837 resultados para Milan


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Constantino y sus sucesores, Constancio II, Constante y Juliano, expresaron su particular interés por supervisar la aplicación de determinadas leyes imperiales mediante el uso de la fórmula ad nostram scientiam referatur y de otras similares. Constantino fue el príncipe que la empleó con más frecuencia, especialmente durante el período de 313-324, exceptuando el intervalo de 315-316, cuando la confrontación con Licinio le obligó a renunciar a atender directamente las cuestiones administrativas. La progresiva disminución de la inclusión de estas cláusulas en los textos legales imperiales a partir de la unificación del Imperio en 324 se debe poner en relación con la aparición de los curiosi y luego de los agentes in rebus, como oficiales encargados de vigilar la observancia de las normas vigentes.

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Introduction Sleep disturbances are common in critically ill patients treated in the intensive care unit (ICU) with the potential for serious consequences and long-term effects on health outcomes and patient morbidity.
Objectives Our aim was to describe sleep management and sedation practices of adult ICUs in ten countries and to evaluate roles and responsibilities of the ICU staff in relation to key sleep and sedation decisions.
Methods A multicenter, self-administered survey sent to nurse managers of adult ICUs across 10 countries. The questionnaire comprised four domains: sleep characteristics of the critically ill; sleep and sedation practices; non-pharmacological and pharmacological interventions used to improve sleep; and the autonomy and influence of nurses on sleeping practices in the ICU.
Results Overall response rate was 66% (range 32% UK to 100% Cyprus), providing data from 522 ICUs. In all countries, the most frequent patient characteristic perceived to identify sleep was lying quietly with closed eyes (N=409, 78%) (range 92% Denmark to 36% Italy). The most commonly used sedation scale was the Richmond Agitation-Sedation Score (RASS) (N=220, 42%) (range 81% UK to 0% Denmark, Cyprus where most ICUs used the Ramsay score). In most ICUs, selection of sleep medication (N=265, 51%) and assessment of effect (N=309, 59%) was performed by physicians and nurses based on collaborative discussion. In a minority of ICUs (N=161, 31%), decisions and assessments were made by physicians alone. The most commonly used (in all countries) non-pharmacological intervention to promote sleep was reducing ICU staff noise (N=473, 91%) (range 100% Denmark, Norway to 78% Canada). Only 95 ICUs (18%) used earplugs on a frequent basis (range 0% Greece, Cyprus, Denmark to 57% Sweden). Propofol was the drug used most commonly for sedation (N=359, 69%) (range 96% Sweden to 29% Canada). Chloral hydrate was used by only 63 (12%) ICUs (range 0% Greece, Cyprus, Denmark, Italy to 56% Germany). Sedation scales were used on a routine basis by 77% of the 522 ICUs. Participants scored nursing autonomy for sleep and sedation management as moderate; median score of 5 (scale of 0 to 10), range 7 (Canada, Greece, Sweden) to 4 (Norway, Poland). Nursing influence on sleep and sedation decisions was perceived considerable; median score 8, range 9 (Denmark) to 5 (Poland).
Conclusions We found considerable across country variation in sleep promotion and sedation management practices though most have adopted a sedation scale as recommended in professional society guidelines. Most ICUs in all countries used a range of pharmacological and non-pharmacological interventions to promote sleep. Most units reported inter-professional decision-making with nurses perceived to have substantial influence on sleep/sedation decisions.


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BACKGROUND: Calcium channel blockers (CCBs) may affect prostate cancer (PCa) growth by various mechanisms including those related to androgens. The fusion of the androgen-regulated gene TMPRSS2 and the oncogene ERG (TMPRSS2:ERG or T2E) is common in PCa, and prostate tumors that harbor the gene fusion are believed to represent a distinct disease subtype. We studied the association of CCB use with the risk of PCa, and molecular subtypes of PCa defined by T2E status.

METHODS: Participants were residents of King County, Washington, recruited for population-based case-control studies (1993-1996 or 2002-2005). Tumor T2E status was determined by fluorescence in situ hybridization using tumor tissue specimens from radical prostatectomy. Detailed information on use of CCBs and other variables was obtained through in-person interviews. Binomial and polytomous logistic regression were used to generate odds ratios (ORs) and 95% confidence intervals (CIs).

