Libertà di espressione e sorveglianza globale

La presente tesi ha come scopo quello di individuare alcune problematiche relative all’esercizio e alla limitazione del diritto alla libertà di espressione nel contesto delle attività globali di sorveglianza e controllo delle tecnologie dell’informazione e della comunicazione. Tali attività, poste in essere da parte degli Stati e da parte degli operatori privati, sono favorite dal nebuloso rapporto tra norme di fonte pubblica, privata e informatica, e sono invece osteggiate dal ricorso, collettivo e individuale, alle possibilità offerte dalle tecnologie stesse per la conduzione di attività in anonimato e segretezza. La sorveglianza globale nel contesto delle privatizzazioni si serve del codice e dell’autonomia privata, così come la resistenza digitale ricorre alle competenze informatiche e agli spazi di autonomia d’azione dell’individuo. In questo contesto, la garanzia dell’esistenza e dell’esercizio dei diritti fondamentali dell’individuo, tra tutti il diritto alla libertà di espressione e il diritto alla tutela della riservatezza, passa per l’adozione di tecniche e pratiche di autotutela attraverso l’utilizzo di sistemi di cifratura e comunicazioni anonime. L’individuo, in questo conflitto tecnico e sociale, si trova a dover difendere l’esercizio dei propri diritti e finanche l’adempimento ai propri doveri, quando attinenti a particolari figure professionali o sociali, quali avvocati, operatori di giustizia, giornalisti, o anche semplicemente genitori. In conclusione dell’elaborato si propongono alcune riflessioni sulla formazione della cittadinanza e del mondo professionale, da parte dei giuristi delle nuove tecnologie, all’uso cosciente, consapevole e responsabile delle nuove tecnologie dell’informazione, con lo stimolo ad orientare altresì le proprie attività alla tutela e alla promozione dei diritti umani fondamentali, democratici, costituzionali, civili e sociali.

Sviluppo di mezzi e sistemi di sorveglianza e monitoraggio dei ditteri culicidi di importanza sanitaria

Nel corso degli ultimi anni le problematiche legate al ruolo vettore delle zanzare stanno emergendo sia per quanto riguarda l’uomo che gli animali allevati e selvatici. Diversi arbovirus come West Nile, Chikungunya, Usutu e Dengue, possono facilmente spostarsi a livello planetario ed essere introdotti anche nei nostri territori dove possono dare avvio a episodi epidemici. Le tecniche di monitoraggio e sorveglianza dei Culicidi possono essere convenientemente utilizzate per il rilevamento precoce dell’attività virale sul territorio e per la stima del rischio di epidemie al fine dell’adozione delle opportune azioni di Sanità Pubblica. Io scopo della ricerca del dottorato è inserito nel contesto dei temi di sviluppo del Piano regionale sorveglianza delle malattie trasmesse da vettori in Emilia Romagna. La ricerca condotta è inquadrata prevalentemente sotto l’aspetto entomologico applicativo di utilizzo di dispositivi (trappole) che possano catturare efficacemente possibili insetti vettori. In particolare questa ricerca è stata mirata allo studio comparativo in campo di diversi tipi di trappole per la cattura di adulti di zanzara, cercando di interpretare i dati per capire un potenziale valore di efficacia/efficienza nel rilevamento della circolazione virale e come supporto alla pianificazione della rete di sorveglianza dal punto di vista operativo mediante dispositivi adeguati alle finalità d’indagine. Si è cercato di trovare un dispositivo idoneo, approfondendone gli aspetti operativi/funzionali, ai fini di cattura del vettore principale del West Nile Virus, cioè la zanzara comune, da affiancare all’unica tipologia di trappola usata in precedenza. Le prove saranno svolte sia in campo che presso il laboratorio di Entomologia Medica Veterinaria del Centro Agricoltura Ambiente “G. Nicoli” di Crevalcore, in collaborazione con il Dipartimento di Scienze e Tecnologie Agroambientali della Facoltà di Agraria dell’Università di Bologna.

