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Cerebral oedema complicating diabetic ketoacidosis (DKA) remains the major cause of morbidity and mortality in children with type 1 diabetes, but its aetiology remains unknown. Our objective was to determine the impact of baseline biochemical factors and of treatment-related variables on risk of the development of cerebral oedema in children with DKA. This was a national UK case-control study. Through the British Paediatric Surveillance Unit we identified 43 cases of cerebral oedema. Through a parallel reporting system, we also identified 2,940 episodes of DKA and selected 169 control subjects on the basis of comparable age, sex, numbers of new or known cases of diabetes and date of admission. Baseline biochemical data and treatment-related variables were extracted from the clinical notes of cases and control subjects. Allowing for differences in age, sex and new or known diabetes, cases were more acidotic at diagnosis of DKA (odds ratio [OR] for events in the least acidotic compared with the most acidotic tertile=0.02 [95% CI: 0.002-0.15], p<0.001). In addition, cases had higher potassium and urea levels at baseline. Calculated osmolality and baseline glucose were not significantly different. After allowing for severity of acidosis, insulin administration in the first hour (OR 12.7 [1.41-114.5], p=0.02) and volume of fluid administered over the first 4 h (OR 6.55 [1.38-30.97], p=0.01) were associated with risk. Low baseline plasma sodium and an elevated p(a)CO(2) also contributed to risk in the final regression model. Bicarbonate administration was not associated with increased risk of an event when corrected for acidosis. In this case-control study of DKA, baseline acidosis and abnormalities of sodium, potassium and urea concentrations were important predictors of risk of cerebral oedema. Additional risk factors identified were early administration of insulin and high volumes of fluid. These observations should be taken into account when designing treatment protocols.

BackgroundIn September 2024, Lombardy expanded eligibility for HPV vaccination. Now it is available for free to all individuals up to 26 years of age and to all individuals engaging in risky sexual behaviors, although HPV is transmissible beyond traditional risk categories: via skin-to-skin contact, even with condom use.Prevention efforts often remain limited to specific populations, such as gay, bisexual and other men who have sex with men and young adolescents. Lombardy’s policy marks a crucial step in increasing vaccine accessibility for all, especially for sexually active adults of all genders and sexualities.Brescia Checkpoint was established in 2024 and is the first local community-based organization providing comprehensive sexual health services, including HPV vaccination promotion.Material and MethodsBetween November 2024 and February 2025, Brescia Checkpoint offered free and confidential rapid HIV and syphilis testing once a month. During pre-test counselling, all clients completed an anonymous questionnaire and discussed with peer providers about HPV and vaccination benefits.The unvaccinated were informed by peers that the physician conducting the tests could sign a document recommending their eligibility for free HPV vaccination under the new regional guidelines. This initiative leveraged the physician’s authority to facilitate free vaccination at public centers and to empower individuals to get vaccinated. To reinforce support, clients were encouraged to report any barriers encountered.Results61 clients received HIV and syphilis testing, and 36.1% of them were already vaccinated for HPV. Among those vaccinated, 8 (36.4%) had purchased the vaccine out-of-pocket. The majority of clients were not vaccinated for HPV (63.9%), all of them were willing to get vaccinated and received the recommendation from the physician. Demographic data revealed that HPV vaccination rates were higher among gay and bisexual men (45.5%). Significant gaps in vaccination coverage can be seen in all populations, particularly among young people under 26 years of age and those over 30 years, despite the extended eligibility criteria (table 1). No client reported experiencing barriers at vaccination centers.Abstract SC1 Table 1HPV vaccination coverage among HIV/syphilist testing clients, by age, sexual orientation, gender identity, place of residence, employment statusConclusionsThis initiative highlights the crucial role of community-based organizations in bridging gaps in HPV vaccine access through peer-mentorship and collaboration with physicians. We firmly believe that this approach strengthens public health efforts beyond traditional clinical settings. Providing individuals with strong peer and physician support could enable them to effectively prioritize their health.We plan to investigate further the effectiveness of vaccination recommendations issued within our program in increasing vaccination uptake. This experience could serve as a replicable model in other settings and contribute to a more comprehensive HPV prevention strategy.

Summary Gradual transitions from K-feldspar free gneisses to K-feldspar bearing augengneisses are sometimes observed in metamorphic terranes. They have been explained with metasomatic porphyroblastic growth connected with regional metamorphism, or with pre-metamorphic presence of magmatic megacrysts. A transition of this kind can be observed in the Serie dei Laghi (Southern Alps, Italy), where coarse-grained meta-arenites ( Cenerigneiss ) grade into Ceneri augengneisses with large K-feldspar porphyroclasts, and banded amphibolites of the “Strona Ceneri Border Zone” grade into Hbl augengneisses rich in K-feldspar. The Ceneri augengneisses are chemically indistinguishable from the Cenerigneiss , but have higher 87 Sr /86 Sr (0.7256–0.7258 vs. 0.7215–0.7233), similar to those of the Ordovician granites that were intruded, before the regional metamorphism, into the protoliths of both Cenerigneiss and amphibolites . The Cenerigneiss contains two types of zircons: (1) highly luminescent, rounded grains or fragments, yielding U–Pb SHRIMP ages from 0.43 to 1.0 Ga; (2) euhedral grains with oscillatory zoning (magmatic), with U–Pb SHRIMP concordant ages of 466 ± 13 Ma. This age coincides with the Rb–Sr whole rock emplacement age of the Ordovician granitoids (466 ± 5 Ma). The Hbl augengneisses form three groups with distinct geochemical patterns, whose distributions on inter-element diagrams trend towards the Ordovician metagranites and meta-aplites. In addition, the Hbl augengneisses have higher 87 Sr /86 Sr (0.7132–0.7147 vs. 0.7031–0.7046) and lower 143 Nd /144 Nd (0.51214–0.51219 vs. 0.51273–0.51297) than the amphibolites , suggesting the addition of an isotopically evolved component. The observed chemical and isotope patterns, as well as the vicinity of the augen gneisses to the Ordovician intrusions, lead us to conclude that the Ceneri augengneisses and Hbl augengneisses are the result of infiltration of residual hydrous magmas into the protolith of both the Cenerigneiss and the amphibolites at the time of Ordovician granite emplacement, long before the regional metamorphism in the Serie dei Laghi.