RESULTS: The study included 1,747 PCa patients and 1,635 age-matched controls. A subset of 563 patients treated with radical prostatectomy had T2E status determined, of which 295 were T2E positive (52%). Use of CCBs (ever vs. never) was not associated with overall PCa risk. However, among European-American men, users had a reduced risk of higher-grade PCa (Gleason scores ≥7: adjusted OR = 0.64; 95% CI: 0.44-0.95). Further, use of CCBs was associated with a reduced risk of T2E positive PCa (adjusted OR = 0.38; 95% CI: 0.19-0.78), but was not associated with T2E negative PCa.

CONCLUSIONS: This study found suggestive evidence that use of CCBs is associated with reduced relative risks for higher Gleason score and T2E positive PCa. Future studies of PCa etiology should consider etiologic heterogeneity as PCa subtypes may develop through different causal pathways. 

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This study provides the first spatially detailed and complete inventory of Ambrosia pollen sources in Italy – the third largest centre of ragweed in Europe. The inventory relies on a well tested top-down approach that combines local knowledge, detailed land cover, pollen observations and a digital elevation model that assumes permanent ragweed populations mainly grow below 745m. The pollen data were obtained from 92 volumetric pollen traps located throughout Italy during 2004-2013. Land cover is derived from Corine Land cover information with 100m resolution. The digital elevation model is based on the NASA shuttle radar mission with 90m resolution. The inventory is produced using a combination of ArcGIS and Python for automation and validated using cross-correlation and has a final resolution of 5km x 5km. The method includes a harmonization of the inventory with other European inventories for the Pannonian Plain, France and Austria in order to provide a coherent picture of all major ragweed sources. The results show that the mean annual pollen index varies from 0 in South Italy to 6779 in the Po Valley. The results also show that very large pollen indexes are observed in the Milan region, but this region has smaller amounts of ragweed habitats compared to other parts of the Po Valley and known ragweed areas in France and the Pannonian Plain. A significant decrease in Ambrosia pollen concentrations was recorded in 2013 by pollen monitoring stations located in the Po Valley, particularly in the Northwest of Milan. This was the same year as the appearance of the Ophraella communa leaf beetle in Northern Italy. These results suggest that ragweed habitats near to the Milan region have very high densities of Ambrosia plants compared to other known ragweed habitats in Europe. The Milan region therefore appears to contain habitats with the largest ragweed infestation in Europe, but a smaller amount of habitats is a likely cause the pollen index to be lower compared to central parts of the Pannonian Plain. A low number of densely packed habitats may have increased the impact of the Ophraella beetle and might account for the documented decrease in airborne Ambrosia pollen levels, an event that cannot be explained by meteorology alone. Further investigations that model atmospheric pollen before and after the appearance of the beetle in this part of Northern Italy are needed to assess the influence of the beetle on airborne Ambrosia pollen concentrations. Future work will focus on short distance transport episodes for stations located in the Po Valley, and long distance transport events for stations in Central Italy that exhibit peaks in daily airborne Ambrosia pollen levels.

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info:eu-repo/semantics/published

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Embryo implantation into the endometrium is a complex biological process involving the integration of steroid hormone signaling, endometrial tissue remodeling and maternal- fetal communications. A successful pregnancy is the outcome of the timely integration of these events during the early stages of implantation. The involvement of ovarian steroid hormones, estrogen (E) and progesterone (P), acting through their cognate receptors, is essential for uterine functions during pregnancy. The molecular mechanisms that control the process of implantation are undergoing active exploration. Through our recent efforts, we identified the transcription factor, CCAAT Enhancer Binding Protein Beta (C/EBPb) as a prominent target of estrogen and progesterone signaling in the uterus. The development of a C/EBPb-null mouse model, which is infertile, presented us with an opportunity to analyze the role of this molecule in uterine function. We discovered that C/EBPb functions in two distinct manners: (i) by acting as a mediator of E-induced proliferation of the uterine epithelium and (ii) by controlling uterine stromal cell differentiation, a process known as decidualization, during pregnancy. My studies have delineated important mechanisms by which E regulates C/EBPb expression to induce DNA replication and prevent apoptosis of uterine epithelial cells during E-induced epithelial growth. In subsequent studies, I analyzed the role of C/EBPb in decidualization and uncovered a unique mechanism by which C/EBPb regulates the synthesis of a unique laminin-containing extracellular matrix (ECM) that supports stromal cell differentiation and embryo invasion. In order to better define the role of laminin in implantation, we developed a laminin gamma 1-conditional knockout mouse model. This is currently an area of ongoing investigation. The information gained from our analysis of C/EBPb function in the uterus provides new insights into the mechanisms of steroid hormone action during early pregnancy. Ultimately, our findings may aid in the understanding of dysregulation of hormone-controlled pathways that underlie early pregnancy loss and infertility in women.

