435 research outputs found
Design and Optimization of Adaptable BCH Codecs for NAND Flash Memories
NAND flash memories represent a key storage technology for solid-state storage systems. However, they suffer from serious reliability and endurance issues that must be mitigated by the use of proper error correction codes. This paper proposes the design and implementation of an optimized Bose-Chaudhuri-Hocquenghem hardware codec core able to adapt its correction capability in a range of predefined values. Code adaptability makes it possible to efficiently trade-off, in-field reliability and code complexity. This feature is very important considering that the reliability of a NAND flash memory continuously decreases over time, meaning that the required correction capability is not fixed during the life of the device. Experimental results show that the proposed architecture enables to save resources when the device is in the early stages of its lifecycle, while introducing a limited overhead in terms of are
Le attività di culto nella scuola pubblica, tra laicità , «libertas Ecclesiae» e libertà religiosa collettiva
Il contributo, sottoposto a valutazione, Ăš frutto della riflessione comune dei due Autori; tuttavia, i paragrafi 1, 2, 3 e 4 sono opera di Fabiano Di Prima, i paragrafi 5, 6, e 7 di Marco DellâOglioSOMMARIO: - 1. Premessa. Il "ritorno" della religione e la riaffermazione degli Stati nazionali nell'ultimo quarto di secolo; l'"accerchiamento" della laĂŻcitĂ©Â - 2. Il mancato sviluppo di una metodica giurisprudenziale focalizzante la "specificitĂ " della laicitĂ italiana; l'emersione di un trend individuante solo i (relativi) profili comuni alla laĂŻcitĂ©Â - 3. Un caso paradigmatico: la sentenza n. 166 del 2016 del T.A.R. Emilia Romagna sul tema dello svolgimento di attivitĂ cultuali nella scuola pubblica - 4. Il quadro normativo e giurisprudenziale del ventennio scorso: le ignorate direttrici speciali (implicitamente) favorevoli; l'interpretazione "stretta" (d'indole separatista) della normativa generale scolastica negli anni '90 e quella successiva "pragmaticamente ampia" (a fronte delle concorrenti novitĂ socio-culturali e di sistema) - 5. Gli ultimi anni: il mancato intervento del Legislatore atto a orientare in senso costituzionale le scelte della P.A.; l'incrementale difficoltĂ di quest'ultima a prevenire/gestire le potenziali insorgenti "micro-conflittualitĂ "; la conseguente adozione d'un registro prudenziale "minimalista" â 6. La non condivisibile soluzione accolta dal T.A.R. (sentenza n. 166 del 2016) di contrarietĂ netta allo svolgimento di atti di culto a scuola. L'incidenza del trend "intrinsecamente separatista"; il cono d'ombra sulle specificitĂ della laicitĂ italiana; la perdita di vista delle direttrici con esse congruenti e delle garanzie ivi offerte alla "Libertas Ecclesiae" e alla libertĂ religiosa collettiva - 7. Conclusioni: l'urgenza di un intervento legislativo statuale, e di un'iniziativa chiarificatrice a livello bilaterale, a presidio delle libertĂ fondamentali in discussione
ADAGE: An Automated Synthesis tool for Adaptive BCH-based ECC IP-Cores
Bose-Chaudhuri-Hocquenghem (BCH) codes are a family of Error Correction Codes (ECCs) largely applied in modern Flash-based Hard Disks to significantly improve their endurance and reliability. ADAGE is an advanced ESL tool for the automatic generation of BCH-based ECC IP-Cores with adaptable correction capability. End-users can freely and dynamically change it on-the-fly. In addition, ADAGE supports architectural exploration of both decoders and encoder
Il riconoscimento civile dello scioglimento canonico del matrimonio non consumato e lâattuale regime pattizio: spunti per un ripensamento (in vista dâun possibile âritornoâ)
The Concordato lateranense, as modified in 1984, no longer includes a provision on the recognition of the civil effects of dispensations super rato: and this is mainly due to political-ideological constraints which affect both the (bilateral) path of revision, and the concurrent intervention of the Constitutional Court (decision No. 18/1982) which endorses (while negotiations were still ongoing) the theory underpinning those constraints (the Stateâs âdominationâ over the regulation of the marital relationship), while examining the super rato procedure in a formalistic way and stating that judicial protection is not sufficiently guaranteed. Firstly, the present paper deals