Acta Orientalia Vilnensia
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SANITÀ E REGIONALISMO DIFFERENZIATO TRA SERVIZI LABOUR INTENSIVE E ASSISTENZA TERRITORIALE INTEGRATA
No full textIl saggio approfondisce il tema del lavoro in sanità, alla luce degli scenari sfidanti emersi dalla Missione 6 del PNRR e dalle riforme su regionalismo differenziato e assistenza territoriale integrata. L’A. affronta, in chiave attualizzante, il tema del riparto delle competenze in materia e le conseguenze degli interventi della Consulta sulla c.d. riforma Calderoli. Viene, poi, esaminato il ruolo dell’Accordo Collettivo Nazionale e i rapporti con le fonti sottordinate, al fine di focalizzare le cause del progressivo abbandono del SSN da parte del personale medico e infermieristico, valutando i possibili esiti della riforma dei Medici di medicina generale. La disamina dei nuovi modelli, prescelti dalla deospedalizzazione, fa emergere difficoltà non risolvibili con una mera redistribuzione del personale interno al Ssn, che non si traduca in reali investimenti in nuovo personale e risorse di formazione e finanziarie aggiuntive. Vengono, pertanto, prospettati programmi di potenziamento dei livelli di assistenza sanitaria, coordinati stabilmente con i servizi del territorio attraverso gli strumenti che la tecnologia consente di organizzare a rete, capaci di realizzare un sistema di regolazione, coerente in tutti i suoi aspetti e idoneo a collegare più efficacemente la materia del reclutamento ai temi delle classificazioni e delle progressioni di carriera
Reconfigurable Distributed Model Predictive Control for Decentralized IT/OT Systems
No full textThe rapid evolution of industrial environments, driven by the proliferation of dynamic devices such as wireless robots and smart sensors, has introduced unprecedented complexity. Navigating this landscape requires not only adapting to internal system changes but also aligning with managers' visions. This paper proposes a new approach that enables real-time reconfiguration of industrial systems. At its core is a modeling framework that captures node-level dependencies, revealing how coordination complexity can exponentially degrade system performance. By leveraging the flexibility offered by virtualization and IT/OT (Information Technology and Operational Technology) infrastructure, the proposed Distributed Model Predictive Control (DMPC) method evaluates a multitude of operational scenarios, allowing the system to adapt dynamically. The workflow culminates in the reconfiguration of Industrial Internet of Things (IIoT) nodes through WebAssembly (WASM), seamlessly bridging the gap between virtual parameters and physical reality. A mathematical process formulation, including an exponential latency model, provides a robust framework that manages complexity while ensuring responsive system behavior
Enhanced recovery after urological reconstructive surgery in pediatric patients: a systematic review and meta-analysis
No full textEnhanced Recovery After Surgery (ERAS) is a protocol that includes rules aimed to minimize surgical stress and to reduce the post-operative period. Initially applied in intestinal surgery of adults, a recent meta-analysis suggested that ERAS is valid also in pediatric gastrointestinal surgery. This study systematically reviewed and performed a meta-analysis to evaluate ERAS benefits in pediatric urological reconstructive surgery. A PubMed search identified studies comparing ERAS and traditional protocols in pediatric urological reconstructive surgery. Data on major and minor complications, hospital readmission, and length of hospital stay were collected and analyzed. Analyses were performed using OR and Cl 95%. A p-value < 0.05 was considered significant. A total of 10 papers met the inclusion criteria, with 1410 included patients (492 ERAS group, 918 No-ERAS). There were significant differences in major complications (p < 0.001) and length of stay (p < 0.001) and the incidence of minor complications (p = 0.002) favoring patients undergoing ERAS protocol; differently, there was no difference in hospital readmission (p = 0.763). ERAS protocol is safe and feasible for children undergoing reconstructive urological surgery, reducing the risks of complications and the length of hospital stay, without increasing readmission risk. ERAS should also be a standardized procedure in pediatric reconstructive urological surgery
Contaminazioni e migrazioni gastronomiche nelle ricette di Jehane Benoît "Grande Dame" della cucina canadese
No full textAttraverso le pubblicazioni di Jehane Benoît, celebre autrice quebecchese di ricettari della metà del secolo scorso, cercheremo di mettere in evidenza alcuni aspetti sociolinguistici della cucina
quebecchese. L’analisi dell’Encyclopédie de la cuisine canadienne, una delle sue opere più importanti, e di alcune riviste gastronomiche a cui ha collaborato, ha permesso di constatarne l’importanza come
mediatrice e vettore di trasmissione delle tradizioni gastronomiche sia locali che straniere negli anni ‘50 in Québec, mostrando il ruolo fondamentale della cucina nei processi di integrazione socioculturale e di affermazione identitaria all’interno della società canadese
High employment rate and unresolved issues in the Italian labor market
No full textThis contribution aims to provide an in-depth analysis of employment in Italy, focusing on the positive economic outcomes of the past two years in terms of employment and unemployment rates, despite a very modest GDP growth. It also highlights the persistent structural issues in the labor market that remain unresolved. Among these are low real wages, significant gender disparities that disadvantage women, regional differences between the North and South, high youth unemployment (especially in the South), brain drain, and the widespread prevalence of irregular work and the underground economy
Stereotactic radiotherapy for oligometastatic mediastinal lymph-nodes: a multicentre retrospective experience
