Miomatosis uterina, sintomatología urinaria y alteraciones sexuales en mujeres con indicación de tratamiento quirúrgico

Introducción Las pacientes con miomas uterinos pueden llegar a sufrir de síntomas urinarios y de disfunción sexual. Es para nosotros importante conocer la frecuencia de estas patologías en pacientes con miomas con indicación de cirugía atendidos en el Hospital Universitario Mayor Méderi y la relación entre estas tres entidades. Metodología Estudio cuasi experimental de antes-después. El estudio se encuentra dividido en dos fases, en esta primera fase a las pacientes se les aplicó los cuestionarios FSFI, IIQ-7 y UDI-6 antes de realizar el procedimiento quirúrgico. En una segunda fase se realizará un nuevo abordaje a los 6 y 12 meses donde se aplicarán los mismos instrumentos. Se utilizó coeficiente de Spearman y Kruskall-Wallis para evaluar la relación. Resultados En esta primera fase se incluyeron 81 participantes, con una mediana de años de 46 (RIQ=42-49) mínimo 33 y máximo 71 años. La mediana de miomas fue de 1 (RIQ1-2) máximo 5 miomas. El resultado total de la FSFI fue de 21(RIQ=18,5-25,5). La mediana de la escala UDI -6 fue de 50,4 (RIQ=0-31,2) y la mediana de IIQ-7 fue de 4,75 (RIQ=0-23,7). Se presentó una correlación negativa débil entre los puntajes de FSFI y los cuestionarios UDI-6 (-0.3604) e IIQ 7 (-0.3530), con una prevalencia de riesgo de disfunción sexual de 61%. Conclusiones En esta primera fase de la investigación se pudo observar una existencia de correlación entre la función sexual y la sintomatología urinaria. La prevalencia de disfunción sexual es mayor que en población de mujeres sin patología de miomas uterino.

Impacto de la implementación de un modelo de gestión integral de atención de la enfermedad y cuidado coordinado en la población en diálisis en Colombia

La atención hospitalaria en el costo global de la atención de los pacientes en diálisis es muy importante. Este estudio se realizó con el fin de evaluar resultados posteriores a la implementación de un modelo de gestión de la enfermedad y cuidado coordinado en una red de diálisis en Colombia, evaluando los cambios específicos en las tasas de hospitalización de una cohorte de pacientes renales con dos años de seguimiento. El modelo se enfoca básicamente en mejorar la atención de los pacientes en diálisis protocolizando en el manejo de comorbilidades (diabetes, riesgo cardiovascular, patologías infecciosas) y en el cuidado coordinado entre el tratamiento ambulatorio y hospitalario de los pacientes en diálisis asegurando la continuidad en el proceso de atención de los pacientes. El Estudio observacional analítico de cohortes compuesto por 2 fases una primera cohorte histórica retrospectiva y una segunda con dos cohortes prospectivas, incluyó pacientes mayores de 18 años, con más de 90 días en diálisis, con al menos tres meses de intervención con el modelo de gestión de enfermedad en la red Renal Therapy Services (RTS®). En conclusión, la realización de este estudio, se pudo asociar a la reducción en la atención hospitalaria de pacientes en diálisis y a una menor mortalidad, modelos como este y otras soluciones para mejorar los desenlaces en salud en los pacientes en diálisis deben seguir siendo implementados para aliviar la carga de la enfermedad y reducir los costos de la atención en salud de esta población.

