Archivio Istituzionale della Ricerca - Università degli Studi di Pavia
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Clinical Outcome Measurement Scales: A Domain Ontology and a Use Case for Stroke Rehabilitation
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Cancer mortality in Europe in 2020, and an overview of trends since 1990
No full textIntroduction: Cancer remains a leading cause of death in Europe, with over 1.2 million deaths recorded in the EU-27 in 2020. Methods: Using WHO death certification data for 33 European countries from 1990 to 2020, we analyzed mortality trends for all neoplasms and 24 cancer sites, stratified by sex and age. We computed age-standardized mortality rates (ASMR) and applied joinpoint regression models to evaluate temporal trends. Results: In 2020, the leading causes of cancer death in the EU-27 were lung (ASMR: 30.1/100 000), colorectal (14.6/100 000), and prostate (9.8/100 000) cancer in males and breast (13.8/100 000), lung (13.2/100 000), and colorectal (8.6/100 000) cancer in females. Pancreatic cancer was the fourth most common cause of cancer death in both sexes (ASMR: 8.2/100 000 males and 5.8/100 000 females). Most Central and Eastern European countries reported rates over two-fold higher compared to Western Europe. While overall cancer mortality declined since 1990 (average annual percent change: -1.3% in males and -0.8% in females in the EU-27), mortality from pancreatic (+0.2% in males and +0.8% in females) and female lung cancer (+1.9%) increased. Conclusion: Declines in cancer mortality are attributable to reduced tobacco use, and improvements in organized screening programs and treatment. Pancreatic cancer mortality remains stable, while female lung cancer mortality continues to rise in some countries, largely due to later adoption of smoking and low cessation rates. Lower participation in screening programs and limited access to novel therapies in many Central and Eastern European countries contribute to poorer cancer outcomes, highlighting the need for equitable prevention, early detection, and treatment strategies across Europe
La sperimentazione di Germano Lombardi. Prima perlustrazione su genesi testuale e strategie costruttive della trilogia "gialla" degli anni Settanta
No full textThe Parma University Campus as major trip attractor. Traffic microsimulation for modelling vehicle access scenarios
No full textUniversity campuses are multi-modal and major trip attractors, facing strong interactions of several transport modes within a unique system. Although campuses may share common features, they have different transport needs. The development of policies that encourage active mobility and transit service and the improvement of road infrastructures are main strategies to accomplish sustainable transportation goals. While many universities devote efforts to reducing drive-alone commute trips, private vehicles often remain the most affordable and convenient choice for many employees and students. In addition to discourage or apply strict restrictions to vehicular traffic, the optimization of the inbound and outbound flows is a necessary approach to reduce congestion and safety issues on and near campus Micro-simulation models are increasingly popular for examining these complex traffic problems at detail level, emulating traffic behavior in a transport network over time and space to predict a system performance. In this perspective, the article describes the case study of the mitigation of motorized traffic problems of the University Campus of Parma (Italy), which is implementing multiple sustainability strategies towards modal shift to non-motorized systems and optimization of public transport. Specifically, a traffic micro-simulation modelling was implemented to study the vehicle access at the main entrance to the Campus delimited area from the public road network via a multi-lane roundabout. Different scenarios, that do not involve any investment in infrastructure but only interventions in the management of the scheduled educational activities and services, were presented for increasing the users' safety and level of service. Following a description of the software calibration process and its validation to match the locally observed conditions, some operational solutions based on the re-planning of the lesson timetable were presented to reduce the current congestion levels within the campus and in its vicinity during peak hours
International jurisdiction over personality rights disputes: a European private international law perspective
No full textDetermining which national courts should have the authority to adjudicate cross-border civil law disputes arising from the infringement of personality rights - namely, the right to reputation and the right to privacy - has long been a sensitive and debated issue in legal literature and practice. The challenges in resolving conflicts of jurisdiction over personality rights disputes can be traced to two layers of complexity that specifically characterise torts against personality and set them apart from other categories of torts. First, since infringements of personality rights are typically committed in connection with the production and dissemination of media content, these disputes are ordinarily underlined by competing fundamental rights as a matter of constitutional and international human rights law - namely, the right to reputation or privacy on the side of the alleged victim and the right to freedom of expression on the side of the allegedly liable person. As such, selecting the