Archivio Istituzionale della Ricerca - Università degli Studi della Campania "Luigi Vanvitelli"
Not a member yet
116395 research outputs found
Sort by
Architettura religiosa e muralismo contemporaneo nel percorso delle Fontanelle a Napoli tra rappresentazione e conservazione
No full textChanging clinical and laboratory characteristics of Progressive Multifocal Leukoencephalopathy: a retrospective national cohort study
No full textBackground: Progressive Multifocal Leukoencephalopathy (PML) is a severe demyelinating disease caused by JC polyomavirus (JCV), affecting immunocompromised individuals. We describe PML demographic, clinical, radiological and laboratory characteristics and survival over time and according to underlying condition in a large retrospective patient cohort. Methods: This is a retrospective cohort including Italian PML patients observed between 1987 and 2024, with known year of diagnosis and underlying disease. Results: We included 456 cases with either a definite (n=376, 82.4%) or clinico-radiological (n=80, 17.6%) PML diagnosis. The relative frequency of HIV-associated cases decreased through four time periods (1987-1996; 1997-2004; 2005-2012; 2013-2024) from 99% to 43%, in parallel with increasing age (p<0.0001), proportion of women (p<0.001) and CD4+ counts (p<0.001), but not cerebrospinal fluid (CSF) or plasma JCV-DNA levels at diagnosis. One-year survival probability increased from 23.8% in 1987-1996 to 59.2% in 2013-2024, with highest values in natalizumab-treated multiple sclerosis (93.8%), followed by combination antiretroviral treatment (cART)-treated HIV infection (55%), hematological malignancies (50.8%), primary immunodeficiencies (41.3%) and cART-untreated HIV infection (11.9%). At multivariate analysis excluding cART-untreated people with HIV, JCV-DNA levels in both CSF and plasma were independently associated with an increased mortality risk of 2.9% and 7.2%, respectively, for each Log increase in JCV-DNA. Conclusions: This observational study showed a changing epidemiological context over 37 years. Although survival improved over time, it remained poor even in the last decade, with a one-year survival probability of 59.2%
Balancing autonomy and care: The ethical and legal dilemmas of artificial nutrition and hydration under compulsory health treatment
No full textThe complex issue of informed consent in the context of administering Artificial Nutrition and Hydration (ANH) under Compulsory Health Treatment (TSO) is explored, examining whether ANH can be forcibly administered, particularly in cases involving patients with eating disorders such as severe anorexia. The tension between respecting patient autonomy and the medical duty to provide care, especially when the patient cannot give valid consent, is highlighted. While TSO represents a significant limitation on personal freedom, it must be justified only under extreme clinical conditions, with the patient’s informed consent being paramount whenever possible. Advocacy for a therapeutic alliance and empathetic-supportive approach is emphasized, stressing the importance of non-coercive methods and respecting patient self-determination. Additionally, a multidisciplinary approach in decision-making is underscored, involving ethicists, legal experts, and family members to ensure that decisions align with the patient’s best interests and uphold their dignity and autonomy
Could ChatGPT Automate Water Network Clustering? A Performance Assessment Across Algorithms
No full textWater distribution networks (WDNs) are characterized by complex challenges in management and optimization, especially in ensuring efficiency, reducing losses, and maintaining infrastructure performances. The recent advancements in Artificial Intelligence (AI) techniques based on Large Language Models, particularly ChatGPT 4.0 (a chatbot based on a generative pre-trained model), offer potential solutions to streamline these processes. This study investigates the ability of ChatGPT to perform the clustering phase of WDN partitioning, a critical step for dividing large networks into manageable clusters. Using a real Italian network as a case study, ChatGPT was prompted to apply several clustering algorithms, including k-means, spectral, and hierarchical clustering. The results show that ChatGPT uniquely adds value by automating the entire workflow of WDN clustering—from reading input files and running algorithms to calculating performance indices and generating reports. This makes advanced water network partitioning accessible to users without programming or hydraulic modeling expertise. The study highlights ChatGPT’s role as a complementary tool: it accelerates repetitive tasks, supports decision-making with interpretable outputs, and lowers the entry barrier for utilities and practitioners. These findings demonstrate the practical potential of integrating large language models into water management, where they can democratize specialized methodologies and facilitate wider adoption of WDN managing strategies
Sex-related differences among patients with reflex neurally mediated syncope
No full textFew studies have evaluated the effect of sex in patients with reflex neurally mediated syncope. The aim of our study was to describe the sex-related differences in clinical characteristics and responses to HUTT among a large population with syncope. 1845 consecutive patients who underwent HUTT for suspected or established reflex syncope were evaluated. The study population was dichotomized according to sex. The clinical characteristics, the HUTT positivity rate and responses were compared between the groups. The trends of blood pressure (BP) and heart rate (HR) and the HUTT positivity rate were analyzed across different age groups according to sex. 1845 patients (45 ± 20 years) were included; 938 were females. Females showed lower values of systolic BP with higher values of HR compared to males up to 49 years. The HUTT positivity rate was significantly lower in females compared to males (61.1% vs 66%; p = 0.03). After adjusting for age decades, females had a higher positivity rate than males until the age of 29 years. Females showed an overall significantly lower rate of cardioinhibitory response compared with males (22.2% vs 29.3%; p = 0.0005). Female patients with suspected reflex neurally mediated syncope showed a different hemodynamic profile characterized by lower BP values and higher HR values than males until the age of 49 years. The overall HUTT positivity rate was lower in females than in males; however, females had a higher positivity rate until the age of 29 years. The prevalence of cardioinhibitory response was lower in females