Perspetivas de utilização do potencial eólico em Timor-Leste

A exigência energética global está mais orientada para a utilização das fontes de Energias Renováveis (FERs), comprometendo e garantindo um desenvolvimento sustentável. Este trabalho tem como objetivo contribuir para o atingir das metas do PED 2011-2030, no que refere à utilização das FER, em particular do potencial eólico em Timor-Leste. Timor-Leste tem apresentado um grande interesse na política de aproveitamento de FER para alcançar a meta de longo prazo de PED 2030, comprometendo-se com o desenvolvimento sustentável através de ERs. Este trabalho pretende contribuir em particular com o estudo do aproveitamento de energia eólica. Com base no clima do vento de longo termo entre 2004 – 2012, da estação meteorológica (EM) de Díli e conjugando estes com os dados da campanha experimental de Martifer cedidos, de Dezembro 2008 - Novembro 2009, obteve-se o coeficiente de variabilidade (Cvariab.) inter-anual. Foi assim possível construir o mapa médio do vento de longo termo, com modelo atmosférico de mesoscala, numa resolução refinada de 3×3 km. Para a identificação dos locais mais favoráveis do vento, foi utilizado o modelo ArcGIS para georreferenciação do recurso. A filtragem das restrições e os constrangimentos do terreno permitiu construir o mapa do vento sustentável de Timor-Leste, por distritos, subdistritos, sucos, do enclave de Oecússi e a ilha de Atauro, o que conduziu à hierarquização de cinco zonas favoráveis (zona 1 - 5). A contribuição para o plano energético de Timor-Leste consiste em duas fases: - a 1ª fase o aproveitamento eólico em três PEs nas zonas monitorizadas (3 e 5) oriundo de dados cedidos pela Martifer, contabilizou-se um total de 424.694 MWh de produção de energia anual, tendo-se verificado o custo normalizado de energia (LCOE) no valor médio calculado de 0,046 €/kWh; - na 2ª fase a construção de acesso e o desenvolvimento de PEs nas zonas 1, 2 e 4 para o Cenário de Max-Renovável. Assim sendo, viabilizam a "Perspetiva de Utilização da Energia Eólica" no quadro do PED 2011 - 2030 de Timor-Leste, que viria reduzir o custo de produção de energia atual, e a emissão de CO2; Abstract: Prospects of Using Wind Energy in Timor-Leste The demand for global energy is more focused on the use of Reneweable Energy sources (REs), ensuring and committing itself to sustainable development. This study was prompted by the wish to contribute to the achievement the goals of the Strategic Development Plan (PED 2011-2030) regarding the use of REs, particularly the wind energy in Timor-Leste. Timor-Leste has presented a great interest in the use of renewable energy sources policy to achieve the long term goal of the PED 2030, committing to a sustainable development through renewable energy. This thesis intends to contribute in particular with the study of the use of wind energy. Based on the long term wind climate between 2004 and 2012 of the Díli weather station and combining these data with the Martifer campaign experimental data of December 2008 - November 2009, the interannual variation coefficient (Cv) was obtained. Thus, it was possible to build the map of long term average wind with atmospheric mesoscale model in a refined resolution of 3×3 km. The ArcGIS model was used for the identification of the most favorable locations of the wind for its georeferencing. The constraining of filtering and the constraints of the terrain allowed to construe the sustainable wind map of Timor-Leste in distritos, subdistritos, sucos, and also of the enclave of Oecussi and Atauro island, which led to the ranking of five favorable areas (zone 1-5) for an immediate experimental campaign of wind characterization and utilization of this resource in wind parks. The contribution to Timor-Leste's energy plan consists of two phases: - the first phase of three wind farms in zone (3 and 5) from data provided by Martifer, a total of 424,694 MWh, and levelyzed cost of electricity (LCOE) in the calculated average value of 0.046 €/kWh; - in the second phase the construction of access and development of wind farms in zones 1, 2 and 4 for the Max-Renewable Scenario. As such, they make possible the "Perspective of Wind Energy Use" in Timor Leste’s PED 2011 - 2030, which would reduce current energy production costs and CO2 emissions.

L'alternanza scuola-lavoro al museo: una ricerca empirico-descrittiva in Emilia-Romagna

La tesi si propone di approfondire il tema dell’Alternanza scuola-lavoro (ASL) al museo, un ambito di interesse che ha ricevuto un’importante attenzione a seguito della promulgazione della L.107/2015. La legge ha, infatti, stabilito l’obbligatorietà per tutti gli studenti del triennio delle scuole secondarie di secondo grado di svolgere dei percorsi di ASL in contesti di lavoro differenti, con un esplicito riferimento a quello museale. Il contesto di riferimento scelto per la ricerca è l’Emilia-Romagna, una scelta fatta tenendo conto dell’impegno che la regione ha portato avanti, già dalla fine degli anni Novanta, in direzione di valorizzazione di percorsi integrati scuola-formazione professionale. La ricerca è partita dall’analisi della letteratura di riferimento sul rapporto istruzione-mondo del lavoro in ambito nazionale e internazionale e ha previsto due successive fasi: la prima con una esplorazione qualitativa del fenomeno su un campione ristretto di testimoni privilegiati, appartenenti all’ambito istituzionale, scolastico e museale mediante interviste; la seconda con un’esplorazione quantitativa del fenomeno tramite survey su un campione più ampio mediante la sommistrazione di questionari rivolti agli studenti e ai referenti e tutor ASL delle scuole e dei musei. Nello specifico l’analisi ha coinvolto 430 studenti di 28 scuole della regione che hanno partecipato a 495 percorsi di alternanza scuola-lavoro realizzati nel corso del triennio e a partire dall’anno scolastico 2015-2016. Inoltre hanno preso parte alla ricerca 56 referenti e tutor ASL di 45 scuole e 86 referenti e tutor ASL provenienti da 83 musei.

