University of Chieti-Pescara

We present our library for universal algebra in the UniMath framework dealing with multi-sorted signatures, their algebras and the basics for equation systems. We show how to implement term algebras over a signature without resorting to general inductive constructions (currently not allowed in UniMath) still retaining the computational nature of the definition. We prove that our single sorted ground term algebras are instances of homotopy W-types. From this perspective, the library enriches UniMath with a computationally well-behaved implementation of a class of W-types. Moreover, we give neat constructions of the univalent categories of algebras and equational algebras by using the formalism of displayed categories and show that the term algebra over a signature is the initial object of the category of algebras. Finally, we showcase the computational relevance of our work by sketching some basic examples from algebra and propositional logic.

Objective To compare the effectiveness and cost of in‐vitro fertilization (IVF) with or without preimplantation genetic testing for aneuploidy (PGT‐A) when only one or two blastocysts are obtained. Methods A dataset was gathered from 1829 patients including 368 non‐PGT‐A and 1461 PGT‐A cycles with one or two blastocysts obtained, between April 2013 and July 2022. Patients were matched 1:1 by propensity‐score matching for maternal age, number of metaphase‐II oocytes inseminated and number of blastocysts obtained, achieving a database of 242 patients per group. The non‐PGT‐A and PGT‐A groups were compared for differences in live birth rate (LBR) per embryo transfer (ET), cumulative LBR per patient, miscarriage rate (MR) per clinical pregnancy, number of days between oocyte retrieval and conclusion of the IVF cycle (primary outcome), mean expenses incurred at the clinic and incremental cost‐effectiveness ratio (ICER). Results More than twice as many ETs were conducted in the non‐PGT‐A group compared with the PGT‐A group, yet the cumulative LBR per patient was similar between groups (23.6% (95% CI, 18.5–29.5%) vs 27.3% (95% CI, 21.9–33.4%)). This outcome was achieved with a higher LBR per ET (16.2% (95% CI, 12.6–20.5%) vs 41.5% (95% CI, 33.9–49.4%)) and lower MR per clinical pregnancy (30.1% (95% CI, 21.8–42.6%) vs 13.9% (95% CI, 7.5–24.0%)) in the PGT‐A group. The MR per patient was also lower in the PGT‐A group (9.5% (95% CI, 6.2–14.1%) vs 4.5% (95% CI, 2.4–8.2%)). The mean duration between oocyte retrieval and IVF cycle conclusion was 131 (95% CI, 113–150) days in the non‐PGT‐A group vs 74 (95% CI, 61–87) days in the PGT‐A group ( P < 0.001; power = 99.8%). The ICER of PGT‐A for the months saved between oocyte retrieval and conclusion of the IVF cycle was €499 overall, ranging between €170 and €2065 according to the number of blastocysts obtained and/or maternal age. The ICER of PGT‐A for prevented miscarriages was €18 968, decreasing to €3525 when calculated among patients aged ≥ 35 years with two blastocysts obtained. Conclusions When conducted in expert IVF clinics for patients indicated for the procedure, PGT‐A is clinically valuable even when only one or two blastocysts are obtained. PGT‐A reduces the number of ETs and miscarriages while the cumulative LBR per patient remains unaffected, and allows these outcomes to be achieved in a shorter timeframe. The ICER of PGT‐A vs non PGT‐A decreased as maternal age increased. © 2024 International Society of Ultrasound in Obstetrics and Gynecology.

Purpose Body composition can be estimated using anthropometric-based regression models, which are population-specific and should not be used interchangeably. However, the widespread availability of predictive equations in the literature makes selecting the most valid equations challenging. This systematic review compiles anthropometric-based predictive equations for estimating body mass components, focusing on those developed specifically for athletes using multicomponent models (i.e. separation of body mass into ≥ 3 components). Methods Twenty-nine studies published between 2000 and 2024 were identified through a systematic search of international electronic databases (PubMed and Scopus). Studies using substandard procedures or developing predictive equations for non-athletic populations were excluded. Results A total of 40 equations were identified from the 29 studies. Of these, 36 were applicable to males and 17 to females. Twenty-six equations were developed to estimate fat mass, 10 for fat-free mass, three for appendicular lean soft tissue, and one for skeletal muscle mass. Thirteen equations were designed for mixed athletes, while others focused on specific contexts: soccer (n = 8); handball and rugby (n = 3 each); jockeys, swimming, and Gaelic football (n = 2 each); and futsal, padel, basketball, volleyball, American football, karate, and wheelchair athletes (n = 1 each). Conclusions This review presented high-standards anthropometric-based predictive equations for assessing body composition in athletes and encourages the development of new equations for underrepresented sports in the current literature. Graphical abstract