Understanding of animal collectives is limited by the ability to track each individual. We describe an algorithm and software that extract all trajectories from video, with high identification accuracy for collectives of up to 100 individuals. idtracker.ai uses two convolutional networks: one that detects when animals touch or cross and another for animal identification. The tool is trained with a protocol that adapts to video conditions and tracking difficulty.The idtracker.ai software tracks freely moving animals in large groups of up to 100 individuals. The tool is versatile and has been applied to groups of fruit flies, zebrafish, medaka, ants and mice.

The Court of Justice of the European Union (CJEU) interprets directives and regulations, forming what will be called a hybrid space where national legal systems and supranational elements converge, particularly when asserting the autonomy of a notion. Comparative law has supported legal norm harmonisation but has also revealed the diversity within legal systems, including the EU’s, through the study of legal formants. The goal of this contribution is to show how a comparative approach, incorporating the concept of hybridity from other disciplines, can aid in analysing autonomous interpretation and the influence of hybridisation on legal concepts and terminology.

During recent years, mindfulness-based approaches have been gaining relevance for treatment in clinical populations. Correspondingly, the empirical study of mindfulness has steadily grown; thus, the availability of valid measures of the construct is critically important. This paper gives an overview of the current status in the field of self-report assessment of mindfulness. All eight currently available and validated mindfulness scales (for adults) are evaluated, with a particular focus on their virtues and limitations and on differences among them. It will be argued that none of these scales may be a fully adequate measure of mindfulness, as each of them offers unique advantages but also disadvantages. In particular, none of them seems to provide a comprehensive assessment of all aspects of mindfulness in samples from the general population. Moreover, some scales may be particularly indicated in investigations focusing on specific populations such as clinical samples (Cognitive and Affective Mindfulness Scale, Southampton Mindfulness Questionnaire) or meditators (Freiburg Mindfulness Inventory). Three main open issues are discussed: (1) the coverage of aspects of mindfulness in questionnaires; (2) the nature of the relationships between these aspects; and (3) the validity of self-report measures of mindfulness. These issues should be considered in future developments in the self-report assessment of mindfulness.

We provide a general mathematical framework for group and set equivariance in machine learning. We define group equivariant non-expansive operators (GENEOs) as maps between function spaces associated with groups of transformations. We study the topological and metric properties of the space of GENEOs to evaluate their approximating power and set the basis for general strategies to initialize and compose operators. We define suitable pseudo-metrics for the function spaces, the equivariance groups and the set of non-expansive operators. We prove that, under suitable assumptions, the space of GENEOs is compact and convex. These results provide fundamental guarantees in a machine learning perspective. By considering isometry-equivariant non-expansive operators, we describe a simple strategy to select and sample operators. Thereafter, we show how selected and sampled operators can be used both to perform classical metric learning and to inject knowledge in artificial neural networks. Controlling the flow and representation of information in deep neural networks is fundamental to making networks intelligible. Bergomi et al introduce a mathematical framework in which the space of possible operators representing the data is constrained by using symmetries. This constrained space is still suitable for machine learning: operators can be efficiently computed, approximated and parameterized for optimization.

The present study describes the development of and results obtained from the first version of a new mindfulness scale: the Comprehensive Inventory of Mindfulness Experiences beta (CHIME-β). The aim of the present analysis was to investigate two relevant open questions in mindfulness assessment: (1) the coverage of aspects of mindfulness and (2) the type of interrelationships among these aspects. A review of the aspects of mindfulness assessed by eight currently available mindfulness questionnaires led to the identification of nine aspects of mindfulness. The CHIME-β was constructed in order to cover each of these aspects in a balanced way. Initially, principal component and confirmatory factor analyses, as well as reliability and validity analyses, were performed in the entire sample ( n  = 313) of individuals from the general population and mindfulness-based stress reduction (MBSR) groups. The factor structure that emerged from this analysis was further investigated in meditation-trained individuals ( n  = 144) who had just completed an MBSR intervention. Results suggested a four-factor structure underlying the nine aspects proposed. The relationship between these mindfulness factors appears to be influenced by the degree of meditation experience. In fact, the mindfulness factors showed a greater interconnectedness among mediation-trained participants. Finally, data suggest that a non-avoidant stance plays a central role in mindfulness, while the capacity to put inner experiences into words may be related to mindfulness rather than a component of the construct.