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"Le magasin de la mémoire est volontiers plus fourni de matière que n'est celui de l'invention" disait Montaigne dans ses Essais. Lointaine et proche, plurielle et éclatée, la présence sérafade qui traverse l’histoire et la culture de Bragance et de tout le Nord Est du Portugal convoque aujourd’hui comme hier, ici comme là-bas les thèmes de l’errance, de l’exil et du passage des frontières, soient-elles géographiques, politiques ou langagières. Cette édition du Forum de l’APEF - Association Portugaise d’Études Françaises réalisée à Bragance est l’occasion de réfléchir aux multiples enjeux (littéraires, politiques, éthiques) de telles notions, d’abord associées à un peuple historiquement contraint à l’exode, mais dont le destin peut servir de (pré)figuration à d’autres expériences exiliques, notamment dans notre actualité. Qu’elles convoquent la mémoire individuelle et collective en tant que fonds d’un vécu, d’une blessure, voire d’un trauma, quelles configurations prennent-elles aujourd’hui dans les oeuvres d’art et de langage? Quelles constructions symboliques, imaginaires, mythiques suscitent-elles? Quelle vision de l’histoire du présent et de celle de l’avenir traduisent-elles? Étendre ce questionnement aux littératures de langue française, prétendant moins à l’exhaustivité qu’à faire connaître, à même les oeuvres, le regard et les paroles singulières d’auteurs et acteurs tels que Jean-Marie Le Clézio, Tayeb Salih ou Leonora Miaono, Benjamin Stora, Leila Sebba ou Laura Acabo, Julien Gracq, Milan Kundera ou Patrick Modiano, tel est le fil conducteur de la trentaine de communications qui rythment nos deux journées de travail. Le but commun qui nous anime est de porter sur une littérature conçue au carrefour des langues et des cultures des analyses différentes mais complémentaires, car finalement aucune objectivation n’est juste et chaque parole, parce qu’elle s’élève de ce lieu intranquille et subjectif qu’est le langage est avant tout un acte de liberté.

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El artículo trata de hacer una aproximación a la vida de François Vatel, analizando la época en la que vivió y su relación con la corte de Versalles, partiendo de la película Vatel (Roland Joffé, 2000). Al mismo tiempo hemos considerado interesante comparar su vida con la de otro artífice de sueños: Leonardo da Vinci, cuyo papel en la corte de Milán a las órdenes de Ludovico Sforza el Moro fue similar, aunque un siglo antes.

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This study aimed to detect and analyse regular patterns of play in fast attack of football teams, through the combination of the sequential analysis technique and semi-structured interviews to experienced first League Portuguese coaches. The sample included 36 games (12 games of the respective national leagues per team) of the F.C. Barcelona, Inter Milan, and Manchester United teams that were coded with the observational instrument tool developed by Sarmento et al. (2010) and the data analysed through sequential analysis with the software SDIS-GSEQ 5.0. Based on the detected patterns, semi-structured interviews were carried out to 8 expert high-performance football coaches and data were analysed through the content analysis technique using the software NVivo 10. The detected patterns of play revealed specific characteristics of the teams under study. The combination of the results of sequential analysis with the qualitative interviews to the professional coaches proved to be very fruitful in this game the analysis of scope, allowing reconcile scientific knowledge with practical interpretation of coaches who develop their tasks in the field.