Background To combat the high prevalence of physical inactivity among children, there is an urgent need to develop and implement real-world interventions and policies that promote physical activity (PA) and reduce sedentary behaviour (SB). To inform policy makers, the current body of evidence for children’s PA/SB interventions needs to be translated. Objectives The current systematic review and meta-analysis aimed to identify modifiable determinants of device-measured PA and SB targeted in available intervention studies with randomized controlled trial (RCT) and controlled trial (CT) designs in children and early adolescents (5–12 years) and to quantify the effects of the interventions within their respective settings on the determinants of PA/SB and the outcomes PA and SB. Methods A systematic search was conducted in MEDLINE, PsycINFO, Web of Science, SPORTDiscus and CENTRAL. Studies were considered if they were randomized controlled trials (RCTs) or controlled trials (CTs), included children and/or early adolescents (5–12 years; henceforth termed children), measured PA and/or SB using device-based methods and measured PA and/or SB and determinants of PA/SB at least at two timepoints. Risk of bias was assessed using the Cochrane Risk of Bias Tool for Randomised Trials (RoB2) for RCTs and Risk of Bias in Non-randomised Studies of Interventions (ROBINS-I) for CTs. The quality of the generated evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE). Robust Bayesian meta-analysis was conducted to quantify the effects of the interventions on the determinants of PA/SB, and the outcomes PA and SB, stratifying by study design, duration of PA/SB measurement, intervention setting and duration of follow-up measurement. Study characteristics and interventions were summarized. Results Thirty-eight studies were included with a total sample size of n = 14,258 (67% girls). Settings identified were school, family/home, community and combinations of these. The review identified 38 modifiable determinants, spanning seven categories on individual, interpersonal and physical environmental levels, with 66% of determinants on the individual level. Overall, the results indicated trivial-to-moderate effects of the interventions on the determinants of PA and SB, with mostly trivial level of evidence for the presence of an effect (as indicated by a small Bayes factor; BF10 < 3.00). The exceptions were moderate effects on parental PA modelling in the family/home setting and SB measured during specific parts of the school day. Higher quality of evidence was found in the family/home setting compared with other settings. Discussion Overall, the results indicated that interventions have neither been effective in modifying the determinants of PA/SB, nor changing the PA/SB outcomes in children. In general, the approach in the current review revealed the breadth of methodological variability in children’s PA interventions. Research is needed to address novel approaches to children’s PA research and to identify potential determinants to inform policy and future interventions. Registration International prospective register of systematic reviews (PROSPERO): CRD42021282874.

Normal science is about assessing what is already known about a topic, about what needs to be known, and careful methods to collect the data required to answer the scientific question. It is the mainstay of scientific progress. But sometimes, luck or chance (eg, serendipity) plays a significant role in scientific process. We trace career experiences in our lives to show how serendipity, the gift that Mother Nature gives to science, has a nontrivial role in scientific progress and professional careers. This gift often encourages us to change the focus of experiments or to look for the answers to our questions in ways that were not immediately obvious.

The Italian telephone-based Mini-Mental State Examination (Itel-MMSE) is considered a very easy tool for screening individuals with dementia, gained importance during COVID-19, but lacks validation and faces a ceiling effect. In the present study, we conducted a study standardizing and validating it, establishing cut-off values for two versions. Across 24 Italian sites, 707 healthy individuals (50–89 years, men: 268, women: 439) with diverse educational levels (3–24 years) were recruited. Subjects met criteria for normal conditions investigated through a semi-structured interview covering neurological, psychiatric, general medical, and psychopharmacological history. Two test versions were created to assess test–retest reliability at 45-day intervals. We also enrolled 187 subjects with Mild Cognitive Impairment (MCI) and 181 with Alzheimer's Disease (AD) for validation. The raw scores obtained on both versions of Itel-MMSE were set as dependent variables in linear regression models that included age, education, and gender as independent variables. Mean raw Itel-MMSE1 score was 20.82 (range: 13–22). Multiple linear regression demonstrated significant effects of sociodemographic variables for age and education, establishing a new cut-off ≥ 18.49. Mean raw Itel-MMSE2 score was 20.97 (range: 10–22), with a new cut-off ≥ 18.45. Validation showed high informative values, with areas under the curve (AUCs) for MCI and AD conditions and both versions (Itel-MMSE1: MCI AUC = 0.801, AD AUC = 0.907; Itel-MMSE2: MCI AUC = 0.827, AD AUC = 0.977). The Itel-MMSE proves valuable as a screening method for detecting and monitoring dementia in remote phone screenings, with different cut-offs aiding MCI patient identification in clinical settings.

This work gives sufficient conditions for uniqueness in distribution of semimartingale, obliquely reflecting Brownian motion in a nonpolyhedral, piecewise $\mathcal {C}^2$ cone, with radially constant, Lipschitz continuous direction of reflection on each face. The conditions are shown to be verified by the conjectured diffusion approximation to the workload in a class of bandwidth-sharing networks, thus ensuring that the conjectured limit is uniquely characterized. This is an essential step in proving the diffusion approximation. This uniqueness result is made possible by replacing the Krein–Rutman theorem used by Kwon and Williams (1993) in a smooth cone with the recent reverse ergodic theorem for inhomogeneous, killed Markov chains of Costantini and Kurtz (Ann Appl Probab, 2024. https://doi.org/10.1214/23-AAP2047; Stoch Process Appl 170:104295, 2024. https://doi.org/10.1016/j.spa.2024.104295).

