Proprieta' analgesiche dello xenon

Nella prima sezione della tesi, sono analizzate e discusse le basi fisiologiche della percezione dolorifica, mettendo in risalto la sua natura multiforme e quindi la sua influenzabilità da parte di innumerevoli fattori. Nella seconda parte, si prendono in esame i mediatori periferici e i neurotrasmettitori della via nocicettiva, con l’analisi dei loro recettori e quindi, per ciascuno di essi, il possibile ruolo nella modulazione del dolore, con particolare riferimento al glutammato e ai recettori NMDA. Nella terza ed ultima sezione, sono presentati e analizzati gli studi che evidenziano il ruolo dello xenon nella modulazione della via nocicettiva, i meccanismi d’azione e quindi i sistemi influenzati, nei modelli animali e nell’uomo, concludendo con possibili applicazioni cliniche nel trattamento del dolore acuto e cronico

Ruolo di nuovi biomarcatori nella diagnosi e trattamento di sepsi e shock settico

La sepsi e lo shock settico hanno al giorno d’oggi un’incidenza crescente e sono una causa importante di morbilità e mortalità, sia nelle terapie intensive sia nei reparti di degenza ordinaria. Le cause di questo aumento dell’incidenza sono da ascrivere ad un invecchiamento della popolazione generale, un maggiore utilizzo di dispositivi invasivi soprattutto vascolari, la presenza di infezioni nosocomiali e la relativa antibioticoresistenza, terapie immunosoppressive prolungate, e – non da ultimo – una migliorata accortezza diagnostica dovuta ad una maggiore consapevolezza medica della problematica, sulla base di linee guida recentemente pubblicate. La sepsi se non trattata evolve naturalmente in shock settico, che è una condizione a rischio di vita con oltre il 40% di mortalità intraospedaliera. I pazienti che sopravvivono possono avere pesanti ricadute sul loro stato generale e sulla qualità di vita una volta dimessi dall’ospedale. Così come un precoce riconoscimento di un infarto miocardico acuto implica una maggiore quota di miocardio risparmiato, un precoce riconoscimento della sepsi significa maggiori probabilità di sopravvivenza e maggior numero di vite salvate. Per questo, è fondamentale iniziare precocemente la terapia, sia di supporto che antibiotica, la quale andrà successivamente variata in modo da risultare mirata al germe infettante e ridurre le probabilità di sviluppo di resistenza. In questo scenario è possibile inserire l’uso di biomarcatori di infezione e di disfunzione d’organo al fine di rendere la diagnosi specifica sempre più precoce e valutare la risposta alla terapia, possibilmente con sensibilità e specificità idonei a prendere fondatamente delle decisioni cliniche. Fra questi, la procalcitonina è un marcatore di infezione batterica ormai presente nella diagnostica routinaria di molte realtà come pronto soccorso, corsie e terapie intensive, usata come traccia diagnostica e di follow up della terapia. L’attività endotossinica (EAA), qualora positiva, rappresenta un biomarcatore affidabile di infezione da germi gram negativi i cui livelli, in base alla letteratura disponibile, correlano con la mortalità e con la necessità di terapie ulteriori. Il brain natriuretic peptide (BNP) rappresenta un biomarcatore di disfunzione cardiaca, anche questo utile per diagnosi e soprattutto per follow up di scompenso cardiaco, anche in questo caso correlato con la mortalità e la necessità di terapie ulteriori. Tuttavia, il loro ruolo predittivo preciso deve essere contestualizzato al tipo di paziente, alle altre variabili cliniche di uso routinario e soprattutto alla capacità di compenso del paziente. Pertanto è stato condotto uno studio clinico con l’obiettivo di correlare parametri ematici routinari (conta dei globuli bianchi, proteina C reattiva, conta piastrinica) con marcatori di infezione e di performance cardiaca (EAA e BNP), contestualizzare il valore di queste correlazioni nella gestione dei pazienti settici, e valutare la loro influenza sull’outcome. In questo studio osservazionale prospettico sono stati reclutati 15 pazienti critici con segni clinici di sepsi e almeno un dosaggio EAA entro 6 ore dal ricovero in terapia intensiva. Sono state determinate correlazioni tra età, sesso, tipo di infezione, livelli di biomarcatori (BNP, proteina C reattiva, procalcitonina, globuli bianchi e delle piastrine), così come livelli di EAA con misure di outcome (per esempio, la durata della degenza, la necessità di terapie sostitutive renali (CRRT), mortalità intra-ospedaliera e mortalità a 30 giorni). Nessuna differenza statisticamente significativa è stata rilevata tra il livello EAA e la mortalità a 30 giorni. La mortalità non è risultata significativamente più elevata per le donne (57%) rispetto agli uomini (50%), p = 1. L’età avanzata è risultata correlata ad una maggiore necessità di CRRT (p = 0,022). I pazienti con livelli di EAA inferiore a 0,6 hanno mostrato valori di BNP più bassi con una correlazione moderata (ρ = 0,39). Una correlazione significativa è stata rilevata tra i livelli di BNP e conta leucocitaria (p = 0,033), e tra mortalità intra-ospedaliera e conta piastrinica (p = 0,029). I pazienti che hanno ricevuto CRRT avevano livelli significativamente più elevati di BNP (p = 0,004). La conta leucocitaria ha correlato anche con la necessità di CRRT (p = 0,021). Anche se non significativo, è stato rilevato un trend di correlazione tra età e durata della degenza (ρ = 0,436), e tra età e conta leucocitaria (p = 0,054). In conclusione, si dimostra che il valore diagnostico e prognostico dei dati routinari di terapia intensiva correlati con nuovi biomarcatori, deve essere adattato per ogni paziente settico in base alle loro malattie di base, disabilità e riserva funzionale al fine di giustificare trattamenti intensivi e razionalizzare le risorse disponibili

