177,365 research outputs found
The design of transportation networks: a multi objective model combining equity, efficiency and efficacy
No full textA network design problem consists in locating facilities (nodes and arcs) that enable the transfer of flows (passengers and/or goods) from given origin-destination pairs. The topic can have several applications within transportation and logistics contexts. In this work we propose a multi-objective model in which balancing or equity aspects, i.e. measures of the distribution of distances of users from the path, are considered. These kinds of models can be used when there is the need to balance risks or benefits among all the potential users deriving from the location of the path to be designed. The application of the proposed model to a benchmark problem used in the literature to test these kinds of models, shows that it is able to find solutions characterized by significant level of equity but also of efficiency and efficacy
Adding sufentanil to levobupivacaine or ropivacaine intrathecal anaesthesia affects the minimum local anaesthetic dose required.
No full textWe carried out this prospective, randomized, double-blind study in order to evaluate whether the intrathecal addition of sufentanil 3.3 mcg affects both the minimum local anaesthetic dose (MLAD) of spinal levobupivacaine and ropivacaine for a caesarean section and enhances the spinal block characteristics.One hundred and eighty women were randomly allocated into four groups: levobupivacaine (Group L), levobupivacaine plus sufentanil (Group L+S), ropivacaine (Group R) and ropivacaine plus sufentanil (Group R+S). Each received 3 ml of the study solution intrathecally as part of a combined spinal/epidural technique. The initial dose was 12 mg for Groups L and L+S, and 15 mg for Groups R and R+S. The test solution was required to achieve a visual analogue pain score (VAPS) of 30 mm or less to be considered effective at skin incision, uterine incision, birth, peritoneal closure and at the conclusion of surgery. Effective or ineffective responses determined a 0.5 mg decrease or increase of the same drug, respectively, for the next patient in the same group, using an up-down sequential allocation.Using the Dixon and Massey formula, the MLAD was 10.65 mg [confidence interval (CI) 95\%: 10.14-11.56] in Group L, 4.73 mg (CI 95\%: 4.39-5.07) in Group L+S, 14.12 mg (CI 95\%: 13.50-14.60) in Group R and 6.44 mg (CI 95\%: 5.86-7.02) in Group R+S.The addition of sufentanil reduced the MLAD of both the local anaesthetics. It did not affect their potency ratio significantly and resulted in enhanced spinal anaesthesia
Prognostic assessment of repeatedly measured time-dependent biomarkers, with application to dilated cardiomyopathy
No full textWe propose newtime-dependent sensitivity, specificity,ROCcurves and net reclassification indices that can take into account biomarkers or scores that are repeatedlymeasured at different time-points. Inference proceeds through inverse probability weighting and resampling. The newly proposed measures exploit the information contained in biomarkers measured at different visits, rather than using only the measurements at the first visits. The contribution is illustrated via simulations and an original application on patients affected by dilated cardiomiopathy. The aim is to evaluate if repeated binary measurements of right ventricular dysfunction bring additive prognostic information on mortality/urgent heart transplant. It is shown that taking into account the trajectory of the new biomarker improves risk classification, while the first measurement alone might not be sufficiently informative. The methods are
implemented in an R package (longROC), freely available on CRAN
Le difficili riforme dei beni culturali
No full textLo scritto ripercorre le principali tappe degli interventi legislativi volti a modificare gli assetti organizzativi e le soluzioni procedimentali alle quali è affidata la tutela e la valorizzazione dei beni culturali
Riscontri autoptici e placche pleuriche nel Registro Mesoteliomi della Regione Friuli Venezia Giulia
No full textAims: To describe the cases of MM that occurred in the Friuli Venezia Giulia Region in the period 1995-2009 and evaluate the diagnostic contribution of autopsy findings. Methods: Via the Regional Register a search for MM cases was made following standardized criteria for diagnosis and past asbestos exposure assessment. Pleural plaques were identified by autopsy findings; the relationship between presence of pleural plaques and assessment of past asbestos exposure was analyzed. Results: 834 cases of MM were recorded and 458 autopsy findings were available; for 142 cases (15% of males and 23% of women) the first diagnosis was made at autopsy. Data were available on previous asbestos exposure in 91% (416 subjects) of cases with autopsy findings: 255 had “certain occupational exposure” (group 1), 116 “other occupational and non- occupational exposure” (group 2), 45 “negative and unknown exposure” (group 3). Logistic regression showed that significant predictors for pleural plaques were age at diagnosis (OR=1.03 each year (95% CI=1.01-1.05), asbestos exposure in group 1 versus group 2 (OR=6.8 (95% CI=4-12), and exposure in group1 versus group 3 (OR=6.4 (95% CI=3-13). Among subjects in groups 1 and 2, the presence of pleural plaques was significantly associated with latency (OR=1.03 for each year of latency; 95% CI=1.01-1.22) and asbestos exposure in group 1 versus group 2 (OR=7.8; 95% CI=4.4-13.0). Conclusions: Autopsy findings improved the diagnostic level of MM in elderly subjects, for whom reliable data on past asbestos exposure is often lacking. In subjects suffering from MM direct interview is always the best tool to evaluate past asbestos exposure; autopsy findings of pleural plaques cannot replace the anamnestic history when this is lacking, although such findings can act as a suppor
On the Distinction between Land of War and Land of Islam and its Ongoing Reflections on the Prohibitions for Muslim Women to Marry Christians and Hebrews
No full textThe essay links the prohibition for Muslim women to marry non Muslims - stated or at least applied in each country whose citizens profess Islam (the majority, indeed) - to the distinction between land of war and land of Islam, nowadays rejected by the Islamic law schools. Thus, it suggest ways to overlap this prohibition, which represents a high hurdle against the spread of love and mutual understanding, that the ongoing globalization and mixing of cultures facilitates
Targeting the immune system for pulmonary iInflammation and cardiovascular complications in COVID-19 patients
No full textIn December 2019, following a cluster of pneumonia cases in China caused by a novel coronavirus (CoV), named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the infection disseminated worldwide and, on March 11th, 2020, the World Health Organization officially declared the pandemic of the relevant disease named coronavirus disease 2019 (COVID-19). In Europe, Italy was the first country facing a true health policy emergency, and, as at 6.00 p.m. on May 2nd, 2020, there have been more than 209,300 confirmed cases of COVID-19. Due to the increasing number of patients experiencing a severe outcome, global scientific efforts are ongoing to find the most appropriate treatment. The usefulness of specific anti-rheumatic drugs came out as a promising treatment option together with antiviral drugs, anticoagulants, and symptomatic and respiratory support. For this reason, we feel a duty to share our experience and our knowledge on the use of these drugs in the immune-rheumatologic field, providing in this review the rationale for their use in the COVID-19 pandemic
Appropriate Similarity Measures for Author Cocitation Analysis
No full textWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
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