100,573 research outputs found
Supreme Court of the United States, 26 giungo 2003, Lawrence J.G. e Garner T. v. Texas, opinione di maggioranza
No full textE' la traduzione integrale dell'opinione di maggioranza con cui la Corte Suprema degli Stati uniti d'America ha reso incostituzionali le leggi che condannavano penalmente la sodomia
Resilience engineering for socio-technical risk analysis. Application in neuro-surgery
No full textAbstract
Healthcare practitioners are generally forced to adapt their actions to cope with the complexity of daily conditions, taking advantage of their inherent potential for resilient performance. Following the principles of Resilience Engineering, this article details the application of the Functional Resonance Analysis Method (FRAM), for a semi-quantitative risk analysis of patient's pathway. The analysis adopts a holistic perspective on the complexity of everyday work in order to manage emergent behaviours, mainly related to iatrogenic disease associated with neuro-anesthesia treatment.
Enhancing the traditional FRAM approach, the paper presents a structured systemic analysis for a case study in the neurosurgery peri‐operative patient's pathway. A multi-layer semi-quantitative framework is used as a basis for a novel decision support tool: the Variability Impact Matrix (VIM). The VIM aids to prioritize corrective measures and the need for functional performance indicators. A combination of social and technical perspectives is confirmed being necessary to cope with complex work environments, such as healthcare practices.
journal homepage: www.elsevier.com/locate/ress
Resilience engineering for socio-technical risk analysis: Application in
neuro-surgery
Riccardo Patriarca a,⁎, Andrea Falegnami a , Francesco Costantino a , Federico Bilotta b
a Department of Mechanical and Aerospace Engineering, Sapienza University of Rome, Italy
b Department of Anesthesiology, Critical Care and Pain Medicine, Sapienza University of Rome, Italy
A R T I C L E I N F O
Keywords:
System safety
Complex systems
Resilience engineering
Resilience indicators
Healthcare management
Healthcare engineering
Patient pathway
A B S T R A C T
Healthcare practitioners are generally forced to adapt their actions to cope with the complexity of daily con-
ditions, taking advantage of their inherent potential for resilient performance. Following the principles of
Resilience Engineering, this article details the application of the Functional Resonance Analysis Method (FRAM),
for a semi-quantitative risk analysis of patient's pathway. The analysis adopts a holistic perspective on the
complexity of everyday work in order to manage emergent behaviours, mainly related to iatrogenic disease
associated with neuro-anesthesia treatment.
Enhancing the traditional FRAM approach, the paper presents a structured systemic analysis for a case study
in the neurosurgery peri‐operative patient's pathway. A multi-layer semi-quantitative framework is used as a
basis for a novel decision support tool: the Variability Impact Matrix (VIM). The VIM aids to prioritize corrective
measures and the need for functional performance indicators. A combination of social and technical perspectives
is confirmed being necessary to cope with complex work environments, such as healthcare practices
Fatto illecito doloso, danno psichico, danno esistenziale (Nota a T. Alba, 9 agosto 2004, De Santis c. Cipriani).
No full textLetter, [Author unclear] to Paulina T. Merritt
No full textHandwritten letter to Paulina Merritt from an unknown author, October 1, 1876.
Lactose malabsorption and irritable bowel syndrome. Effect of a long-term lactose-free diet.