A Byzantine Metaphysics of Artefacts? The Case of Michael of Ephesus’ Commentary on Aristotle’s Metaphysics

The ontology of artefacts in Byzantine philosophy is still a terra incognita. One way of mapping this unexplored territory is to delve into Michael of Ephesus’ commentary on Aristotle’s Metaphysics. Written around 1100, this commentary provides a detailed interpretation of the most important source for Aristotle’s ontological account of artefacts. By highlighting Michael’s main metaphysical tenets and his interpretation of key-passages of the Aristotelian work, this study aims to reconstruct Michael’s ontology of artefacts and present it as one instance, which is perhaps exemplary, of the Byzantine ontology of artefacts. In particular, the study shows that this commentary holds a definite position on the nature of artefacts, according to which they are neither substances nor hylomorphic compounds. Indeed, artefacts lack a form altogether and their forms exist only in thought. As a result, Michael’s commentary provides an ontological interpretation of artefacts as accidental beings, i.e., as matter which acquires a mere property as opposed to a substantial form. While such an interpretation shows originality when compared to the Aristotelian text, it also indicates adherence to the reading established by Alexander of Aphrodisias, despite important departures concerning the status of natural forms.publishedVersio

Aristotle’s Take on Inadvertently Made Objects

The way metaphysicians conceive of inadvertently made objects has consequences for their understanding of the relation between intentions and kinds. Indeed, the very possibility of concrete material objects produced without human intention shakes the common identification of an object’s kind and the intentions of the maker. The disruptive potential of inadvertently made objects also affects historians of philosophy, who have often failed to engage with the issue. In this paper, I shall reconstruct Aristotle’s account of inadvertently made objects and the fortune of his examples. I will argue that Aristotle opens a conceptual space for inadvertent objects and will indicate the consequences for the relation between the intentions of the maker and an object’s essence. Furthermore, I will put Aristotle into conversation with modern accounts and show the extent to which Aristotelian inadvertent objects constitute an instance different from the currently debated cases of appropriation, residues and by-products.publishedVersio

BUAP bachelor’s degree in English language teaching teachers’ conceptualizations towards integrating culture within language teaching: a case study

"This research displays a concern about the integration of culture into language education, especially in a context wherein students are educated as they are pursuing a Bachelor’s degree in English Language Teaching. Such interest has been led by the concept of interculturality, a notion and process that has been uprising as a result of the spread of cross-cultural communication and that therefore, has influenced language education. When interculturality is placed in an educational context, it translates into intercultural competence, which, in this research, can be understood through the concepts of language, culture, and the relationship between these two notions. In the first place, what authors have stated as well as the alternatives they have given regarding the approach to culture within language education bearing in mind an intercultural stance are documented. Secondly, the conceptions that a group of language teachers from Benemérita Universidad Autónoma de Puebla (BUAP) hold with respect to the teaching of culture in language education are surveyed. Last of all, this work grants an analysis that integrates the theory grounding the relevance of the cultural component within language teaching and the language teachers’ conceptualizations of notions such as language, culture and how they are related"

