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The vegetative state is a condition in which a person is wakeful without being aware. To understand a patient who can be considered neither alive nor dead, caregivers and professionals re-define traditional identities, roles, and practices. By drawing on wider research, in the current chapter, we aimed to show how caregivers and practitioners positioned the patient and themselves within the institutional context of five nursing homes in Lombardy. We conducted 65 semi-structured interviews with 35 caregivers (sons, partners, parents) and 30 professionals (health, mental health professionals, and social workers). Our discourse analysis identified three different interpretative repertoires to position the patient: an organic, an interactional, and a possibilistic one. Their encounter both leads to disagreement and convergence. In particular, by taking each other’s perspective, professionals and caregivers might converge toward the common ground of balanced hope, where the possibility for patients’ awareness is neither fostered nor denied. In this space of possibilities, caregivers find a justification for their monitoring and patient stimulation activity and take on the role of spokesperson for the patient. This common ground allows them to communicate, justify their reciprocal action and acknowledge their roles and expertise in taking care of the patient.

High genetic heterogeneity in the human leukocyte antigen (HLA) increases the likelihood of efficient immune response to pathogens and tumours. As measure of HLA diversity, HLA evolutionary divergence (HED) has been shown to predict the response of tumours to immunotherapy and haematopoietic stem cell transplantation (HSCT) in adults. We retrospectively investigated the association of HED with outcomes of 153 paediatric/young adults patients, treated for malignant disorders with HSCT from 9–10/10 HLA-matched unrelated donors. HED was calculated as pairwise genetic distance between alleles in patient HLA-A, -B, -C, -DRB1, -DQB1 and -DPB1, using the locus median to stratify patients with ‘high’ or ‘low’ HED. Patients with high HED-B and -DRB1 showed significantly improved disease-free survival (DFS), especially when combined (70.8% vs 53.7% p = 0.008). High HED-B + -DRB1 was also associated with improved overall survival (OS) (82.1 vs 66.4% p = 0.014), and concomitant reduction of non-relapse-mortality (5.1% vs 21.1% p = 0.006). The impact on OS and DFS of combined HED-B + -DRB1 was confirmed in multivariate analysis [hazard ratio (HR) 0.39, p = 0.009; and HR 0.45, p = 0.007 respectively]. Only high HED scores for HLA-DPB1 were associated, in univariate analysis, with reduced incidence of relapse (15.9% vs 31.1%, p = 0.03). These results support HED as prognostic marker in allogeneic HSCT and, if confirmed in larger cohorts, would allow its use to inform clinical risk and potentially influence clinical practice.

Trichosporon japonicum is a very rare opportunistic yeast causing fungal disease in humans, especially in immunocompromised hosts. Here, we describe a new case of T. japonicum isolated from the blood of a pyrexial pediatric patient with refractory acute B cell lymphoblastic leukemia and acute respiratory distress. Prompt diagnosis through early clinical suspicion and appropriate molecular microbiology analysis allowed the yeast to be accurately identified at species level. Subsequent drug susceptibility testing and focused antifungal treatment with voriconazole and amphotericin B led to a complete clinical and mycological resolution of the infection, which represents the second successful case of T. japonicum bloodstream infection described in literature to date.

The paper presents a collection of analytical benchmark problems specifically selected to provide a set of stress tests for the assessment of multifidelity optimization methods. In addition, the paper discusses a comprehensive ensemble of metrics and criteria recommended for the rigorous and meaningful assessment of the performance of multifidelity strategies and algorithms.

Pandemics often put science and scientists at the centre of the public discussion, having relevant effects on the science-society relationships (Metcalfe et al., 2020). For instance, while trust in science as an endeavour may remain stable, trust in scientist may reduce significantly (Eichengreen et al., 2020). During the COVID-19 pandemic, health agencies’ and doctors’ guidelines were crucial in orienting public policies (e.g., lockdowns) and social actions (e.g., wearing a mask). However, their role was surrounded by polemics (Observa, 2020). Being “amateur scientists”, laypeople do not passively accept experts’ opinions, but they actively re-elaborate and resist them (Bauer & Gaskell, 2009). Interestingly, the nature of this re-elaboration is often political (Hamilton & Safford, 2020). By comparing different political positionings, the ongoing research aims to: (1) investigate the contents of the emerging representations of science (themes and key players); (2) highlight the functions and the roles assigned to science-based institutions and scientists; (3) identify laypeople’s perspectives on the different sources of information. We conducted 60 semi-structured interviews with Italian laypeople (30 women; Age M = 44.4) having different political positionings: 30 supporting and 30 opposing the Italian government. Thirty interviews were conducted during the first wave (March-May 2020) and thirty during the second (November-December 2020). Our communication will discuss the results of our thematic analysis (Braun & Clark, 2006) by focusing on two dimensions: (1) the emerging representations of science and scientists in the two waves of infections in Italy and (2) the relationship between these representations and laypeople’s political leaning.

