Foetal heart rate recording: analysis and comparison of different methodologies

Monitoring foetal health is a very important task in clinical practice to appropriately plan pregnancy management and delivery. In the third trimester of pregnancy, ultrasound cardiotocography is the most employed diagnostic technique: foetal heart rate and uterine contractions signals are simultaneously recorded and analysed in order to ascertain foetal health. Because ultrasound cardiotocography interpretation still lacks of complete reliability, new parameters and methods of interpretation, or alternative methodologies, are necessary to further support physicians’ decisions. To this aim, in this thesis, foetal phonocardiography and electrocardiography are considered as different techniques. Further, variability of foetal heart rate is thoroughly studied. Frequency components and their modifications can be analysed by applying a time-frequency approach, for a distinct understanding of the spectral components and their change over time related to foetal reactions to internal and external stimuli (such as uterine contractions). Such modifications of the power spectrum can be a sign of autonomic nervous system reactions and therefore represent additional, objective information about foetal reactivity and health. However, some limits of ultrasonic cardiotocography still remain, such as in long-term foetal surveillance, which is often recommendable mainly in risky pregnancies. In these cases, the fully non-invasive acoustic recording, foetal phonocardiography, through maternal abdomen, represents a valuable alternative to the ultrasonic cardiotocography. Unfortunately, the so recorded foetal heart sound signal is heavily loaded by noise, thus the determination of the foetal heart rate raises serious signal processing issues. A new algorithm for foetal heart rate estimation from foetal phonocardiographic recordings is presented in this thesis. Different filtering and enhancement techniques, to enhance the first foetal heart sounds, were applied, so that different signal processing techniques were implemented, evaluated and compared, by identifying the strategy characterized on average by the best results. In particular, phonocardiographic signals were recorded simultaneously to ultrasonic cardiotocographic signals in order to compare the two foetal heart rate series (the one estimated by the developed algorithm and the other provided by cardiotocographic device). The algorithm performances were tested on phonocardiographic signals recorded on pregnant women, showing reliable foetal heart rate signals, very close to the ultrasound cardiotocographic recordings, considered as reference. The algorithm was also tested by using a foetal phonocardiographic recording simulator developed and presented in this research thesis. The target was to provide a software for simulating recordings relative to different foetal conditions and recordings situations and to use it as a test tool for comparing and assessing different foetal heart rate extraction algorithms. Since there are few studies about foetal heart sounds time characteristics and frequency content and the available literature is poor and not rigorous in this area, a data collection pilot study was also conducted with the purpose of specifically characterising both foetal and maternal heart sounds. Finally, in this thesis, the use of foetal phonocardiographic and electrocardiographic methodology and their combination, are presented in order to detect foetal heart rate and other functioning anomalies. The developed methodologies, suitable for longer-term assessment, were able to detect heart beat events correctly, such as first and second heart sounds and QRS waves. The detection of such events provides reliable measures of foetal heart rate, potentially information about measurement of the systolic time intervals and foetus circulatory impedance.

Networking: the "making of" social networks. A closer look at the process and antecedents of some resourcing-oriented behaviors in organizations.

Social networks are one of the “hot” themes in people’s life and contemporary social research. Considering our “embeddedness” in a thick web of social relations is a study perspective that could unveil a number of explanations of how people may manage their personal and social resources. Looking at people’s behaviors of building and managing their social networks, seems to be an effective way to find some possible rationalization about how to help people getting the best from their resources . The main aim of this dissertation is to give a closer look at the role of networking behaviors. Antecedents, motivations, different steps and measures about networking behaviors and outcomes are analyzed and discussed. Results seem to confirm, in a different setting and time perspective, that networking behaviors include different types and goals that change over time. Effects of networking behaviors seem to find empirical confirmation through social network analysis methods. Both personality and situational self-efficacy seem to predict networking behaviors. Different types of motivational drivers seem to be related to diverse networking behaviors.

Il valore precettivo dei diritti sociali fondamentali previsti dal titolo IV della Carta

Il dibattito giuridico, politico ed economico in tema di protezione dei diritti sociali nel contesto del processo di integrazione europea risale alle origini stesse di tale processo. A circa dieci anni dall’attribuzione alla Carta dei diritti fondamentali dell’UE dello stesso valore giuridico dei Trattati, sembra possibile tracciare un primo bilancio in termini di aspettative inverate ed aspettative non soddisfatte quanto alla giustiziabilità dei diritti sociali fondamentali contenuti nel Titolo IV direttamente o indirettamente al rapporto di impiego (articoli da 27 a 34). A questo fine, la tesi ha adottato una struttura tripartita capace di coniugare una metodologia di analisi pratica, in relazione alla giurisprudenza della Corte di giustizia UE post Lisbona (Capitolo III), con un’analisi dal carattere maggiormente teorico-ricostruttivo (Capitoli I e II). La ricerca cerca di dimostrare come tanto i più interessanti sviluppi quanto i limiti registratisi nella giurisprudenza della CGUE (rispettivamente, l’efficacia diretta, anche orizzontale, di alcuni di essi negli ordinamenti nazionali, e la determinazione del loro ambito di applicazione e delle modalità di interazione con il diritto secondario e primario) possano essere meglio compresi tenendo in debito conto il percorso ed il significato di ciascuno di tali diritti nel contesto del processo di integrazione europea. In breve, si sostiene che la “costituzionalizzazione” dei diritti sociali in esame abbia certamente un “valore aggiunto” che, tuttavia, riflette la natura sui generis e le finalità dell’Unione, il sistema di riparto di competenze tra Stati membri e Unione, ed il significato ultimo del sistema UE di tutela dei diritti fondamentali. Ciò non toglie che questi caratteri, con il tempo, possano infine mutare.