No full textLiver X Receptors: Regulators of Cholesterol Metabolism, Inflammation, Autoimmunity, and Cancer
No full textThe interplay between cellular stress and immune response can be variable and sometimes contradictory. The mechanisms by which stress-activated pathways regulate the inflammatory response to a pathogen, in autoimmunity or during cancer progression remain unclear in many aspects, despite our recent knowledge of the signalling and transcriptional pathways involved in these diseases. In this context, over the last decade many studies demonstrated that cholesterol metabolism is an important checkpoint for immune homeostasis and cancer progression. Indeed, cholesterol is actively metabolized and can regulate, through its mobilization and/or production of active derivatives, many aspects of immunity and inflammation. Moreover, accumulation of cholesterol has been described in cancer cells, indicating metabolic addiction. The nuclear receptors liver-X-receptors (LXRs) are important regulators of intracellular cholesterol and lipids homeostasis. They have also key regulatory roles in immune response, as they can regulate inflammation, innate and adaptive immunity. Moreover, activation of LXRs has been reported to affect the proliferation and survival of different cancer cell types that show altered metabolic pathways and accumulation of cholesterol. In this minireview we will give an overview of the recent understandings about the mechanisms through which LXRs regulate inflammation, autoimmunity, and cancer, and the therapeutic potential for future treatment of these diseases through modulation of cholesterol metabolism
Seismic pre-dimensioning of irregular concrete frame structures: Mathematical formulation and implementation of a learn-heuristic algorithm
No full textIrregular frame structures can exhibit an inefficient dynamic behavior, such as undesirable torsional effects and asymmetric displacements, that can severely affect structural performances in case of a seismic event. To mitigate the influence of geometric irregularities, the pre-dimensioning of structural elements is crucial to achieve the best possible seismic behavior. Identifying the optimal solutions in terms of elements’ cross-sections and orientations is a non-trivial problem that in general designers tackle following trial-and-error attempts which can become numerous in the most complicated cases. This paper formally describes the pre-dimensioning problem and presents a Learn-heuristic that hybridizes a Genetic Algorithm and a k-Means algorithm procedure for its solution. The algorithm is validated on a diverse set of 3D reinforced concrete structures and through a Structural Pre-dimensioning challenge, where the performances of the algorithm are compared against those accomplished by a group of Ph.D. candidates. The computational results evidenced that the proposed optimization framework achieves pre-dimensioning solutions that significantly improve the designs provided by the Ph.D. students, thus suggesting a favorable inclusion of the proposed solution method in classical pre-dimensioning processes
Growing a Modular Framework for Modal Systems: HOLMS
No full textWe present HOLMS (HOL Light Library for Modal Systems), an evolving modular framework for mechanising modal reasoning within the HOL Light proof assistant. Building on earlier work on Gödel-Löb logic (GL), HOLMS introduces a compositional architecture to formalise modal adequacy proofs and implement automated decision procedures for various normal modal systems, currently including K, T, K4, and GL. To clarify the compositional nature of our framework and illustrate how it bridges general-purpose proof assistants, enriched sequent calculi, and formalised mathematics, we highlight some design choices and structural features of HOLMS, such as its use of the metalanguage, embedding strategies, and modularity metrics
Handwritten biographical information on Paulina T. McClung Merritt
No full textA handwritten biography of Paulina T. McClung Merritt by an unknown author, 1892.
Heterogeneous and tissue-specific regulation of effector T cell responses by IFN-gamma during Plasmodium berghei ANKA infection.
No full textIFN-γ and T cells are both required for the development of experimental cerebral malaria during Plasmodium berghei ANKA infection. Surprisingly, however, the role of IFN-γ in shaping the effector CD4(+) and CD8(+) T cell response during this infection has not been examined in detail. To address this, we have compared the effector T cell responses in wild-type and IFN-γ(-/-) mice during P. berghei ANKA infection. The expansion of splenic CD4(+) and CD8(+) T cells during P. berghei ANKA infection was unaffected by the absence of IFN-γ, but the contraction phase of the T cell response was significantly attenuated. Splenic T cell activation and effector function were essentially normal in IFN-γ(-/-) mice; however, the migration to, and accumulation of, effector CD4(+) and CD8(+) T cells in the lung, liver, and brain was altered in IFN-γ(-/-) mice. Interestingly, activation and accumulation of T cells in various nonlymphoid organs was differently affected by lack of IFN-γ, suggesting that IFN-γ influences T cell effector function to varying levels in different anatomical locations. Importantly, control of splenic T cell numbers during P. berghei ANKA infection depended on active IFN-γ-dependent environmental signals--leading to T cell apoptosis--rather than upon intrinsic alterations in T cell programming. To our knowledge, this is the first study to fully investigate the role of IFN-γ in modulating T cell function during P. berghei ANKA infection and reveals that IFN-γ is required for efficient contraction of the pool of activated T cells
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