No full textMediastinal oligometastases represent a clinical and technical challenge, due to the need to combine optimal treatment with the risk of severe toxicity. In this retrospective multicentre experience, we report the data of a cohort of patients treated with stereotactic body radiotherapy (SBRT) for oligometastatic mediastinal lymph-nodes. Inclusion criteria of the study were: written informed consent for the treatment, ECOG PS ≤ 2, diagnosis of oligometastatic mediastinal lymph-nodes up to 5 lesions being the mediastinum the only active site of disease, patients treated with radiotherapy schedules applying a minimum 6 Gy per fraction. Prior radiotherapy to the mediastinum was not considered as an exclusion criterion. A total of 63 lymph-node metastases in 49 patients with median age of 69.5 years (range 47–83 years) received SBRT between September 2020 and April 2024, for a median total dose of 30 Gy (range 21–50 Gy) in 5 fractions (range 3–5). With a median follow-up of 15 months, 1- and 2-year local control rates were 96.9% and 91.8%, while distant progression-free survival rates were 66.7% and 30.2%. Median time to new systemic therapy was 12 months, while 1- and 2-year polymetastatic-free survival (PMFS) and overall survival (OS) were respectively 78% and 64%, and 86.2% and 75.8%. At statistical analysis, patients who develop a further oligoprogression treated with a second course of SBRT have a longer time to new systemic treatment (p = 0.017), being genitourinary and gynecological malignancies related to improved PMFS and OS at univariate analysis. Only one late G3 adverse event was observed, consisting of dysphagia treated with intravenous steroids. In our series, SBRT for oligometastatic mediastinal lymph-nodes was safe with a single G3 late adverse event, with promising results in terms of local control and time to activation of a new systemic therapy
Cuproptosis: A Review on Mechanisms, Role in Solid and Hematological Tumors, and Association with Viral Infections
No full textCuproptosis is a distinct modality of regulated cell death precipitated by an overload of intracellular copper, critically dependent on mitochondrial respiration. The underlying mechanism involves the direct interaction of copper ions with lipoylated components integral to the mitochondrial tricarboxylic acid (TCA) cycle. This binding event triggers the aggregation of these proteins, induces significant proteotoxic stress, and leads to the depletion of essential ironsulfur cluster proteins, culminating in cell demise. Given that copper homeostasis is frequently dysregulated within cancer cells, rendering them potentially more susceptible to copper-induced toxicity, cuproptosis has rapidly become a focal point of oncological research. This systematic review meticulously analyzes and synthesizes findings from a curated collection of 45 research articles. It aims to provide a comprehensive description of the molecular intricacies of cuproptosis, explore its documented associations with a spectrum of solid tumors (including gastric, lung, liver, neuroblastoma, and ovarian cancers) and lymphoma, and examine its emerging connections with viral infections like COVID-19 and pseudorabies virus. The review elaborates on the reported prognostic significance of cuproptosis-related genes and associated pathways across various malignancies. Furthermore, it details the burgeoning therapeutic strategies designed to harness cuproptosis, encompassing the application of copper ionophores, the development of sophisticated nanomedicine platforms, and synergistic approaches that combine cuproptosis induction with immunotherapy, chemotherapy, or sonodynamic therapy. The potential clinical utility of cuproptosis-associated biomarkers for predicting patient prognosis and therapeutic response is discussed based on the evidence presented in the reviewed literature
Density functional theory study of mesophase formation in model lipid systems
No full textThe emergence of mesophases in phospholipids is a fascinating phenomenon, which finds application in a wealth of research fields, from designing of building blocks to drug delivery. Here, we investigate structural properties and phase behavior of a coarse-grained model for phospholipid systems, represented by a dipolar Gay–Berne potential, within the framework of Percus–Yevick (PY) integral equation theory and classical density functional theory (DFT), with the aim of shedding light on the appearance of mesophases. Despite the well-known efficiency of PY theory in predicting structure, thermodynamics, and phase behavior of fluids at relatively low computational cost, we are not aware of any previous applications to phospholipid systems modeled through this potential. We focus on the role played by density, temperature, and dipolar head group strengths on the pair correlation functions of the phospholipid molecules, assessing our theoretical predictions against molecular dynamics simulations. Then, we utilize such correlation functions as structural input for DFT in order to locate the liquid crystalline phase transitions, with a particular emphasis on isotropic–nematic and nematic–smectic A transitions. The results highlight that enhanced dipolar interactions are able to stabilize ordered phases at low densities and high temperatures. This is indicated by the increase in orientational and translational order parameters and by the heightened compressibility in the smectic phase. Three different phase diagrams, corresponding to the different head group strengths investigated, are also drawn. A qualitative agreement with simulations is found, even though the densities at which transitions take place are typically underestimated
Giustizia bellezza cultura
No full textIl volume raccoglie gli atti del Convegno internazionale svoltosi presso l’Università di Messina
dal 26 al 28 settembre 2024 ed intende approfondire il rapporto fra giustizia, bellezza e cultura.
La diffusione del valore della giustizia è un bene prodotto dalle relazioni sociali fra cittadini con-
sapevoli, capaci di prevenire i conflitti prima del loro sorgere e di gestirli in modo responsabile
una volta venuti in essere. Ciò richiede lo sviluppo di dinamiche di cooperazione basate sulla
fiducia e sulla reciprocità: la realizzazione di questo ideale regolativo della giustizia costituisce la
nobiltà del diritto, ne disegna la trama misteriosa, è la forma della sua bellezza.
Il volume è il primo numero della Collana "Giustizia processo cultura", che raccoglie studi di storia e filosofia della giustizia nonché studi di diritto processuale fondati sull’idea della giustizia come bene culturale. La cultura della giustizia è un bene comune, prezioso tanto per i singoli quanto per l’intera comunità, un formidabile strumento per la realizzazione dell’ordinamento giuridico, per garantire a tutti gli individui l’effettivo esercizio dei diritti fondamentali e il libero sviluppo della persona