Quantum Double and Differential Calculi

We show that bicovariant bimodules as defined by Woronowicz are in one to one correspondence with the Drinfeld quantum double representations. We then prove that a differential calculus associated to a bicovariant bimodule of dimension n is connected to the existence of a particular (n+1)--dimensional representation of the double. An example of bicovariant differential calculus on the non quasitriangular quantum group E_q(2) is developed. The construction is studied in terms of Hochschild cohomology and a correspondence between differential calculi and 1-cocycles is proved. Some differences of calculi on quantum and finite groups with respect to Lie groups are stressed.Comment: Revised version with added cohomological analysis. 14 pages, plain te

“Self stabbing sucide”: 116 casi occorsi nella città di Milano dal 1993 al 2016

Introduzione Mentre molti omicidi nel Mondo sono compiuti con armi da taglio, i suicidi realizzati con siffatta modalit\ue0 lesiva sono rari accadimenti, comprovati nello 0,5-0,7% di tutti i casi di autosoppressione; in genere, sui corpi si osserva una sola ferita mortale, per quanto possano esserne eccezionalmente osservate anche molte, che sollevano la necessit\ue0 di stabilire se trattasi di modalit\ue0 realmente suicida piuttosto che omicida. In questi casi, ulteriori informazioni per configurare l\u2019esatta natura dell\u2019accadimento, sono desumibili dall\u2019anamnesi della vittima, dai dati circostanziali e di sopralluogo, nonch\ue9 dalle caratteristiche delle lesioni e dalla loro localizzazione. In questo studio, presentiamo l\u2019analisi dei casi di suicidio con armi da taglio, occorsi a Milano in 24 anni. Materiali e metodi Sono stati analizzati retrospettivamente 23417 verbali di autopsia redatti tra il 1993 e il 2016 presso la Sezione di medicina legale dell\u2019Universit\ue0 degli Studi di Milano estrapolando da 4022 suicidi totali, solo quelli realizzati con armi da taglio. Su questi casi, abbiamo approfondito lo studio delle caratteristiche delle vittime, della distribuzione e del numero delle lesioni autoinferte e delle caratteristiche dell\u2019arma feritrice. Risultati Abbiamo desunto 116 casi di suicidio con armi da taglio di cui: 103 realizzati con modalit\ue0 semplice e 13 con modalit\ue0 complessa, che hanno visto maggiormente coinvolti maschi italiani di et\ue0 compresa tra 41-e 50 anni, affetti da patologie psichiatriche, che si sono uccisi nella propria abitazione utilizzando, prevalentemente, coltelli da cucina. Le lesioni sono risultate monodistrettuali e localizzate agli arti superiori o al torace. In tutti i casi osservati, la morte, per la presenza di lesioni \u201cda assaggio\u201d a profondit\ue0 variabile, mancanza di segni di lotta, sangue limitato all\u2019area circostante il corpo e per la direzionalit\ue0 delle lesioni, da destra a sinistra, con il gomito piegato a 90 gradi verso il corpo, \ue8 stata attribuita, anche nel caso dei suicidi complessi, a shock emorragico da azione suicida. Conclusioni Gli inusuali suicidi compiuti con armi da taglio richiedono un approccio forense completo basato su un approfondito esame della scena del crimine durante il sopralluogo giudiziario, un\u2019accurata raccolta dei dati anamnestico-circostanziali e degli esiti autoptici i quali, unitamente alle indagini tossicologiche, possono rappresentare strumenti fondamentali per esprimersi motivatamente su un giudizio di accadimento omicida piuttosto che suicida

User fees in private non-for-profit hospitals in Uganda: a survey and intervention for equity