with the origin, the extent and the incidence of these constraints in leading to the removal of the aforesaid provision; highlighting, hereinafter, the resulting (contradictions and) contrasts, due to such removal, with respect to the axiology, the philosophy and the purposes of the Agreement of Villa Madama. Afterwards, the essay carries out a nimble examination of the innovations/developments occurring - after the conclusion of the Agreement - in the two (respective) legal systems, which facilitate (in various aspects) a more complete delineation of the specificity of the super rato procedures (and of the effective extent of the guarantees provided therein); emphasizing, with regard to the Italian legal system, the key developments in case law that appear to indicate â in many ways â the urgency of a complete dispelling of that persistent âshadowâ (of political-ideological kind) burdening the Agreement
Tiotropium is less likely to induce oxygen desaturation in stable COPD patients compared to long-acting ÎČ2-agonists
SummaryIn a three-way crossover pilot study, the acute effects of tiotropium 18ÎŒg inhalation on the respiratory function and arterial blood gas tensions of 30 patients with stable chronic obstructive pulmonary disease (COPD) were compared with those of salmeterol 50ÎŒg and formoterol 12ÎŒg. In each study day, lung function and arterial blood gas analyses were performed before and up to 180min after inhalation. All treatments significantly improved lung function, increased DLco, decreased PaO2, and increased P(A-a)O2, with no change in PaCO2. The effects of salmeterol and tiotropium on PaO2 were slower in onset and more prolonged than those of formoterol but PaO2AUC0â180min was significantly greater for formoterol and salmeterol than for tiotropium. It is likely that the significant but small decreases in PaO2 and increases in P(A-a)O2 have been caused by pulmonary vasodilator effects. Since the three agents were similar in inducing bronchodilation, we believe that tiotropium is preferable in patients with hypoxemia caused by stable COPD because it seems to carry a smaller risk of worsening systemic hypoxemia
Chronic obstructive lung disease \u201cexpert system\u201d: Validation of a predictive tool for assisting diagnosis
Purpose: The purposes of this study were development and validation of an expert system (ES) aimed at supporting the diagnosis of chronic obstructive lung disease (COLD). Methods: A questionnaire and a WebFlex code were developed and validated in silico. An expert panel pilot validation on 60 cases and a clinical validation on 241 cases were performed. Results: The developed questionnaire and code validated in silico resulted in a suitable tool to support the medical diagnosis. The clinical validation of the ES was performed in an academic setting that included six different reference centers for respiratory diseases. The results of the ES expressed as a score associated with the risk of suffering from COLD were matched and compared with the final clinical diagnoses. A set of 60 patients were evaluated by a pilot expert panel validation with the aim of calculating the sample size for the clinical validation study. The concordance analysis between these preliminary ES scores and diagnoses performed by the experts indicated that the accuracy was 94.7% when both experts and the system confirmed the COLD diagnosis and 86.3% when COLD was excluded. Based on these results, the sample size of the validation set was established in 240 patients. The clinical validation, performed on 241 patients, resulted in ES accuracy of 97.5%, with confirmed COLD diagnosis in 53.6% of the cases and excluded COLD diagnosis in 32% of the cases. In 11.2% of cases, a diagnosis of COLD was made by the experts, although the imaging results showed a potential concomitant disorder. Conclusion: The ES presented here (COLDES) is a safe and robust supporting tool for COLD diagnosis in primary care settings
Effects of pulmonary rehabilitation on exercise capacity in patients with COPD: A number needed to treat study
BACKGROUND: Pulmonary rehabilitation (PR) is recognized as an evidence-based treatment in improving dyspnea and quality of life in patients with COPD. We evaluated the number needed to treat (NNT) to achieve an increase in physical capacity, as defined by a significant improvement in the six-minute walk test (6MWT) in patients with COPD undergoing PR.