How to cope with air transport disruptions: airport airside resilience and vulnerability

The efficiency of airport airside operations is often compromised by unplanned disruptive events of different kinds, such as bad weather, strikes or technical failures, which negatively influence the punctuality and regularity of operations, causing serious delays and unexpected congestion. They may provoke important impacts and economic losses on passengers, airlines and airport operators, and consequences may propagate in the air network throughout different airports. In order to identify strategies to cope with such events and minimize their impacts, it is crucial to understand how disruptive events affect airports’ performance. The research field related with the risk of severe air transport network disruptions and their impact on society is related to the concepts of vulnerability and resilience. The main objective of this project is to provide a framework that allows to evaluate performance losses and consequences due to unexpected disruptions affecting airport airside operations, supporting the development of a methodology for estimating vulnerability and resilience indicators for airport airside operations. The methodology proposed comprises three phases. In the first phase, airside operations are modelled in both the baseline and disrupted scenarios. The model includes all main airside processes and takes into consideration the uncertainties and dynamics of the system. In the second phase, the model is implemented by using a generic simulation software, AnyLogic. Vulnerability is evaluated by taking into consideration the costs related to flight delays, cancellations and diversions; resilience is determined as a function of the loss of capacity during the entire period of disruption. In the third phase, a Bayesian Network is built in which uncertain variables refer to airport characteristics and disruption type. The Bayesian Network expresses the conditional dependence among these variables and allows to predict the impacts of disruptions on an airside system, determining the elements which influence the system resilience the most.

Molecular mechanisms controlling physiological plasticity in marine mussels under the influence of natural and anthropogenic stress factors

Marine mussels are exceptionally well-adapted to live in transitional habitats where they are exposed to fluctuating environmental parameters and elevated levels of natural and anthropogenic stressors throughout their lifecycle. However, there is a dearth of information about the molecular mechanisms that assist in dealing with environmental changes. This project aims to investigate the molecular mechanisms governing acclimatory and stress responses of the Mediterranean mussel (Mytilus galloprovincialis) by addressing relevant life stages and environmental stressors of emerging concern. The experimental approach consisted of two phases to explore (i) the physiological processes at early life history and the consequences of plastic pollution and (ii) the adult physiology processes under natural habitats. As the first phase, I employed a plastic leachate (styrene monomer), and polystyrene microplastics to understand the modulation of cytoprotective mechanisms during the early embryo stages. Results revealed the onset of transcriptional impairments of genes involved in MXR-related transporters and other physiological processes induced by styrene and PS-MPs. In the second phase, as a preliminary analysis, microbiota profile of adult mussels at the tissue scale and its surrounding water was explored to understand microbiota structures that may reflect peculiar adaptations to the respective tissue functions. The broader experiment has been implemented to understand the variability of transcriptional profiles in the mussel digestive glands in the natural setting. All the genes employed in this study have shown possibilities to use as molecular biomarker responses throughout the year for monitoring the physiology of mussels living in a particular environment and, in turn, more properly detecting changes in the environment. As a whole, my studies provide insights into the interactions between environmental parameters, and intrinsic characters, and physiology of marine bivalves, and it could help to interpretation of responses correctly under stress conditions and climate change scenarios.

Different views on Digital Scholarship: separate worlds or cohesive research field?

This article presents a systematic review of the literature on Digital Scholarship, aimed at better understanding the collocation of this research area at the crossroad of several disciplines and strands of research. The authors analysed 45 articlesin order to draw a picture of research in this area. In the first phase, the articles were classified, and relevant quantitative and qualitative data were analysed. Results showed that three clear strands of research do exist: Digital Libraries, Networked Scholarship and Digital Humanities. Moreover, researchers involved in this research area tackle the problems related to technological uptake in the scholar's profession from different points of view, and define the field in different – often complementary – ways, thus generating the perception of a research area still in need of a unifying vision. In the second phase, authors searched for evidence of the disciplinary contributions and interdisciplinary cohesion of research carried out in this area through the use of bibliometric maps. Results suggest that the area of Digital Scholarship, still in its infancy, is advancing in a rather fragmented way, shaping itself around the above-mentioned strands, each with its own research agenda. However, results from the cross-citation analysis suggest that the Networked Scholarship strand is more cohesive than the others in terms of cross-citations.