BACKGROUND: In developing countries, user fees may represent an important source of revenues for private-non-for-profit hospitals, but they may also affect access, use and equity. METHODS: This survey was conducted in ten hospitals of the Uganda Catholic Medical Bureau to assess differences in user fees policies and to propose changes that would better fit with the social concern explicitly pursued by the Bureau. Through a review of relevant hospital documents and reports, and through interviews with key informants, health workers and users, hospital and non-hospital cost was calculated, as well as overall expenditure and revenues. Lower fees were applied in some pilot hospitals after the survey. RESULTS: The percentage of revenues from user fees varied between 6% and 89% (average 40%). Some hospitals were more successful than others in getting external aid and government subsidies. These hospitals were applying lower fees and flat rates, and were offering free essential services to encourage access, as opposed to the fee-for-service policies implemented in less successful hospitals. The wide variation in user fees among hospitals was not justified by differences in case mix. None of the hospitals had a policy for exemption of the poor; the few users that actually got exempted were not really poor. To pay hospital and non-hospital expenses, about one third of users had to borrow money or sell goods and property. The fee system applied after the survey, based on flat and lower rates, brought about an increase in access and use of hospital services. CONCLUSION: Our results confirm that user fees represent an unfair mechanism of financing for health services because they exclude the poor and the sick. To mitigate this effect, flat rates and lower fees for the most vulnerable users were introduced to replace the fee-for-service system in some hospitals after the survey. The results are encouraging: hospital use, especially for pregnancy, childbirth and childhood illness, increased immediately, with no detrimental effect on overall revenues. A more equitable user fees system is possible

A computational study of salt diffusion and heat extraction in solar pond plants

The problem of the development of salt concentration profiles in a solar pond is investigated, the thermodiffusion contribution is also taken into account, using a one-dimensional mathematical model and a finite-difference approach. A novel scheme of heat extraction from the solar pond is presented, along with preliminary two-dimensional computational fluid dynamics (CFD) simulations

A simple method to save on costs in pulmonary emphysema operations

The hazard of prolonged air leaks causing protracted postoperative hospital stay increases the already high costs of lung volume reduction operations for severe emphysema. To solve the problem, Cooper [1] proposed to reinforce the staple line with bovine pericardial strips. Subsequently, an inert material, such as expanded polytetrafluoroethylene (Gore-Tex; WL Gore & Associates, Inc, Flagstaff, AZ), was introduced, displaying the same advantages of bovine pericardium but apparently of more practical use [2]. Lung volume reduction operations can be performed either through sternotomy or videothoracoscopy. The use of videothoracoscopy is increasing as the reduced trauma seems particularly desirable in such compromised patients, although automatic staplers further increase costs. Each unilateral lung volume reduction procedure usually requires 8 to 12 loading units, and the number of cartridges doubles with bilateral procedures. Also because of our experience with more than 1,700 thoracoscopic procedures, we opted for videothoracoscopy within our department. It was immediately apparent that polytetrafluoroethylene sleeves specifically designed for automatic endoscopic staplers further increased the expenses, as each loading unit of polytetrafluoroethylene reinforcing sleeves costs about 66 US. Considering the number of reinforcing strips required (8 to 12 for unilateral lung volume reduction operation, 16 to 24 for bilateral lung volume reduction operation) the expense is relevant. Following the instructions of the manufacturer, the polytetrafluoroethylene sleeve (SEAMGUARD Staple Line Reinforcement Material; W.L.Gore & Associates) is positioned on a 45-mm Endopath stapler (Ethicon Endosurgery Inc, Cincinnati, OH), and after firing, the exceeding part of the sleeve is grasped distally to the jaws, removed and discarded. We developed our own technique to reuse these parts of the sleeve to reinforce three more staple lines. The two remaining parts of Seamguard are sectioned with straight scissors along the folding lines of the residual sheets of Gore-Tex, thus producing three wide and three narrowe strips (Fig 1). One of the larger strips is now laid on the cutting surface of the stapler\u2019s cartridge jaw and tied to it with two Vicryl 4-0 precut threads (Ethicon) (Fig 2). The narrower strip is fixed to the stapler\u2019s anvil in the same way. It is important to check that the two knotted threads are positioned within the limits of the cut line and the knots are kept externally with long edges. The Gore-Tex sheet exceeding the cutting zone of the stapler must be sectioned (see dotted line in Fig 2) to prevent the polytetrafluoroethylene lamina flaps from folding back while the stapler is applied onto the parenchyma. Sometimes the distal thread is pushed forward by the stapler blade without being sectioned. Grasping one of the two longer edges of the thread and sectioning it with endoscopic scissors overcomes the problem (Fig 3). The same steps are repeated until the entire parenchyma line is stapled, reusing every part of each new Seamguard sleeveOur hospital pays 66 for each set of Seamguard. At an average of 8 to 12 (for unilateral operation) and 16 to 24 units (for bilateral operations) is required, the expense can reach $528 to$792 or $1,056 to$1,584, respectively. With our technique the cost for reinforcing the staple lines is reduced to one fourth (ie, $132 to$198 [for unilateral procedures] to $264 to$396 [for bilateral procedures]). Because the cost of the stapler and its reloading units cannot be reduced, the marked reduction of expenses for reinforcing the staple line with Seamguard allows us to cope with the economic aspect of this operation. The slightly longer time required for fashioning and tying the stripes is overcome by its economic advantage; furthermore, the cutting and tying time decreases progressively as experience increases