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My thesis consists of three essays that investigate strategic interactions between individuals engaging in risky collective action in uncertain environments. The first essay analyzes a broad class of incomplete information coordination games with a wide range of applications in economics and politics. The second essay draws from the general model developed in the first essay to study decisions by individuals of whether to engage in protest/revolution/coup/strike. The final essay explicitly integrates state response to the analysis. The first essay, Coordination Games with Strategic Delegation of Pivotality, exhaustively analyzes a class of binary action, two-player coordination games in which players receive stochastic payoffs only if both players take a ``stochastic-coordination action''. Players receive conditionally-independent noisy private signals about the normally distributed stochastic payoffs. With this structure, each player can exploit the information contained in the other player's action only when he takes the “pivotalizing action”. This feature has two consequences: (1) When the fear of miscoordination is not too large, in order to utilize the other player's information, each player takes the “pivotalizing action” more often than he would based solely on his private information, and (2) best responses feature both strategic complementarities and strategic substitutes, implying that the game is not supermodular nor a typical global game. This class of games has applications in a wide range of economic and political phenomena, including war and peace, protest/revolution/coup/ strike, interest groups lobbying, international trade, and adoption of a new technology. My second essay, Collective Action with Uncertain Payoffs, studies the decision problem of citizens who must decide whether to submit to the status quo or mount a revolution. If they coordinate, they can overthrow the status quo. Otherwise, the status quo is preserved and participants in a failed revolution are punished. Citizens face two types of uncertainty. (a) non-strategic: they are uncertain about the relative payoffs of the status quo and revolution, (b) strategic: they are uncertain about each other's assessments of the relative payoff. I draw on the existing literature and historical evidence to argue that the uncertainty in the payoffs of status quo and revolution is intrinsic in politics. Several counter-intuitive findings emerge: (1) Better communication between citizens can lower the likelihood of revolution. In fact, when the punishment for failed protest is not too harsh and citizens' private knowledge is accurate, then further communication reduces incentives to revolt. (2) Increasing strategic uncertainty can increase the likelihood of revolution attempts, and even the likelihood of successful revolution. In particular, revolt may be more likely when citizens privately obtain information than when they receive information from a common media source. (3) Two dilemmas arise concerning the intensity and frequency of punishment (repression), and the frequency of protest. Punishment Dilemma 1: harsher punishments may increase the probability that punishment is materialized. That is, as the state increases the punishment for dissent, it might also have to punish more dissidents. It is only when the punishment is sufficiently harsh, that harsher punishment reduces the frequency of its application. Punishment Dilemma 1 leads to Punishment Dilemma 2: the frequencies of repression and protest can be positively or negatively correlated depending on the intensity of repression. My third essay, The Repression Puzzle, investigates the relationship between the intensity of grievances and the likelihood of repression. First, I make the observation that the occurrence of state repression is a puzzle. If repression is to succeed, dissidents should not rebel. If it is to fail, the state should concede in order to save the costs of unsuccessful repression. I then propose an explanation for the “repression puzzle” that hinges on information asymmetries between the state and dissidents about the costs of repression to the state, and hence the likelihood of its application by the state. I present a formal model that combines the insights of grievance-based and political process theories to investigate the consequences of this information asymmetry for the dissidents' contentious actions and for the relationship between the magnitude of grievances (formulated here as the extent of inequality) and the likelihood of repression. The main contribution of the paper is to show that this relationship is non-monotone. That is, as the magnitude of grievances increases, the likelihood of repression might decrease. I investigate the relationship between inequality and the likelihood of repression in all country-years from 1981 to 1999. To mitigate specification problem, I estimate the probability of repression using a generalized additive model with thin-plate splines (GAM-TPS). This technique allows for flexible relationship between inequality, the proxy for the costs of repression and revolutions (income per capita), and the likelihood of repression. The empirical evidence support my prediction that the relationship between the magnitude of grievances and the likelihood of repression is non-monotone.

