Digital governance in tax-funded European healthcare systems: From the Back office to patient empowerment

Digital healthcare promises to achieve cost-efficiency gains, improve clinical effectiveness, support better public sector governance by enhancing transparency and accountability, and increase confidence in medical diagnoses, especially in the field of oncology. This article aims to discuss the benefits offered by digital technologies in tax-based European healthcare systems against the backdrop of structural bureaucratic rigidities and a slow pace of implementation. Artificial intelligence (AI) will transform the existing delivery of healthcare services, inducing a redesign of public accountability systems and the traditional relationships between professionals and patients. Despite legitimate ethical and accountability concerns, which call for clearer guidance and regulation, digital governance of healthcare is a powerful means of empowering patients and improving their medical treatment in terms of quality and effectiveness. On the path to better health, the use of digital technologies has moved beyond the back office of administrative processes and procedures, and is now being applied to clinical activities and direct patient engagement

Is ALT control really necessary for routine ART monitoring in resource poor settings?

2006 AIDS Conference in Toront

On the role of galactic magnetic halo in the ultra high energy cosmic rays propagation

The study of propagation of Ultra High Energy Cosmic Rays (UHECR) is a key step in order to unveil the secret of their origin. Up to now it was considered only the influence of the galactic and the extragalactic magnetic fields. In this article we focus our analysis on the influence of the magnetic field of the galaxies standing between possible UHECR sources and us. Our main approach is to start from the well known galaxy distribution up to 120 Mpc. We use the most complete galaxy catalog: the LEDA catalog. Inside a sphere of 120 Mpc around us, we extract 60130 galaxies with known position. In our simulations we assign a Halo Dipole magnetic Field (HDF) to each galaxy. The code developed is able to retro-propagate a charged particle from the arrival points of UHECR data across our galaxies sample. We present simulations in case of Virgo cluster and show that there is a non negligible deviation in the case of protons of $7 \times 10^{19}$ eV, even if the $B$ value is conservative. Then special attention is devoted to the AGASA triplet where we find that NGC3998 and NGC3992 could be possible candidates as sources.Comment: Version accepted from ApJ, 5 figure

Bistable nonlinear damper based on a buckled beam configuration

International audienceThis article addresses a particular realization of a compact bistable nonlinear absorber based on the concept of Nonlinear Energy Sink. The article presents both a detailed description of the absorber mechanics and an illustration of the targeted energy transfer between the absorber and a linear system. The experimental results are accompanied with the numerical simulations. Beside practical improvements linked to the features of absorber design, the obtained results stay in line with those found for simpler realizations of a bistable Nonlinear Energy Sinks

Loss of correlation between HIV viral load and CD4+ T-cell counts in HIV/HTLV-1 co-infection in treatment naive Mozambican patients

Seven hundred and four HIV-1/2-positive, antiretroviral therapy (ART) naïve patients were screened for HTLV-1 infection. Antibodies to HTLV-1 were found in 32/704 (4.5%) of the patients. Each co-infected individual was matched with two HIV mono-infected patients according to World Health Organization clinical stage, age +/-5 years and gender. Key clinical and laboratory characteristics were compared between the two groups. Mono-infected and co-infected patients displayed similar clinical characteristics. However, co-infected patients had higher absolute CD4+ T-cell counts (P = 0.001), higher percentage CD4+ T-cell counts (P < 0.001) and higher CD4/CD8 ratios (P < 0.001). Although HIV plasma RNA viral loads were inversely correlated with CD4+ T-cell-counts in mono-infected patients (P < 0.0001), a correlation was not found in co-infected individuals (P = 0.11). Patients with untreated HIV and HTLV-1 co-infection show a dissociation between immunological and HIV virological markers. Current recommendations for initiating ART and chemoprophylaxis against opportunistic infections in resource-poor settings rely on more readily available CD4+ T-cell counts without viral load parameters. These guidelines are not appropriate for co-infected individuals in whom high CD4+ T-cell counts persist despite high HIV viral load states. Thus, for co-infected patients, even in resource-poor settings, HIV viral loads are likely to contribute information crucial for the appropriate timing of ART introduction

Party system change and parliamentary scrutiny of the Executive in Italy

Conventional wisdom suggests that internal institutionalisation of parliamentary procedures causes greater policy effects on executive decisions and secondary legislation. The role played by parliaments in policy-making depends on internal processes, but it also depends on other factors, such as the changing structure of the party system \u2013 the bipolarisation of which determines the legislative opposition\u2019s strategy and performance. The empirical research discussed in this paper shows that the Italian parliamentary process for approving and implementing secondary legislation changed considerably \u2013 from pervasive and substantive to formalistic and procedural \u2013 during the 1990s, as a result of the parliamentary opposition behaving differently in response to the accomplished alternation in government. Despite the greater institutionalisation of the Italian Parliament, parliamentary scrutiny of secondary legislation has in fact had a diminishing impact on policy. This paper evaluates the increasingly limited power of parliamentary committees to amend delegated legislation in draft against a comparative analysis of the law-making process and performance of the opposition. The effect on policy of parliamentary scrutiny of secondary legislation is found to be proportionately related to consociational practices during the legislative process. The scrutiny of parliaments is greater when the balance between the legislative majority and opposition is characterised by consociational practices