The brain is a highly complex physical system made of assemblies of neurons that work together to accomplish elaborate tasks such as motor control, memory and perception. How these parts work together has been studied for decades by neuroscientists using neuroimaging, psychological manipulations, and neurostimulation. Neurostimulation has gained particular interest, given the possibility to perturb the brain and elicit a specific response. This response depends on different parameters such as the intensity, the location and the timing of the stimulation. However, most of the studies performed so far used previously established protocols without considering the ongoing brain activity and, thus, without adaptively targeting the stimulation. In control theory, this approach is called open-loop control, and it is always paired with a different form of control called closed-loop, in which the current activity of the brain is used to establish the next stimulation. Recently, neuroscientists are beginning to shift from classical fixed neuromodulation studies to closed-loop experiments. This new approach allows the control of brain activity based on responses to stimulation and thus to personalize individual treatment in clinical conditions. Here, we review this new approach by introducing control theory and focusing on how these aspects are applied in brain studies. We also present the different stimulation techniques and the control approaches used to steer the brain. Finally, we explore how the closed-loop framework will revolutionize the way the human brain can be studied, including a discussion on open questions and an outlook on future advances.

Known as “designer drugs” or “legal highs,” new psychoactive substances (NPS), are a growing concern globally. These substances refer to synthetic or modified compounds designed, including synthetic cannabinoids, synthetic cathinones, synthetic opioids, and other compounds, mimicking the effects of traditional illicit drugs while avoiding legal restrictions. The chemical structures of NPS can change quickly, complicating efforts to understand their effects and risks. Although marketed as safe and legal, the use of NPS poses significant challenges to public health and mental health professionals, being a rising concern related to unknown risks, unpredictable and potentially severe physical and mental health consequences, including anxiety, paranoia, hallucinations, and toxicity-related overdose. Moreover, their easy availability, both online and in physical stores and their global distribution networks, can contribute to increased use. Efforts to address the accessibility of NPS often involve collaboration between law enforcement, regulatory agencies, and public health organizations. Strategies include updating and expanding legislation to cover a broader range of substances, enhancing international cooperation, and increasing public awareness about risks associated with these substances. It is important for health professionals, policymakers, and public to stay informed about the evolving NPS scenario and work together to implement effective prevention, education, and harm reduction measures.

A curse is a magical practice that causes harm to someone. It is ‘a ritual performance that transfers subjective power to some objects, or the subversive power that plagues one following such performance’ (Frankfurter 2006: 158). By its very nature, a curse involves wishing harm and the substantial effect caused by this desire. Curses are generally associated with hostile or malevolent intentions and are cast to bring about suffering, bad luck, illness, or other forms of harm to the cursed person or object. Curses are often seen as acts of revenge, punishment, or to exert control over others, and they are believed to work by tapping into negative energies or supernatural forces and directing them towards the target. Unlike spells, curses typically produce adverse outcomes and are not used for positive purposes, like healing or protection. Today, we generally define a curse as nothing more than an insult or offence, which can either be ignored or cause a reaction but whose effectiveness is of little interest. According to David Frankfurter (2006), the curse held significantly greater weight as a form of communication, capable of inducing changes in the mental or physical state of the target individual. Lester K. Little (2007) adds that the intervention of another speech act of equal authority can reverse these alterations. Norse mythology and literature undoubtedly offer several records of cursing practices in medieval Scandinavia. In particular, while the curses portrayed in Old Norse sagas are primarily literary creations, they offer substantial evidence of a cultural heritage helpful in examining the representation of magic and the system of beliefs related to it during the Middle Ages.

Patients with acute pulmonary embolism (PE) have a wide spectrum of clinical presentations, from incidental findings to sudden cardiac death. Management and treatment recommendations in currently available guidelines vary according to patient risk and haemodynamic profile. A clot-in-transit (CiT) in the right heart chambers may be occasionally identified and is, therefore, an under-recognised but challenging condition, often preceding an abrupt clinical deterioration, and associated with increased mortality. Data on the detection of a CiT are sparse but consistent in attributing negative prognostic relevance, and therefore the presence of CiT should be systematically investigated and recorded in the setting of PE. In this review, the challenges related to the identification of a CiT are highlighted. Here, we propose an algorithm where the role of the Pulmonary Embolism Response Team (PERT) is reinforced. The PERT should convene once the CiT is suspected, to define the timeline for the diagnostic steps and subsequent management on a case-by-case basis. A patient with PE and CiT requires close bedside monitoring and rapid escalation therapy in case of clinical deterioration. Beyond anticoagulation alone, more aggressive strategies can be considered, including systemic thrombolysis, surgical pulmonary embolectomy and the currently emerging catheter-directed therapies. PROSPERO registration number: CRD42024493303.