Age at hip or knee joint replacement surgery predicts likelihood of revision surgery

We compared revision and mortality rates of 4668 patients undergoing primary total hip and knee replacement between 1989 and 2007 at a University Hospital in New Zealand. The mean age at the time of surgery was 69 years (16 to 100). A total of 1175 patients (25%) had died at follow-up at a mean of ten years post-operatively. The mean age of those who died within ten years of surgery was 74.4 years (29 to 97) at time of surgery. No change in comorbidity score or age of the patients receiving joint replacement was noted during the study period. No association of revision or death could be proven with higher comorbidity scoring, grade of surgeon, or patient gender. We found that patients younger than 50 years at the time of surgery have a greater chance of requiring a revision than of dying, those around 58 years of age have a 50:50 chance of needing a revision, and in those older than 62 years the prosthesis will normally outlast the patient. Patients over 77 years old have a greater than 90% chance of dying than requiring a revision whereas those around 47 years are on average twice as likely to require a revision than die. This information can be used to rationalise the need for long-term surveillance and during the informed consent process.

Review: leucocyte-endothelial cell crosstalk at the blood-brain barrier: a prerequisite for successful immune cell entry to the brain

Leucocyte migration into the central nervous system is a key stage in the development of multiple sclerosis. While much has been learnt regarding the sequential steps of leucocyte capture, adhesion and migration across the vasculature, the molecular basis of leucocyte extravasation is only just being unravelled. It is now recognized that bidirectional crosstalk between the immune cell and endothelium is an essential element in mediating diapedesis during both normal immune surveillance and under inflammatory conditions. The induction of various signalling networks, through engagement of cell surface molecules such as integrins on the leucocyte and immunoglobulin superfamily cell adhesion molecules on the endothelial cell, play a major role in determining the pattern and route of leucocyte emigration. In this review we discuss the extent of our knowledge regarding leucocyte migration across the blood-brain barrier and in particular the endothelial cell signalling pathways contributing to this process.

Continent urinary diversion

During the last decade continent urinary diversion, especially orthotopic bladder substitution has become increasingly popular following radical cystectomy for bladder cancer. In general, if sphincter sparing surgery is possible, orthotopic bladder substitution is performed, if not then continent catheterisable reservoirs are a viable option. Strict patient selection criteria and improved surgical technique have had a positive influence on outcome, not only on survival but also on quality of life issues. It is becoming increasingly obvious, that a nerve sparing surgical technique not only improves sexual function but also continence. In addition, the length of the intestinal segment has an influence on continence and the degree of metabolic consequences, which are discussed in detail. Postoperative surveillance and instruction of patients is of utmost value for good functional results. Overall patient satisfaction and quality of life seem comparable in the various types of continent urinary diversions, and improved when compared to a urinary stoma. Continent urinary diversion offers a good quality of life with few long-term complications and should be considered the treatment of choice in the majority of patients, independent of sex.

Robustness of speckle imaging techniques applied to horizontal imaging scenarios

Atmospheric turbulence near the ground severely limits the quality of imagery acquired over long horizontal paths. In defense, surveillance, and border security applications, there is interest in deploying man-portable, embedded systems incorporating image reconstruction methods to compensate turbulence effects. While many image reconstruction methods have been proposed, their suitability for use in man-portable embedded systems is uncertain. To be effective, these systems must operate over significant variations in turbulence conditions while subject to other variations due to operation by novice users. Systems that meet these requirements and are otherwise designed to be immune to the factors that cause variation in performance are considered robust. In addition robustness in design, the portable nature of these systems implies a preference for systems with a minimum level of computational complexity. Speckle imaging methods have recently been proposed as being well suited for use in man-portable horizontal imagers. In this work, the robustness of speckle imaging methods is established by identifying a subset of design parameters that provide immunity to the expected variations in operating conditions while minimizing the computation time necessary for image recovery. Design parameters are selected by parametric evaluation of system performance as factors external to the system are varied. The precise control necessary for such an evaluation is made possible using image sets of turbulence degraded imagery developed using a novel technique for simulating anisoplanatic image formation over long horizontal paths. System performance is statistically evaluated over multiple reconstruction using the Mean Squared Error (MSE) to evaluate reconstruction quality. In addition to more general design parameters, the relative performance the bispectrum and the Knox-Thompson phase recovery methods is also compared. As an outcome of this work it can be concluded that speckle-imaging techniques are robust to the variation in turbulence conditions and user controlled parameters expected when operating during the day over long horizontal paths. Speckle imaging systems that incorporate 15 or more image frames and 4 estimates of the object phase per reconstruction provide up to 45% reduction in MSE and 68% reduction in the deviation. In addition, Knox-Thompson phase recover method is shown to produce images in half the time required by the bispectrum. The quality of images reconstructed using Knox-Thompson and bispectrum methods are also found to be nearly identical. Finally, it is shown that certain blind image quality metrics can be used in place of the MSE to evaluate quality in field scenarios. Using blind metrics rather depending on user estimates allows for reconstruction quality that differs from the minimum MSE by as little as 1%, significantly reducing the deviation in performance due to user action.