national courts with jurisdiction to adjudicate personality rights disputes may, depending on the number of available courts and the proximity of each competent court to the elements of the dispute, result in disproportionate interference with either the alleged victim’s rights to reputation or privacy, or the allegedly liable person’s freedom of expression. In turn, due to the sensitive nature of the values at stake, the adoption of uniform and coherent jurisdictional solutions for cross-border personality disputes is hindered by the differing national conceptions at both the global and regional European levels regarding how personality rights should be balanced against the competing right to freedom of expression. Secondly, identifying the appropriate connecting factors between cross-border personality rights disputes and geographical territories, in order to allocate jurisdiction over such disputes, has continuously proven to be a complex and uncertain exercise. On the one hand, personality rights protect the intangible assets of the alleged victim’s personal sphere, namely his moral integrity, with the harm arising from the infringement primarily taking the form of non-pecuniary loss or ideal damage. On the other hand, in today’s information society, infringements of personality rights are typically committed via the Internet. Due to its attributes of ubiquity and virtuality, the Internet has amplified the potential for cross-border infringements of personality rights, while simultaneously challenging the application of traditional private international law rules based on geographical connecting factors. The present research focuses on the identification of the national courts with jurisdiction to adjudicate cross-border civil law disputes arising out of the infringement of personality rights, from a European private international law perspective. As such, the research focuses on the relevant instruments of European Union law that contain provisions aimed at resolving conflicts of adjudicative jurisdiction over personality rights disputes: the so-called ‘Brussels Ibis Regulation’ (Regulation (EU) No 1215/2012) and the General Data Protection Regulation, or ‘GDPR’ (Regulation (EU) 2016/679). At the same time, in order to position the approach currently adopted under European Union law within the broader international context, the analysis further encompasses, from a comparative perspective, the approach to adjudicative jurisdiction over cross-border personality rights disputes that emerged in the practice of courts in the United States of America
"Teatri di parole". Lessico e testualità nella poesia di Giorgio Orelli
No full textLa tesi consiste in uno studio approfondito delle informazioni e dei dati raccolti attraverso il censimento e la schedatura precisa delle occorrenze di tutti i lemmi usati da Giorgio Orelli nella sua opera poetica, dalla raccolta d’esordio Né bianco né viola alla produzione edita postuma. Adottando una prospettiva tanto paradigmatica quanto sintagmatica, si dà spazio a diverse campionature ispirate a categorie lessicali specifiche; vengono presi in esame, anzitutto, i valori semantici e retorici dei lessemi, di cui si ricostruisce il particolare itinerario macrotestuale anche attraverso i riferimenti agli scritti in prosa dell’autore. Ci si concentra altresì sul ruolo degli “attori” orelliani, tra cui, soprattutto, i bambini, in grado di agire profondamente sulle strutture linguistiche – un capitolo è dedicato ai neologismi – e testuali. Il lavoro, in effetti, si apre alla testualità, da intendere sia in senso ampio: vengono messe a fuoco le caratteristiche precipue del testo poetico, la tenuta fonico-timbrica e le strategie coesive; sia in senso più stretto: un capitolo è dedicato alla dialogicità e ai discorsi riportati, uno degli aspetti più innovativi della poesia orelliana. In appendice, si propone una selezione di schede lessicali, approntate grazie a quel lavoro preliminare di classificazione, sorta di controcampo statistico alla parte argomentativa e sintagmatica, comunque predominante.The thesis consists of an in-depth study of the information and data collected through the precise cataloguing of all the lemmas used by Giorgio Orelli in his poetic work, from his debut collection Né bianco né viola to his posthumous published works. Adopting both paradigmatic and syntagmatic perspectives, the study examines various lexical categories. The semantic and rhetorical values of the lexemes are examined reconstructing their particular macrotextual journey through references to the author’s prose writings. The focus is also on the role of the “actors” in Orelli’s work, particularly children, who are able to deeply influence linguistic and textual structures – a chapter is dedicated to neologisms. The work, in fact, opens up to textuality, understood both in a broad sense, highlighting the distinctive features of the poetic text, the phonetic structure and cohesive strategies; and in a narrower sense: a chapter is dedicated to dialogism and reported speech, one of the most innovative aspects of Orelli’s poetry. In the appendix, a selection of lexical charts is presented, compiled thanks to the preliminary classification work, a sort of statistical counterpoint to the argumentative and syntagmatic part, which remains predominant
Do biological alterations precede the onset of psychosis? A systematic review and meta-analysis of immune, cardiometabolic, prolactin and HPA axis alterations in clinical high-risk for psychosis