Formare competenze per gestire processi di Open Innovation. Uno studio di caso.

Per comprende più a fondo il problema che le aziende affrontare per formare le persone in grado di gestire processi di innovazione, in particolare di Open Innovation (OI), è stato realizzato nel 2021 uno studio di caso multiplo di un percorso di educazione non formale all’OI realizzato dalla società consortile ART-ER e rivolto ai dottorandi degli atenei emiliano-romagnoli. Nella seconda fase di tale percorso formativo, per rispondere alle sfide di OI lanciate dalle aziende, sono stati costituiti 4 tavoli di lavoro. A ciascun tavolo di lavoro hanno preso parte 3/4 dottorandi, due referenti aziendali, un consulente e un operatore di ART-ER. Il campione complessivo era costituito da 14 dottorandi; 8 referenti aziendali di quattro aziende; 4 membri di una società di consulenza e 4 operatori della società consortile ART-ER. Il seguente interrogativo di ricerca ha guidato l’indagine: l’interazione tra i soggetti coinvolti in ciascun tavolo di lavoro – considerato un singolo caso - si configura come una Comunità di Pratica in grado di favorire lo sviluppo di apprendimenti individuali funzionali a gestire i processi di OI attivati nelle imprese? I dati sono stati raccolti attraverso una ricerca documentale a tavolino, focus group, interviste semistrutturate e un questionario semistrutturato online. L’analisi dei dati è stata effettuata mediante un’analisi qualitativa del contenuto in più fasi con l’ausilio del software MAXQDA. I risultati dimostrano che in tre casi su quattro, i tavoli di lavoro si sono configurati come una Comunità di Pratica. In questi tre tavoli inoltre è emerso lo sviluppo di alcune aree di competenza funzionali alla gestione dei processi di OI. Nella conclusione sono state presentate alcune proposte per la riprogettazione delle future edizioni del percorso formativo.

Enhancing predictive capability of models for solubility and permeability in polymers and composites

The interpretation of phase equilibrium and mass transport phenomena in gas/solvent - polymer system at molten or glassy state is relevant in many industrial applications. Among tools available for the prediction of thermodynamics properties in these systems, at molten/rubbery state, is the group contribution lattice-fluid equation of state (GCLF-EoS), developed by Lee and Danner and ultimately based on Panayiotou and Vera LF theory. On the other side, a thermodynamic approach namely non-equilibrium lattice-fluid (NELF) was proposed by Doghieri and Sarti to consistently extend the description of thermodynamic properties of solute polymer systems obtained through a suitable equilibrium model to the case of non-equilibrium conditions below the glass transition temperature. The first objective of this work is to investigate the phase behaviour in solvent/polymer at glassy state by using NELF model and to develop a predictive tool for gas or vapor solubility that could be applied in several different applications: membrane gas separation, barrier materials for food packaging, polymer-based gas sensors and drug delivery devices. Within the efforts to develop a predictive tool of this kind, a revision of the group contribution method developed by High and Danner for the application of LF model by Panayiotou and Vera is considered, with reference to possible alternatives for the mixing rule for characteristic interaction energy between segments. The work also devotes efforts to the analysis of gas permeability in polymer composite materials as formed by a polymer matrix in which domains are dispersed of a second phase and attention is focused on relation for deviation from Maxwell law as function of arrangement, shape of dispersed domains and loading.

Innovative microbiome-based system for the improvement of productivity, safety and sustainability of mussels farming

Northwestern Adriatic Sea Mediterranean mussels are exposed to fluctuating environmental parameters and to natural and anthropogenic stressors. Today is well known that mussels can be defined as holobiont, even if remains a lot to elucidate about how an organism and its microbial component response to environmental stress. This PhD dissertation aims to investigate microbiome possible adaptive patters exploiting the organism physiology response to stress, using the NGS sequencing method. The experimental approach consisted of two phases to first determine (i) the microbiome at a tissue scale level, (ii) the microbiome and physiological response to natural and anthropogenic stress environment and the chemical assessment of the microecosystem the Northwestern Adriatic Sea Mediterranean Mussel lives in. Results revealed firstly a robust microbiome well differentiated from seawater microecosystem, with compositional variations at the organ level. Thanks to those findings, digestive gland, the organ in which digestive and detoxification processes allow animal to tolerate and accumulate xenobiotics of natural and anthropogenic origin, was the selected tissue for the second phase of the project. The second phase of the project evaluated the putative physiological variations and the compositional changes in microbiome of digestive gland. I then manage to assess microbiome region trends across the north Adriatic, with each sampling site well differentiated from the others. Finally, a chemical method able to a powerful tool for the analytical detection of the major pollutants in mussels were validated. These first results may provide baseline information for future studies approaches of seasonal and region trends of microbiota profiles and physiological responses in terms of metabolism.