6th International Immunoglobulin Symposium: poster presentations

The posters presented at the 6th International Immunoglobulin Symposium covered a wide range of fields and included both basic science and clinical research. From the abstracts accepted for poster presentation, 12 abstracts were selected for oral presentations in three parallel sessions on immunodeficiencies, autoimmunity and basic research. The immunodeficiency presentations dealt with novel, rare class-switch recombination (CSR) deficiencies, attenuation of adverse events following IVIg treatment, association of immunoglobulin (Ig)G trough levels and protection against acute infection in patients with X-linked agammaglobulinaemia (XLA) and common variable immunodeficiency (CVID), and the reduction of class-switched memory B cells in patients with specific antibody deficiency (SAD). The impact of intravenous immunoglobulin on fetal alloimmune thrombocytopenia, pregnancy and postpartum-related relapses in multiple sclerosis and refractory myositis, as well as experiences with subcutaneous immunoglobulin in patients with multi-focal motor neuropathy, were the topics presented in the autoimmunity session. The interaction of dendritic cell (DC)-SIGN and alpha2,6-sialylated IgG Fc and its impact on human DCs, the enrichment of sialylated IgG in plasma-derived IgG, as wells as prion surveillance and monitoring of anti-measles titres in immunoglobulin products, were covered in the basic science session. In summary, the presentations illustrated the breadth of immunoglobulin therapy usage and highlighted the progress that is being made in diverse areas of basic and clinical research, extending our understanding of the mechanisms of immunoglobulin action and contributing to improved patient care.

A real-time video quality estimator for emerging wireless multimedia systems

Wireless Mesh Networks (WMNs) are increasingly deployed to enable thousands of users to share, create, and access live video streaming with different characteristics and content, such as video surveillance and football matches. In this context, there is a need for new mechanisms for assessing the quality level of videos because operators are seeking to control their delivery process and optimize their network resources, while increasing the user’s satisfaction. However, the development of in-service and non-intrusive Quality of Experience assessment schemes for real-time Internet videos with different complexity and motion levels, Group of Picture lengths, and characteristics, remains a significant challenge. To address this issue, this article proposes a non-intrusive parametric real-time video quality estimator, called MultiQoE that correlates wireless networks’ impairments, videos’ characteristics, and users’ perception into a predicted Mean Opinion Score. An instance of MultiQoE was implemented in WMNs and performance evaluation results demonstrate the efficiency and accuracy of MultiQoE in predicting the user’s perception of live video streaming services when compared to subjective, objective, and well-known parametric solutions.

The views of European clinicians on guidelines for long-term follow-up of childhood cancer survivors.

BACKGROUND Evidence-based guidelines are needed to guide effective long-term follow-up (LTFU) of childhood cancer survivors (CCS) at risk of late adverse effects (LAEs). We aimed to ascertain the use of LTFU guidelines throughout Europe, and seek views on the need for pan-European LTFU guidelines. PROCEDURES One expert clinician from each of 44 European countries was invited to participate in an online survey. Information was sought regarding the use and content of LTFU guidelines in the respondent's centre and country, and their views about developing pan-European LTFU guidelines. RESULTS Thirty-one countries (70%) responded, including 24 of 26 full EU countries (92%). LTFU guidelines were implemented nationally in 17 countries (55%). All guidelines included recommendations about physical LAEs, specific risk groups and frequency of surveillance, and the majority about psychosocial LAEs (70%), and healthy lifestyle promotion (65%). A minority of guidelines described recommendations about transition to age-appropriate LTFU services (22%), where LTFU should be performed (22%) and by whom (30%). Most respondents (94%) agreed on the need for pan-European LTFU guidelines, specifically including recommendations about surveillance for specific physical LAEs (97%), action to be taken if a specific LAE is detected (90%), minimum requirements for LTFU (93%), transition and health promotion (both 87%). CONCLUSIONS Guidelines are not universally used throughout Europe. However, there is strong support for developing pan-European LTFU guidelines for CCS. PanCareSurFup (www.pancare.eu) will collaborate with partners to develop such guidelines, including recommendations for hitherto relatively neglected topics, such as minimum LTFU requirements, transition and health promotion.