Applicabilità della microscopia elettronica a scansione con spettroscopia a dispersione di energia a raggi X (SEM-EDS) sul cadavere putrefatto

Introduzione Nel cadavere con alterazione putrefattive o trasformative, la verifica della coerenza tra le lesioni osservate e i mezzi lesivi che le hanno prodotte pu\uf2 rivelarsi ardua: in questi casi, pu\uf2 essere utile ricercare e caratterizzare eventuali microparticelle esogene derivanti dal mezzo lesivo che abbiano interagito, con un meccanismo di transfert, con la matrice biologica cutanea, in corrispondenza della lesione, utilizzando la microscopia elettronica a scansione con spettroscopia a dispersione di energia a raggi X (SEM/EDS). In questo studio, presentiamo le risultanze dell\u2019utilizzo di questa tecnica su cadaveri attinti da diverse forme di lesivit\ue0, alcuni dei quali rinvenuti in stato di putrefazione avanzato. Materiali e metodi Sono stati considerati 7 cadaveri sottoposti ad autopsia giudiziaria presso la Sezione di Medicina Legale dell\u2019Universit\ue0 degli Studi di Milano, con segni di applicazione di diverse lesivit\ue0: traumatico-contusiva (2 casi), arma da taglio (1 caso, putrefatto), asfissia meccanica da impiccamento (3 casi, putrefatti) ed elettrocuzione (1 caso). Si \ue8 proceduto a prelievo mediante due diverse tecniche di campionamento, ai fini di poter eseguire una preliminare valutazione circa l\u2019adeguatezza di entrambe. La casistica \ue8 stata quindi suddivisa in due gruppi, in relazione alle due tecniche di campionamento utilizzate. Il gruppo A ha incluso 3 cadaveri (lesivit\ue0 traumatico-contusiva e da arma da taglio) in cui \ue8 stato eseguito il prelievo di una losanga cutanea in corrispondenza della lesione, disidratata poi in alcol etilico 96% e in alcool assoluto; il gruppo B ha compreso 4 cadaveri (lesivit\ue0 da elettrocuzione e impiccamento) sui quali il prelievo \ue8 stato effettuato mediante uno specifico scotch biadesivo in grafite, avente funzione di supporto conduttore, apponendolo direttamente sulle lesioni. In entrambi i casi, subito dopo, si \ue8 proceduto con l\u2019analisi SEM-EDS. Risultati La tecnica SEM/EDS ha permesso di rilevare presenza di microparticelle esogene derivanti dai mezzi lesivi in tutti i casi esaminati, sia su cadavere fresco che su cadavere putrefatto. Entrambe le tecniche di campionamento si sono rivelate adeguate: le microparticelle sono infatti state rilevate sia in corrispondenza della superficie epiteliale della losanga cutanea prelevata (cadaveri del gruppo A), sia in corrispondenza della superficie adesiva apposta sulla cute (cadaveri del gruppo B). Conclusioni In ambito patologico forense, l\u2019analisi ultrastrutturale con microscopio elettronico a scansione - SEM-EDS - si \ue8 confermata un utile mezzo di ricerca, in sede di applicazione di lesivit\ue0 cutanea, per caratterizzare la tipologia del mezzo lesivo intervenuto. Tale tecnica si \ue8 rivelata applicabile anche in cadaveri in avanzato stato putrefattivo post-mortale, sia mediante prelievo di losanga cutanea, sia mediante apposizione di scotch in grafite