Local Government Cybersecurity: How Michigan Counties Cope with Cyber Threats

In the age of global interconnectedness, we can all be equally affected by cyberattacks. Given the evolving nature of threat landscapes, comprehensive and preemptive practices are needed now more than ever to keep local government and citizen data secure. According to Recorded Future, in 2019, local U.S. government infrastructure was targeted by ransomware attacks 100 times. Cyber threats to local government systems have been increasing exponentially over the last several years, and the frequency of attacks will only continue to grow. Although cyberattacks on local government entities are rising every year, the challenges county IT departments face in combating the thousands of yearly attacks remains largely unexamined. This research study aims to understand how Michigan counties are currently protecting their IT systems, define the challenges they face in improving their cybersecurity posture, and address the potential improvements regarding current cybersecurity practices. This thesis addresses these goals through semi-structured interviews and a post-interview questionnaire with local government IT leaders across the State of Michigan. The results of this research study found challenges local Michigan governments face in enhancing their county's culture of cybersecurity, operating with limited funding and support, and inability to properly utilize state resources due to limited staffing needed to operationalize. A surprising finding was learning how essential communication and relationship building are to cybersecurity and how these relationships impact the culture of cybersecurity in an organization. By identifying these challenges, policymakers can introduce evidence-based policies that will address the essential needs of local Michigan counties and provide actionable and implementable solutions. Additionally, it will enable researchers and cybersecurity professionals to develop recommendations and mitigating solutions to improve local Michigan government cybersecurity.Master of Science in InformationSchool of Informationhttp://deepblue.lib.umich.edu/bitstream/2027.42/168552/1/20210511_Duque,Marilu_Final_MTOP_Thesis.pd

The discursive impact of transnational advocacy networks : how amnesty international and human rights watch influenced the media coverage of the Rwanda genocide

Initial representations of the Rwanda genocide in the Western media were at best inaccurate and at worst, stereotypical, citing African tribal savagery and centuries-old tribal hatred as the reason for the mass killings. Two major human rights organizations, Amnesty International and Human Rights Watch, had the opportunity to correct media portrayals and help shape the agenda for policymakers. The purpose of this study was to take a critical look at media portrayals and discover whether these two nongovernmental organizations played a role in influencing the coverage. An extensive media analysis of three elite Western newspapers found that NGOs were the single largest source of nuanced political explanations countering stereotypes of African tribal warfare. Human Rights Watch, in particular, played a pivotal role in sensitizing the media to the genocide\u27s character as a planned, politically motivated campaign

From Policy to Local Practice: an Implementation Study of the Mother Tongue-based Multilingual Education in the Philippines

The public school system in the Philippines adopted a multilingual policy starting in school year 2012-2013. Implemented as the Mother Tongue-Based Multilingual Education program, the policy localizes the language of early literacy and instruction, the content of the curriculum, and the support systems. This signals a shift away from the country’s long history of standardized curriculums with their one-size-fits-all approach and Western, colonial paradigms, and language policies with their preferential treatment of the colonizer’s language (English) and/or national language. This dissertation describes and assesses how the program was implemented in its first year. The focus is on resources or capacity to implement the program since the literature on implementation studies identifies the availability of these as a factor affecting the passage from policy to local practice. Using the case study design in qualitative research, one division and two elementary schools under it were purposively selected for this inquiry. All Grade 1 teachers in the two schools along with their curriculum consultants or instructional leaders (namely, their principal, district supervisor, and the division supervisor) comprised the study participants. Semi-structured interviews and document review were conducted over a period of one year to generate data. Theory-generated typologies from the conceptual framework as well as emergent themes or categories from real-life data guided the process of data organization and analysis. The findings suggest patterns that tended to reinforce institutional continuities rather than institutional shifts. Critical resources or capacities for change were not productively provided to the local implementers. Additionally, the resource or capacity gaps appeared to be underpinned by a lingering command or hierarchical structure. To get past the weight of this status quo, recommendations are offered. These include policies aimed at strengthening the practice of teacher expertise and instructional leadership, and at modifying the administration of the program to align the school language with the home language

A short & sweet story of CHO

The solid state nuclear magnetic resonance (SSNMR) study of nearly intact plant cell walls along with the computational study of glucose and malonic acid are presented. Previously unassigned 13C chemical shifts are presented for the various carbohydrates in the primary plant cell wall of Arabidopsis thaliana. A continuation of the SSNMR study involved the computational determination of glucose chemical shifts, a model compound for the study of larger carbohydrates. Additional computational studies determined the energy relationship between hydrated tautomers of malonic acid, a commonly occurring atmospheric dicarboxylic acid. In the malonic acid study, agreement between experiment and calculated frequencies verified the presence of the enol form of malonic acid. The development and analysis of a chemical education tool, a quantum chemistry concept inventory, whose aim is to understand misconceptions is also included in this dissertation