Nonsense-mediated mRNA decay (NMD) restricts replication of mammalian RNA viruses

A genome-wide siRNA screen against host factors that affect the infection of Semliki Forest virus (SFV), a positive-strand (+)RNA virus, revealed that components of the nonsense-mediated mRNA decay (NMD) pathway restrict early, post-entry steps of the infection cycle. In HeLa cells and primary human fibroblasts, knockdown of UPF1, SMG5 and SMG7 leads to increased levels of viral proteins and RNA and to higher titers of released virus. The inhibitory effect of NMD was stronger when the efficiency of virus replication was impaired by mutations or deletions in the replicase proteins. Accordingly, impairing NMD resulted in a more than 20-fold increased production of these attenuated viruses. Our data suggest that intrinsic features of genomic and sub-genomic viral mRNAs, most likely the extended 3'-UTR length, make them susceptible to NMD. The fact that SFV replication is entirely cytoplasmic strongly suggests that degradation of the viral RNA occurs through the exon junction complex (EJC)-independent mode of NMD. Collectively, our findings uncover a new biological function for NMD as an intrinsic barrier to the translation of early viral proteins and the amplification of (+)RNA viruses in animal cells. Thus, in addition to its role in mRNA surveillance and post-transcriptional gene regulation, NMD also contributes to protect cells from RNA viruses.

Evaluating perspectives for PRRS virus elimination from pig dense areas with a risk factor based herd index

Porcine reproductive and respiratory syndrome virus (PRRSV) is wide-spread in pig populations globally. In many regions of Europe with intensive pig production and high herd densities, the virus is endemic and can cause disease and production losses. This fuels discussion about the feasibility and sustainability of virus elimination from larger geographic regions. The implementation of a program aiming at virus elimination for areas with high pig density is unprecedented and its potential success is unknown. The objective of this work was to approach pig population data with a simple method that could support assessing the feasibility of a sustainable regional PRRSV elimination. Based on known risk factors such as pig herd structure and neighborhood conditions, an index characterizing individual herds' potential for endemic virus circulation and reinfection was designed. This index was subsequently used to compare data of all pig herds in two regions with different pig- and herd-densities in Lower Saxony (North-West Germany) where PRRSV is endemic. Distribution of the indexed herds was displayed using GIS. Clusters of high herd index densities forming potential risk hot spots were identified which could represent key target areas for surveillance and biosecurity measures under a control program aimed at virus elimination. In an additional step, for the study region with the higher pig density (2463 pigs/km(2) farmland), the potential distribution of PRRSV-free and non-free herds during the implementation of a national control program aiming at national virus elimination was modeled. Complex herd and trade network structures suggest that PRRSV elimination in regions with intensive pig farming like that of middle Europe would have to involve legal regulation and be accompanied by important trade and animal movement restrictions. The proposed methodology of risk index mapping could be adapted to areas varying in size, herd structure and density. Interpreted in the regional context, this could help to classify the density of risk and to accordingly target resources and measures for elimination.

The application of medical informatics to the veterinary management programs at companion animal practices in Alberta, Canada: a case study.

Companion animals closely share their domestic environment with people and have the potential to, act as sources of zoonotic diseases. They also have the potential to be sentinels of infectious and noninfectious, diseases. With the exception of rabies, there has been minimal ongoing surveillance of, companion animals in Canada. We developed customized data extraction software, the University of, Calgary Data Extraction Program (UCDEP), to automatically extract and warehouse the electronic, medical records (EMR) from participating private veterinary practices to make them available for, disease surveillance and knowledge creation for evidence-based practice. It was not possible to build, generic data extraction software; the UCDEP required customization to meet the specific software, capabilities of the veterinary practices. The UCDEP, tailored to the participating veterinary practices', management software, was capable of extracting data from the EMR with greater than 99%, completeness and accuracy. The experiences of the people developing and using the UCDEP and the, quality of the extracted data were evaluated. The electronic medical record data stored in the data, warehouse may be a valuable resource for surveillance and evidence-based medical research.

