Decisiones públicas y efectividad de los derechos humanos.

The complexity of the relations between contemporary legal systems implies a linking problem between the decision-making process and the recipients of the decisions, considering the growing uncertainty of acknowledging the convergence between the decision-makers and the recipients of those, that doesn’t find enough representation in the synthetic scheme of procedural democracy and in the free acceptance of power. The recipients of the decisions, coming from the institutions that de facto have the power to assume, related to the criteria of distribution of the rights and of the most essential ones, are not embodying the status of ‘citizenship’, or it is assumed in a very limited form. In the work, adopting the neo-contractual theory of J. Rawls and assuming as prioritary the problem of effectiveness, are examined all the aspects of the not perceived violation of the basic principle Quod omnes tangit ab omnibus approbari debet, in the framework of the close and ineluctable bond among the effectiveness of the law systems, the effective guarantee of the basic human rights, the concept of democratic citizenship and the the concept of democracy itself.La complejidad de las relaciones jurídicas contemporáneas plantea un problema de conexión entre las decisiones producidas y sus destinatarios por la dificultad creciente de reconocer la coincidencia entre los que deciden y los destinatarios de las decisiones, que ya no logra encontrar una adecuada representación en el esquema sintético de la democracia procedural y de la libre aceptación del poder. Los destinatarios de las decisiones relativas a los criterios de distribución de los derechos y de los bienes fundamentales no poseen el estatus de ciudadano -o, si lo tienen, es muy débilde las entidades que, de hecho, tienen el poder de tomar esas decisiones. Sobre la base de la elaboración neocontractualista de J. Rawls, y adquiriendo como prioritaria la cuestión de la efectividad, en el ensayo se analizan los aspectos de esta no alarmada violación del principio Quod omnes tangit ab omnibus approbari debet, en el marco de la estrecha e ineludible conexión entre la efectividad de los ordenamientos jurídicos, la efectiva garantía de los derechos fundamentales, el concepto de ciudadanía democrática y el mismo tema de la democracia

Utilization of big data to improve management of the emergency departments. Results of a systematic review

Background. The emphasis on using big data is growing exponentially in several sectors including biomedicine, life sciences and scientific research, mainly due to advances in information technologies and data analysis techniques. Actually, medical sciences can rely on a large amount of biomedical information and Big Data can aggregate information around multiple scales, from the DNA to the ecosystems. Given these premises, we wondered if big data could be useful to analyze complex systems such as the Emergency Departments (EDs) to improve their management and eventually patient outcomes. Methods. We performed a systematic review of the literature to identify the studies that implemented the application of big data in EDs and to describe what have already been done and what are the expectations, issues and challenges in this field. Results. Globally, eight studies met our inclusion criteria concerning three main activities: the management of ED visits, the ED process and activities and, finally, the prediction of the outcome of ED patients. Although the results of the studies show good perspectives regarding the use of big data in the management of emergency departments, there are still some issues that make their use still difficult. Most of the predictive models and algorithms have been applied only in retrospective studies, not considering the challenge and the costs of a real-time use of big data. Only few studies highlight the possible usefulness of the large volume of clinical data stored into electronic health records to generate evidence in real time. Conclusion. The proper use of big data in this field still requires a better management information flow to allow real-time application

ER access by foreign citizens between 1999 and 2014 in five large hospital of Rome, Italy

...Lack of information about the health services and the status of illegal immigrant can make difficult for foreign population to access primary care, leading to misuse of emergency rooms (ER). This study investigated the accesses between January 1999 and December 2014 to the ERs of five large hospital of Rome, Italy

Emergency Department as an epidemiological observatory of Human Mobility: the experience of the Moroccan population

We conducted a retrospective study of the accesses to the Emergency Department registered from January 2000 to December 2014 in 5 major hospitals in the Metropolitan Area of Rome. We extrapolated data relating to patients of Moroccan origin from about 5 million total accesses, so we compared with Italians data which, in the same period, came to ED. The Moroccan population is distinguished by a larger number of diagnoses belonging to the ICD-9 code of Infectious Diseases and, more precisely, to Respiratory Infectious Diseases. There are also no differences in the assignment of such diagnoses to Moroccans with Italian citizenship, and this led to think that this could play an important role in the use of the ED and moreover that enrollment to the National Health Service may reduce its inappropriate use. Regarding to Degenerative Disorders, the result of our analysis is quite emblematic, showing that the accesses to the ED is due to Cardiovascular Diseases: 6.33% of Italians' accesses against 1.81% of Moroccans and 2.36% of Moroccans with Italian citizenship. The main explanation for this difference is, obviously, due to the age of the population: about 60% of Moroccans who accessed to ED was less than 40 years old. It is interesting how, in the field of ​​Cardiovascular Diseases, Moroccans have a lower percentage of diagnosis compared to Italians for acute diseases and a greater percentage of diagnoses for chronic diseases, suggesting once again that accesses to ED for migrants often is due to the inability to use the general services of the National Health Service. In conclusion, from the point of view of the Emergency Department, Migration Medicine still has Infectious Diseases as the main reason for access. Degenerative Disorders remain a prerogative of the Italians, but we could certainly assume that the Moroccan population would develop at some point with the aging