Fighting child marriage in developing countries: design and development of a mobile application

Child marriage is still a great issue in developing countries and even if the interventions to prevent it are having results, they are not enough to eliminate the problem. Among the strategies that seem to work most to fight child marriage, there is the empowerment of girls with information combined with education of parents and community. As smartphones are more accessible year after year in developing countries, this thesis wants to investigate if a mobile app could be effective in fighting child marriage and which characteristics such an app should have. The research was organized in four phases and used design and creation and case study methodologies. Firstly, the literature was analyzed and an initial design was proposed. Secondly, expert interviews were performed to gain feedback on the proposed design, and afterwards prototype was built. Thirdly, a case study in the Democratic Republic of Congo (DRC) was performed to test the prototype, gaining insights and improvements through group interviews with 26 girls aged 15-19. Finally, a first version of the app was developed and a second phase of the case study was run in the DRC to understand if the girls were able to use the app. This phase included 14 girls of which 6 had participated in the prototype testing and used questionnaires as a data generation method. The app was built following the Principles for Digital Development. Even if this app is built based on the case study in DRC is modular and easily adaptable to other contexts as it is not content-specific. It was shown that is worth continuing to study this topic and it was defined a conceptual framework for designing learning apps for developing countries, in particular, to fight child, early, and forced marriage.

Comparing lock-in ranges and transient responses of second- and third-order phase-locked loops in master-slave clock distribution networks

The distribution of clock signals throughout the nodes of a network is essential for several applications. in control and communication with the phase-locked loop (PLL) being the component for electronic synchronization process. In systems with master-slave (MS) strategies, the PLLs are the slave nodes responsible for providing reliable clocks in all nodes of the network. As PLLs have nonlinear phase detection, double-frequency terms appear and filtering becomes necessary. Imperfections in filtering process cause oscillations around the synchronous state worsening the performance of the clock distribution process. The behavior of one-way master-slave (OWMS) clock distribution networks is studied and performances of first- and second-order filter processes are compared, concerning lock-in ranges and responses to perturbations of the synchronous state. (c) 2007 Elsevier GmbH. All rights reserved.

Phase II study of weekly plitidepsin as second-line therapy for small cell lung cancer.

OBJECTIVE: To evaluate the antitumor activity and safety profile of plitidepsin administered as a 1h weekly intravenous (i.v.) infusion of 3.2mg/m(2) to patients with small cell lung cancer (SCLC) who relapsed or progressed after one line of chemotherapy. PATIENTS AND METHODS: This was a multicenter, open-label, single-arm, exploratory, phase II clinical trial. Treatment lasted until disease progression, unacceptable toxicity, patient refusal or treatment delay for >2 weeks. Objective response rate (primary efficacy endpoint) was evaluated according to response evaluation criteria in solid tumors (RECIST). The rate of stable disease (SD) lasting for at least 6 months and time-to-event variables were secondary endpoints of efficacy. Toxicity was assessed using National Cancer Institute Common Toxicity Criteria (NCI-CTC) version 2.0. RESULTS: Twenty pretreated SCLC patients (median age, 60 years) with extensive (n=13) or limited-stage disease (n=7) received a total of 24 treatment cycles (median, one cycle per patient; range, 1-2). Objective tumor responses were not observed and only one of the 17 evaluable patients had SD. With a median follow-up of 11.8 months, the progression-free survival and the median overall survival were 1.3 months and 4.8 months, respectively. The most troubling or common toxicities were fatigue, muscle weakness, lymphopenia, anemia (no patients showed neutropenia), and asymptomatic, non-cumulative increase of transaminases levels and alkaline phosphatase. CONCLUSION: This clinical trial shows that a cycle of 1h weekly i.v. infusion of plitidepsin (3.2mg/m(2)) was generally well tolerated other than fatigue and muscle weakness in patients with pretreated SCLC. One patient died due to multi-organ failure. The absence of antitumor activity found here precludes further studies of this plitidepsin schedule as second-line single-agent treatment of SCLC.

New Strategic Direction for Alcohol & Drugs Phase 2 Second Update Report (June 2014) (PDF 1MB)

This second annual report provides an update of progress against the outcomes and indicators set out in NSD Phase 2.