Una valutazione ragionata delle principali linee guida internazionali sulla farmacoterapia della schizofrenia

This review focuses on a comparative analysis on international Guidelines for the treatment of schizophrenia and, more generally, on specific literature, starting from the 2004 APA Guidelines. The first issue taken into consideration is treatment: general purpose of drug treatment is generally distinguished from specific target as well as needs of specific therapeutic practices are distinguished from theoretical aspects of optimal treatment. Guidelines refer to a global reduction in symptoms, primarily in terms of potential clinical recovery. The complexity of schizophrenia implies the need to consider different options for treatment due to the clinical phase of the disorder and other critical factors. The choice of drug treatment is thus considered as a priority in the acute phase of schizophrenia and should be considered as continuous and possibly indefinite, if the response is inadequate or there are frequent relapses over time. The definition of clinical phases of schizophrenia is linked to the chosen reference. The analysis then focuses on the pharmacological treatment of schizophrenia in its various phases, with particular reference to similarities/differences and limitations of the Guidelines. The impression given by a comparative reading of the Guidelines taken into consideration, is that of a general separation between indications for pharmacological management of schizophrenia and clinical practice, both in the acute and chronic phase. Authors then examine the general recommendations to specific drugs focusing particularly on the relationship between first and second generation antipsychotics, with an analysis of comparative efficacy and special considerations (eg, negative symptoms, cognitive symptoms, resistance); recommendations regarding antipsychotic therapy in schizophrenia and early-onset time and duration and treatment strategies are also described and commented. Particular attention is devoted to side effects and monitoring of physical health, both in terms of neurological effects (Tables II-III) and of effects on sexual (Table IV) and hepatic function. Much space is devoted to emerging issues such as metabolic syndrome, obesity, dyslipidemia, diabetes (Tables VI) and cardiovascular risk (Table VII) with emphasis on the growing awareness that many side effects, especially metabolic ones, require particular care with a multidisciplinary approach

Application of Correct-by-Construction Principles for a Resilient Risk-Aware Architecture

In this paper we discuss the application of correct-by-construction techniques to a resilient, risk-aware software architecture for onboard, real-time autonomous operations. We mean to combat complexity and the accidental introduction of bugs through the use of verifiable auto-coding software and correct-by-construction techniques, and discuss the use of a toolbox for correct-by-construction Temporal Logic Planning (TuLiP) for such a purpose. We describe some of TuLiP’s current functionality, specifically its ability to model symbolic discrete systems and synthesize software controllers and control policies that are correct-by-construction. We then move on to discuss the use of these techniques to define a deliberative goal-directed executive capability that performs risk-informed action-planning – to satisfy the mission goals (specified by mission control) within the specified priorities and constraints. Finally, we discuss an application of the TuLiP process to a simple rover resilience scenario

Prevalence, Outcome, and Prevention of Congenital Cytomegalovirus Infection in Neonates Born to Women with Preconception Immunity (CHILd Study)

Background: Human cytomegalovirus (HCMV) is the leading infectious cause of congenital disabilities. We designed a prospective study to investigate the rate, outcome, and risk factors of congenital CMV (cCMV) infection in neonates born to immune women, and the potential need and effectiveness of hygiene recommendations in this population. Methods: The study was composed of 2 sequential parts: an epidemiology (part 1) and a prevention (part 2) study. Performance of part 2 depended upon a cCMV rate >0.4%. Women enrolled in part 1 did not receive hygiene recommendations. Newborns were screened by HCMV DNA testing in saliva and cCMV was confirmed by urine testing. Results: Saliva swabs were positive for HCMV DNA in 45/9661 newborns and cCMV was confirmed in 18 cases. The rate of cCMV was. 19% (95% confidence interval [CI]:. 11-.29%), and 3 out of 18 infants with cCMV had symptoms of CMV at birth. Age, nationality, occupation, and contact with children were similar between mothers of infected and noninfected newborns. Twin pregnancy (odds ratio [OR]: 7.2; 95% CI: 1.7-32.2; P =. 037) and maternal medical conditions (OR: 3.9; 95% CI: 1.5-10.1; P =. 003) appeared associated with cCMV. Given the rate of cCMV was lower than expected, the prevention part of the study was cancelled. Conclusions: Newborns from women with preconception immunity have a low rate of cCMV, which appears to be mostly due to reactivation of the latent virus. Therefore, serological screening in childbearing age would be pivotal to identify HCMV-seropositive women, whose newborns have a low risk of cCMV. Clinical trials registration: www.clinicaltrials.gov (NCT03973359)

Constraint solving in uncertain and dynamic environments - a survey

International audienceThis article follows a tutorial, given by the authors on dynamic constraint solving at CP 2003 (Ninth International Conference on Principles and Practice of Constraint Programming) in Kinsale, Ireland. It aims at offering an overview of the main approaches and techniques that have been proposed in the domain of constraint satisfaction to deal with uncertain and dynamic environments

Practical Verification of Decision-Making in Agent-Based Autonomous Systems

We present a verification methodology for analysing the decision-making component in agent-based hybrid systems. Traditionally hybrid automata have been used to both implement and verify such systems, but hybrid automata based modelling, programming and verification techniques scale poorly as the complexity of discrete decision-making increases making them unattractive in situations where complex log- ical reasoning is required. In the programming of complex systems it has, therefore, become common to separate out logical decision-making into a separate, discrete, component. However, verification techniques have failed to keep pace with this devel- opment. We are exploring agent-based logical components and have developed a model checking technique for such components which can then be composed with a sepa- rate analysis of the continuous part of the hybrid system. Among other things this allows program model checkers to be used to verify the actual implementation of the decision-making in hybrid autonomous systems

Advancing multi-vehicle deployments in oceanographic field experiments

Our research concerns the coordination and control of robotic vehicles for upper water-column oceanographic observations. In such an environment, operating multiple vehicles to observe dynamic oceanographic phenomena, such as ocean processes and marine life, from fronts to cetaceans, has required that we design, implement and operate software, methods and processes which can support opportunistic needs in real-world settings with substantial constraints. In this work, an approach for coordinated measurements using such platforms, which relate directly to task outcomes, is presented. We show the use and operational value of a new Artificial Intelligence based mixed-initiative system for handling multiple platforms along with the networked infrastructure support needed to conduct such operations in the open sea. We articulate the need and use of a range of middleware architectures, critical for such deployments and ground this in the context of a field experiment in open waters of the mid-Atlantic in the summer of 2015.Advancing multi-vehicle deployments in oceanographic field experimentsacceptedVersio