life threatening acute myocardial infarction due to left main dissection during radiofrequency transcatheter ablation of atrial tachycardia

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Millimeter wave spectroscopic measurements of stratospheric and mesospheric constituents over the Italian Alps: stratospheric ozone

Measurements of rotational lines emitted by middle atmospheric trace gases have been carried out from the Alpine station of Testa Grigia (45.9°N, 7.7°E, elev. 3500 m) by means of a Ground-Based Millimeter-wave Spectrometer (GBMS). Observations of species such as O3, HNO3, CO, N2O, HCN, and HDO took place during 4 winter periods, from February 2004 to March 2007, for a total of 116 days of measurements grouped in about 18 field campaigns. By studying the pressure-broadened shape of emission lines the vertical distribution of the observed constituents is retrieved within an altitude range of ?17-75 km, constrained by the 600 MHz pass band and the 65 kHz spectral resolution of the back-end spectrometer. This work discusses the behavior of stratospheric O3 during the entire period of operation at Testa Grigia. Mid-latitude O3 columnar content as estimated using GBMS measurements can vary by large amounts over a period of very few days, with the largest variations observed in December 2005, February 2006, and March 2006, confirming that the northern winter of 2005-2006 was characterized by a particularly intense planetary wave activity. The largest rapid variation from maximum to minimum O3 column values over Testa Grigia took place in December 2006 and reached a relative value of 72% with respect to the average column content for that period. During most GBMS observation times much of the variability is concentrated in the column below 20 km, with tropospheric weather systems and advection of tropical tropospheric air into the lower stratosphere over Testa Grigia having a large impact on the observed variations in column contents. Nonetheless, a wide variability is also found in middle stratospheric GBMS O3 measurements, as expected for mid-latitude ozone. We find that O3 mixing ratios at ?32 km are very well correlated with the solar illumination experienced by air masses over the previous ?15 days, showing that already at 32 km altitude ozone photochemistry dominates over transport processes. The correlation of lower stratospheric ozone concentrations with potential vorticity as an indicator of transport is instead not as clear-cut, due to very complex mixing processes that characterize stratospheric air at mid-latitudes. Correlations of O3 over Testa Grigia with stratospheric tracers such as N2O and HCN, also observed by means of the GBMS, are planned for the future, in order to better characterize lower stratospheric dynamics and therefore lower stratospheric ozone concentrations at mid-latitudes

Taurine: a potential marker of apoptosis in gliomas

New cancer therapies are being developed that trigger tumour apoptosis and an in vivo method of apoptotic detection and early treatment response would be of great value. Magnetic resonance spectroscopy (MRS) can determine the tumour biochemical profile in vivo, and we have investigated whether a specific spectroscopic signature exists for apoptosis in human astrocytomas. High-resolution magic angle spinning (HRMAS) 1H MRS provided detailed 1H spectra of brain tumour biopsies for direct correlation with histopathology. Metabolites, mobile lipids and macromolecules were quantified from presaturation HRMAS 1H spectra acquired from 41 biopsies of grades II (n=8), III (n=3) and IV (n=30) astrocytomas. Subsequently, TUNEL and H&E staining provided quantification of apoptosis, cell density and necrosis. Taurine was found to significantly correlate with apoptotic cell density (TUNEL) in both non-necrotic (R=0.727, P=0.003) and necrotic (R=0.626, P=0.0005) biopsies. However, the ca 2.8 p.p.m. polyunsaturated fatty acid peak, observed in other studies as a marker of apoptosis, correlated only in non-necrotic biopsies (R=0.705, P<0.005). We suggest that the taurine 1H MRS signal in astrocytomas may be a robust apoptotic biomarker that is independent of tumour necrotic status