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Cette thèse a pour objet l'étude de la peinture murale des Xle-Xllle siècles dans l'actuel Canton du Tessin. A cette époque, la région qui compose ce territoire ne constituait pas une unité, mais formait les contrées plus éloignées, adossées au massif central des Alpes, des; villes et des diocèses de Côme et Milan. L'histoire de ses limites territoriales et politiques a déterminé aussi l'orientation de l'histoire des études: l'actuel Canton du Tessiri n'a pas vraiment été considéré ni par les chercheurs qui se sont occupés de la Lombardie, ni par ceux qui se sont occupés de la Suisse: d'une part, car aujourd'hui il ne fait plus partie de la Lombardie, de l'autre, parce qu'à l'époque médiévale il ne faisait pas encore partie du territoire suisse. On a donc affaire à un sujet d'étude marginalisé, qui a pendant longtemps aussi souffert de la marginalité historiographique du Tessin médiéval, considéré comme une région culturellement «en retard» par rapport aux centres de Côme et Milan. À travers le filtre historiographique naît ainsi l'exigence d'étudier ce territoire de manière cohérente, tout en étant conscient de sa fragmentation à l'époque médiévale. Par le recensement et l'analyse de tous les témoignages picturaux des XP-Xllle siècles existants ou désormais disparus, mais pour lesquels subsiste de la documentation visuelle, nous avons essayé de dresser la physionomie artistique de cette région: il s'agissait non seulement de définir leur relations avec les éléments lombards proches, mais dans l'ensemble qu'ils composent avec ceux-ci. Et c'est justement cette unité entre la réalité lombarde et celle tessinoise que, dans la limite du possible, nous avons cherché à recomposer dans ce travail. A cause de sa longue durée, l'arc chronologique choisi s'est révélé fondamental pour saisir les dynamiques et les mécanismes - indispensables, par exemple, pour comprendre le rapport entre centre et périphérie ou la géographie artistique du territoire considéré - qui échapperaient à un regard chronologique plus restreint. Cette contextualisation a mené à une ouverture ultérieure. Historiquement replacés à l'intérieur du panorama pictural lombard, les témoignages tessinois ont été l'objet d'une mise eri perspective plus large qui a permis - quand cela était possible - de les insérer dans la culture artistique contemporaine. Traversée par certaines parmi les plus importantes voies de communication reliant le Nord et le Sud des Alpes, la condition liminaire de cette région ne semble pas avoir conditionné de manière déterminante ses échanges avec d'autres réalités: elle n'apparaît ni plus réceptive, ni plus imperméable que d'autres régions lombardes envers les différents horizons culturels sur lesquels la Lombardie était ouverte, se nourrissant d'apports variés. Les points de contact relevés fournissent des précieux indices sur le fonctionnement des ateliers, sur la circulation des modèles et sur les commanditaires. Ces différents niveaux d'analyse déterminent la structure du travail: le catalogue d'oeuvres examinées - organisé en fiches ordonnées selon la chronologie établie sur la base des résultats apparus lors de l'analyse historique-artistique - est précédé par une partie introductive plus discursive. Cette dernière met en évidence et analyse les émergences principales, situant les ensembles étudiés entre eux et à l'intérieur de l'époque à laquelle ils appartiennent. La définition de la physionomie artistique de la région tessinoise apporte ainsi de nouveaux repères non seulement dans la connaissance de l'art des siècles centraux du Moyen Âge Lombard, mais aussi du vaste espace alpin situé au coeur de l'Occident médiéval.

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The integration of Information and Communication Technologies (ICT) in the tourism industry is an essential element for the success of any tourism enterprise. ICTs provide access to information of tourism products from anywhere and at any time. Tour companies may also reach out to target customers around the world through a series of emerging technologies. This paper aims to make a review of the main key factors of ICT in Tourism. Aspects such as the quality of the website, Digital Marketing, Social Networking, Multimedia, Mobile Technologies and Intelligent Environments are discussed.

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Within the supply chain, the customer does not simply buy parts or services from suppliers, but also buys supplier capabilities, which results in quality products and services. Having a tool that handles the Inspection as well as the Nonconformance, Complaint, Corrective Action and Concession processes is key to successfully track the supplier performance. Taking as a case study a Supplier Quality Management (SQM) currently in operation in an Original Equipment Manufacturer (OEM) for automotive industry, this paper presents a platform to support a Supplier Quality Management System (SQMS), that fits the technical specification ISO/TS 16949 requirements. This prototype is composed by a web platform and a mobile App, having flexibility and mobility as key main characteristics.

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Part 6: Engineering and Implementation of Collaborative Networks