No full textFirst episode psychosis (FEP) individuals show biological abnormalities preceding antipsychotic treatment. However, it remains unclear whether such alterations are also present before the onset of psychosis. We aim to provide estimates of standardized mean differences for immune, cardiometabolic, prolactin, and HPA axis parameters in individuals at clinical high-risk for psychosis (CHR-P) compared to healthy controls (HC) and FEP individuals, and between CHR-P transitioning to psychosis (CHR-T) compared non-transitioning (CHR-NT). A multistep literature search was performed from database inception until September 25, 2023. PRISMA/MOOSE-compliant and pre-registered (PROSPERO: CRD42024507670) systematic review identified studies reporting on immune, cardiovascular or endocrine parameters in CHR-P samples compared with HC or FEP samples or comparing CHR-T vs CHR-NT. Inter-group differences in magnitude of effect were estimated using Hedges g and estimates were pooled using random-effects meta-analysis. Heterogeneity was high for most outcomes. 37 studies were included, total sample 2509 CHR-P, 710 FEP, and 1444 HC individuals. A statistically significant elevation of pro-inflammatory proteins was found among CHR-P compared with HC (k = 12; N = 1710; g = 0.16; p < 0.01) and FEP (k = 7; g = 0.15; p = 0.04) subjects. Interleukin-6 (IL-6) was increased in CHR-P compared to HC (k = 9; N = 1243; g = 0.54; p < 0.01), and interleukin-4 (IL-4) was increased in CHR-T compared with CHR-NT (k = 2; N = 318; g = 0.36; p < 0.01). CHR-P exhibited stronger cortisol awakening response than FEP subjects (k = 3; N = 173; g = 0.51; p = 0.01). CHR-P and FEP individuals did not show statistically significant differences in terms of prolactin levels. An inflammatory state (particularly marked by elevated IL-6 and IL-4 levels) and HPA axis alterations are present in CHR-P individuals
A systematic review and meta-analysis of double trophectoderm biopsy and/or cryopreservation in PGT: balancing the need for a diagnosis against the risk of harm
No full textBACKGROUND: To prevent the transfer of embryos affected by monogenic conditions and/or chromosomal defects, preimplantation genetic testing (PGT) requires trophectoderm biopsy and cryopreservation. In 2-6% of biopsies, the diagnosis may be inconclusive due to DNA amplification failure or low-quality results. In these cases, a round of re-warming, re-biopsy, and re-cryopreservation is required to obtain a genetic diagnosis. In other cases, when the IVF centre starts providing PGT and/or when the patients develop an indication because of multiple failures, miscarriages or the birth of an affected child after IVF, cryopreserved untested embryos may be warmed, biopsied, and then re-vitrified. However, it is still unclear whether multiple manipulations may reduce reproductive outcomes after PGT. OBJECTIVE AND RATIONALE: This study aimed at conducting a systematic review to investigate the available evidence on the safety of double biopsy and/or double cryopreservation-warming and provide recommendations in this regard. We performed meta-analyses of the differences in the reproductive outcomes (live birth per embryo transfer [LBR per ET], clinical pregnancy rate per ET [CPR per ET], and miscarriage rate per clinical pregnancy [MR per CP]) in double cryopreservation and single biopsy (CBC) or double biopsy and double cryopreservation (BCBC) flows vs the control single biopsy and single cryopreservation (BC) flow. Cryo-survival rates before ET and gestational and perinatal outcomes were also reported. SEARCH METHODS: PRISMA guidelines were followed to gather all available information from the literature (PubMed, Scopus, and Embase). We used Medical Subject Headings (MeSH) terms and a list of specific keywords relevant for the study question. We searched for original studies in humans, published in peer-reviewed journals in English up to April 2024. Four independent authors assessed the articles for inclusion. One included paper was retrieved from another source. OUTCOMES: A total of 4219 records were identified, and 10 studies were included in the meta-analysis. Certainty of evidence level ranged from low to moderate. Both the CBC and BCBC groups showed reduced reproductive outcomes compared to the control (BC). Specifically, live birth rates per embryo transfer were lower in the CBC group (OR: 0.56, 95% CI: 0.38-0.81, I2 = 58%; six studies) and the BCBC group (OR: 0.51, 95% CI: 0.34-0.77, I2 = 24%; six studies). CPR per ET were also lower in the CBC group (OR: 0.68, 95% CI: 0.51-0.92, I2 = 57%; seven studies) and the BCBC group (OR: 0.60, 95% CI: 0.46-0.78, I2 = 0%; seven studies). Additionally, MR per CPs were higher in both the CBC group (OR: 1.68, 95% CI: 1.02-2.77, I2 = 50%; seven studies) and the BCBC group (OR: 2.08, 95% CI: 1.13-3.83, I2 = 28%; seven studies). Cryo-survival as well as gestational and perinatal outcomes were within the expected norms in the studies reporting them. WIDER IMPLICATIONS: Improved genetic technologies, standardization of laboratory protocols, operators' proficiency with biopsy and cryopreservation, and continuous monitoring of the performance are essential to minimize inconclusive diagnoses and the putative impact of additional embryo manipulations. Although poorer reproductive outcomes might result from double biopsy and/or double cryopreservations, these practices may still be worthwhile to avoid transferring affected/aneuploid blastocysts. Therefore, the risks must be weighed against the potential benefits for each specific couple. REGISTRATION NUMBER: PROSPERO (ID: CRD42024503678
