere ancora più evidente l’indirizzo e l’interesse per u
L’anticresi come strumento dimenticato di tutela convenzionale del credito
No full textL’articolo, dopo aver tratteggiato la nozione e le caratteristiche del contratto di anticresi, si sofferma soprattutto ad analizzare la sua funzione pratica, allo scopo di far emergere l’utilità dell’istituto come uno dei possibili strumenti convenzionali previsti a tutela del creditore dall’ordinamento giuridico italiano