The Guardian of Dreams: The Neglected Relationship Between Sleep and Psychoanalysis
No full textKnowledge about sleep was very limited at the time when Freud published his seminal work on the interpretation of dreams. He was also not interested in sleep, which was considered a problem of physiology; however, sleep appears to have a central role in his model, since dreaming is considered the guardian of sleep. The function of dreaming, according to Freud, is to protect sleep from disruption, with the dream working to avoid repressed stimuli interrupting the “biological” function of sleep. Before neurophysiological studies provided evidence that sleep is not a passive state, Freud also recognized sleep as an active process, as human beings voluntarily withdraw their attention from the external world to actively move to sleep. The discovery of REM sleep in the 1950s led psychoanalysts to see sleep as the necessary background to the occurrence of dreaming. Although Freud dismissed the clinical importance of sleep disturbances, viewing them as the somatic expression of an instinctual disturbance which would disappear during psychoanalytic treatment, successive authors highlighted the fact that sleep disturbances might have a more specific psychological significance. The similarities between the loss of self that occurs during sleep and the fragmentation of the identity experienced during schizophrenia represent an interesting and yet not fully explored area of research. Thanks to Freud’s work, the desire to sleep assumes the important role of a psychological, active factor that contributes to the occurrence and function of sleep
Combining multifaceted aspects of technology innovations through fuzzy clustering of multilayer networks
No full textThis study advances a novel multilayer network model to explore the connection between different aspects of Technological Innovation in European Union (EU) countries. We follow a fuzzy clustering approach and consider three variables: Research and Development (R&D), High-Tech Exports (HTE), and Human Resources in Science and Technology (HRST). We consider Eurostat data from 2018 to 2023. The variables form the layers, the EU countries are the nodes of the layers, and the weighted intra-layer links are assumed to increase with respect to the similarity of the countries in terms of the related variable. Interlayer connections are modeled probabilistically using a fuzzy clustering approach: two countries in different layers are strongly connected if they belong more probably to the same cluster in the related layers. The analysis offers insights into the patterns of EU countries in terms of Technological Innovation (TI) processes. The proposed framework allows its applicability to a wide set of real-world contexts
ASL reveals regional brain perfusion impairment in neonates with mild hypoxic ischemic encephalopathy
No full textThere is a lack of neuroimaging data and effective biomarkers in infants with mild hypoxic ischaemic encephalopathy (HIE). Cerebral reperfusion injury has shown potential as marker of neurodevelopmental outcome in moderate and severe HIE. We examined cerebral perfusion by using arterial spin labelling (ASL) in infants with mild HIE and its associations with adverse outcomes. We also studied the presence of any potential regional sensitivity of cerebral blood flow (CBF) on the effects of HIE severity. This prospective cohort study included term and near-term neonates admitted for HIE across 3 neonatal intensive care units in Italy between October 2019-2022. Magnetic resonance imaging (MRI)-ASL was performed between 4 and 10 days after birth. Neurodevelopmental outcome was assessed at 24-28 months. Of the 94 infants included in the analysis, 74 neonates had mild [79%], 15 moderate [16%], 5 severe encephalopathy [5%]. Of the 71 neonates with mild HIE and neurodevelopmental outcome available, 15 (21%) showed mild disability. Basal ganglia CBF was the only region significantly associated with cognitive, motor and language Bayley scores (false-discovery-rate < 0.05). HIE severity had a regional dependent effect with involvement of Heschl, Rolandic operculum, limbic lobe, subcortical gray nuclei followed by frontal lobes. Basal ganglia CBF in infants with mild HIE was associated with adverse outcomes even without any MRI visible deep brain nuclei injury
Giovanni Pontano, Commentationes in centum sententiis Ptolemaei . A critical edition
No full textThe Pseudo-Ptolemy’s Centiloquium is a text of controversial origin. With more than two hundred manuscripts, it undoubtedly is one of the most popular works of Western Latin astrology. The Commentationes in centum sententiis Ptolemaei is an astrological work in two books in which Giovanni Gioviano Pontano provides an extensive commentary on the Centiloquium along with his own translation of the Greek text. The first book is addressed to the Duke of Urbino, Federico da Montefeltro, and the second one to Pontano’s close friend and member of the Neapolitan Academy Pietro Golino (Petrus Compater). The Commentationes had a substantial impact on the astrological Literature of the 15th-17th centuries. Published posthumously in 1512 by Pietro Summonte ‒ but early widespread through a noteworthy manuscript tradition ‒ it was reprinted over twenty times until 1674 and became the standard Latin translation of the Centiloquium. While ‒ together with the other treatise De rebus coelestibus ‒ it represents the most exacting of Pontano’s astrological prose, the Commentationes has never been published in a critical edition nor studied in its textual history