Positron emission tomography (PET) imaging of prostate cancer with a gastrin releasing peptide receptor antagonist - from mice to men

UNLABELLED Ex vivo studies have shown that the gastrin releasing peptide receptor (GRPr) is overexpressed on almost all primary prostate cancers, making it a promising target for prostate cancer imaging and targeted radiotherapy. METHODS Biodistribution, dosimetry and tumor uptake of the GRPr antagonist ⁶⁴Cu-CB-TE2A-AR06 [(⁶⁴Cu-4,11-bis(carboxymethyl)-1,4,8,11-tetraazabicyclo(6.6.2)hexadecane)-PEG₄-D-Phe-Gln-Trp-Ala-Val-Gly-His-Sta-LeuNH₂] were studied by PET/CT in four patients with newly diagnosed prostate cancer (T1c-T2b, Gleason 6-7). RESULTS No adverse events were observed after injection of ⁶⁴Cu-CB-TE2A-AR06. Three of four tumors were visualized with high contrast [tumor-to-prostate ratio > 4 at 4 hours (h) post injection (p.i.)], one small tumor (T1c, < 5% tumor on biopsy specimens) showed moderate contrast (tumor-to-prostate ratio at 4 h: 1.9). Radioactivity was cleared by the kidneys and only the pancreas demonstrated significant accumulation of radioactivity, which rapidly decreased over time. CONCLUSION ⁶⁴Cu-CB-TE2A-AR06 shows very favorable characteristics for imaging prostate cancer. Future studies evaluating ⁶⁴Cu-CB-TE2A-AR06 PET/CT for prostate cancer detection, staging, active surveillance, and radiation treatment planning are necessary.

AN OCCUPATIONAL INJURY MANAGEMENT INFORMATION SYSTEM FOR THE UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT HOUSTON

The purpose of this research and development project was to develop a method, a design, and a prototype for gathering, managing, and presenting data about occupational injuries.^ State-of-the-art systems analysis and design methodologies were applied to the long standing problem in the field of occupational safety and health of processing workplace injuries data into information for safety and health program management as well as preliminary research about accident etiologies. The top-down planning and bottom-up implementation approach was utilized to design an occupational injury management information system. A description of a managerial control system and a comprehensive system to integrate safety and health program management was provided.^ The project showed that current management information systems (MIS) theory and methods could be applied successfully to the problems of employee injury surveillance and control program performance evaluation. The model developed in the first section was applied at The University of Texas Health Science Center at Houston (UTHSCH).^ The system in current use at the UTHSCH was described and evaluated, and a prototype was developed for the UTHSCH. The prototype incorporated procedures for collecting, storing, and retrieving records of injuries and the procedures necessary to prepare reports, analyses, and graphics for management in the Health Science Center. Examples of reports, analyses, and graphics presenting UTHSCH and computer generated data were included.^ It was concluded that a pilot test of this MIS should be implemented and evaluated at the UTHSCH and other settings. Further research and development efforts for the total safety and health management information systems, control systems, component systems, and variable selection should be pursued. Finally, integration of the safety and health program MIS into the comprehensive or executive MIS was recommended. ^

Dengue risk factor distribution in Harris County, Texas

As an important emerging arboviral disease in Texas and throughout the world, dengue fever has the potential to make a re-emergence in the Harris County/Houston metropolitan area. Harris County has seen dengue epidemics in the past. The area has a competent vector, Aedes aegypti, capable of transmission of the virus should it be introduced. It is important to examine areas of highest risk for dengue emergence and transmission in Harris County so that surveillance and educational programs can be properly implemented. This study uses mapping software to visually represent risk factor information with areas of known Ae. aegypti populations. This study focused on known demographic risk factors such as race/ethnicity, place of birth, gender as well as socioeconomic status represented by educational attainment and income. This study found that there are several areas, particularly in central Harris County that are at particular risk for dengue transmission. The findings support the hypothesis that in areas of lower socioeconomic status there were increased populations of foreign born populations, Hispanic populations, and identified locations of a competent vector present. These findings suggest that more specific surveillance of Ae. aegypti, testing of the mosquitoes for dengue virus, and active surveillance for human cases should be implemented in these areas. ^