METHODS: The study enrolled 284 patients aged 41 to 86 years (mean age 69.4 years) divided into two groups: a study group (222 patients) undergoing a PR program, and a control group (62 patients) treated only with drugs. The study group included patients with COPD divided in four subgroups according to GOLD stages.
RESULTS: In the study group, 142 out of 222 patients (64%) had an increase of at least 54 m in the 6MWT following PR versus 8 out of 62 patients (13%) in the control group after the same time interval. The NNT in the overall study group was 2; the same NNT was obtained in GOLD stages 2, 3, and 4, but was 8 in stage 1.
CONCLUSIONS: PR is highly effective in improving the exercise capacity of patients with COPD, as demonstrated by a valuable NNT, with better results in patients with a more severe disease
Satisfaction with chronic obstructive pulmonary disease treatment: results from a multicenter, observational study
Background: Understanding the level of patients\u2019 satisfaction with treatment and its determinants have the potential to impact therapeutic management and clinical outcome in chronic conditions such as chronic obstructive pulmonary disease (COPD). Methods: A national, multicenter, longitudinal, observational study of COPD from 20 Italian pulmonary centers to explore patients\u2019 satisfaction to treatment [assessed by the Treatment Satisfaction Questionnaire, 9 items (TSQM-9)] and association with clinical parameters [including dyspnea score, COPD Assessment Test (CAT) score, exacerbation rate], adherence to treatment [Morisky Medication-Taking Adherence Scale (MMAS-4)], illness perception [evaluated by Brief Illness Perception Questionnaire (B-IPQ)] in a 1-year follow up. Results: A total of 401 COPD patients were enrolled [69.4% group B Global Initiative for COPD (GOLD), considering 366 patients with available GOLD 2017 classification at enrollment]. At enrollment, satisfaction with treatment was moderate, being TSQM-9 mean scores for effectiveness 64.2 [95% confidence interval (CI) 62.5\u201365.9], for convenience 75.8 (95% CI 74.2\u201377.3), and for global satisfaction 65.7 (95% CI 64.0\u201367.4). Global satisfaction was negatively associated with disease perception (\u3b2 = 120.4709, p < 0.0001), and grade of dyspnea (\u3b2 = 124.2564, p = 0.009). Satisfaction with treatment was lower in patients with poor compared with optimal adherence to treatment (\u3b2 = 124.5608, p = 0.002). Changes in inhalation regimens during follow up did not modify the satisfaction with treatment. Conclusions: The results of this real-life study showed that the patients\u2019 satisfaction with treatments is only moderate in COPD. A high grade of patients\u2019 satisfaction is associated mainly with a low perception of the disease, high adherence to treatment and lower level of dyspnea
Disease awareness in patients with COPD: measurement and extent
Background: Patient awareness of COPD refers to knowledge and acceptance of the disease and its treatment. Although it is relevant to management and outcomes, the disease awareness of patients is poorly investigated, and no validated questionnaires are currently available. We aimed to develop the novel Disease Awareness in COPD Questionnaire (DACQ), which was validated in relation to demographic and clinical features, in patients participating in the SATisfaction and Adherence to COPD Treatment (SAT) study. Methods: DACQ was developed according to a list of items regarding the patient's knowledge, acceptance, and perception of COPD as well as of treatment needs. The questionnaire was validated by assessing internal structure and consistency, correlations with other patient-reported outcomes, and stability over time. Furthermore, the extent of disease awareness of patients enrolled in the SAT study was assessed by using DACQ, and correlations with demographic and clinical features were evaluated. Results: DACQ was composed of four domains. Overall reliability and stability over time were adequate; correlations between DACQ and other tools measuring different constructs (ie, treatment satisfaction, illness perception, impact of COPD symptoms on daily life, and dyspnea severity) were, as expected, more limited. In the enrolled patient sample, a suboptimal level of disease awareness (<70%) was detected, especially in terms of disease acceptance and perception. Disease knowledge was positively associated with COPD severity, while the impact of symptoms on daily life was negatively associated with disease acceptance, awareness of treatment needs, and overall awareness. Conclusion: DACQ proved to be a reliable tool to assess awareness in COPD patients. Awareness of COPD patients need to be improved. Clinical trial registration: ClinicalTrials.gov ID# NCT02689492
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