Around the mid-twentieth century, Lévi-Strauss highlighted the need for structure and order as a foundation of human thought, and expressed the goal of legitimizing what he called “savage mind” in light of the scientific knowledge of his time. Today, through a re-examination of the characteristics of this form of thought and the proposal of the neuroscientific model known as the Free Energy Principle, it can be hypothesized that it constitutes the evolutionary outcome of a process of maximizing and optimizing Shannon’s entropy contained in the inference structures upon which both neurobehavioral adaptation and the human being’s potential for self-realization depend.
This longitudinal, prospective, multicentre observational cohort study investigates the associations between maternal nutritional status - assessed using the first trimester SIMPLE score and pregestational BMI - and fetal growth trajectories and velocity, as proxies for intrauterine development. Healthy women with singleton pregnancies undergoing first trimester screening were enrolled. Adherence to a healthy lifestyle was evaluated using the SIMPLE score, categorising participants into low (< 6) and high (≥ 6) adherence groups. Fetal growth parameters - including biparietal diameter, head circumference, abdominal circumference (AC), femur length and estimated fetal weight (EFW) - were assessed during second and third trimester ultrasounds, and birth outcomes were recorded. Multi-adjusted linear mixed models examined associations between SIMPLE score groups, individual score items, pregestational BMI and fetal growth, with analyses stratified by fetal sex. Out of 938 enrolled women, 109 (11·6 %) were classified as the low-adherence group. Multi-adjusted linear mixed models showed that low adherence was associated with decreased EFW acceleration from the second to the third trimester. Stratification by fetal sex confirmed the association only among male fetuses. Analysis of pregestational BMI and individual SIMPLE score items revealed significant positive associations between pregestational BMI, AC and EFW growth velocity and a negative association between first trimester Hb (> 110 g/l) and EFW growth velocity. Overall, these findings confirm the clinical utility of the SIMPLE score, demonstrating significant associations with intrauterine growth trajectories and velocity, independent of other markers of nutritional status (e.g. pregestational BMI).
Dynamic magnetic resonance defecography (MRD) is a key imaging modality for comprehensive evaluation of pelvic floor dysfunction, enabling detailed multiplanar anatomical and functional assessment without ionizing radiation. However, despite its established clinical role, MRD reporting is heterogeneous among centers, hindering standardized interpretation, multidisciplinary communication, and comparison across studies. This modified Delphi consensus study aimed to develop a standardized referral dataset and structured reporting framework for MRD. A multidisciplinary panel of 20 Italian experts (radiologists, colorectal surgeons, gynecologists, urologists, gastroenterologists, physiatrists, and a methodologist) conducted a three-round Delphi process to develop consensus-based templates for MRD referral and reporting. Consensus was set at ≥75