NO ABSTRACT

The present study aims to provide an overview of experiences of discrimination, harassment, and violence in a sample of Italian transsexuals who have undergone sex-reassignment surgery (SRS). Lack of support for gender transition from family members was also assessed, before and after SRS. Data were collected in the context of a multicentric study (Milan, Florence, and Bari) on SRS outcome. Patients who underwent SRS were contacted and asked to fill out a questionnaire concerning experiences of discrimination, harassment, violence, and crime they might have experienced in previous years. Seventy-two participants took part in the research: 46 were male-to-female (MtF; 64%) and 26 were female-to-male (FtM; 36%). Thirty-six percent of the total sample (with no differences between MtF and FtM) experienced at least one episode of harassment, violence, or discrimination. The workplace was reported to be the social area with the highest risk of discrimination and harassment (22% of participants). Reports of more than one incident of discrimination, harassment, and violence characterized the majority of participants in the MtF sample. Compared with previous studies carried out in other countries, a much larger proportion of participants could count on a supportive family environment before and after transition. Our results show that Italian society at large is prejudiced against transsexuals, but at a more “micro” level, having a trans person as a family member might result in a protective and tolerant attitude.

A framework for robust optimization under uncertainty based on the use of the generalized inverse distribution function (GIDF), also called quantile function, is here proposed. Compared to more classical approaches that rely on the usage of statistical moments as deterministic attributes that define the objectives of the optimization process, the inverse cumulative distribution function allows for the use of all the possible information available in the probabilistic domain. Furthermore, the use of a quantile based approach leads naturally to a multi-objective methodology which allows an a-posteriori selection of the candidate design based on risk/opportunity criteria defined by the designer. Finally, the error on the estimation of the objectives due to the resolution of the GIDF will be proven to be quantifiable, Comment: 20 pages, 25 figures

This paper investigates the field programmable gate array (FPGA) approach for multi-objective and multi-disciplinary design optimisation (MDO) problems. One class of optimisation method that has been well-studied and established for large and complex problems, such as those inherited in MDO, is multi-objective evolutionary algorithms (MOEAs). The MOEA, nondominated sorting genetic algorithm II (NSGA-II), is hardware implemented on an FPGA chip. The NSGA-II on FPGA application to multi-objective test problem suites has verified the designed implementation effectiveness. Results show that NSGA-II on FPGA is three orders of magnitude better than the PC based counterpart.

NV 20150416, SUPERTRAC

The design activity within the EUROLIFT II project is targeted towards an improvement of the take-off performance of a generic transport aircraft configuration by a re-design of the trailing edge flap. The involved partners applied different optimization strategies as well as different types of flow solvers in order to cover a wide range of possible approaches for aerodynamic design optimization. The optimization results obtained by the different partners have been cross-checked in order to eliminate solver dependencies and to identify the best obtained design. The final selected design has been applied to the wind tunnel model and the test in the European Transonic Wind Tunnel (ETW) at high Reynolds number confirms the predicted improvements.

The design activity within the EUROLIFT II project is targeted towards an improvement of the take-off performance of a generic transport aircraft configuration by a re-design of the trailing edge flap. The involved partners applied different optimization strategies as well as different types of flow solvers in order to cover a wide range of possible approaches for aerodynamic design optimization. The optimization results obtained by the different partners have been cross-checked in order to eliminate solver dependencies and to identify the best obtained design. The final selected design has been applied to the wind tunnel model and the test in the European Transonic Wind Tunnel (ETW) at high Reynolds number confirms the predicted improvements.

Aerodynamic shape design is a challenging application for modem computational fluid dynamic. This is, in-deed, a very productive field, both in term of scientific publications and developed applications. Furthermore it is possible to find excellent analysis/design software released in the public domain. However, industry, in particular automotive and aerospace, but also emerging fields like wind and sea extracted energy, continuously needs increased product performance and competitiveness. This requires increasingly refined, advanced and complex computational models capable of describing flow behavior with higher and higher fidelity. Thus the design tools available to scientist and engineers are challenged by the growing complexity of simulation models. The increasing price to performance ratio of nowadays computers is a strong allied of designers in this though race, but often it is not enough. Objectives of this lecture is to explore and analyze some of the technologies that, together with the increasingly available computational power, may help to exploit the tremendous potential of high fidelity flow field models to aerodynamic shape design challenges. For the sake of simplicity we will concentrate on aerofoil design. Two aspects will be considered: the computer algebra assisted development of code related to gradient computation through adjoint techniques and the use of fitness approximation techniques to improve the performance of search procedures. The concern of this first lecture will be more methodological, while some applications will be illustrated in the next one. The outline of the first part of this lecture is as follows: some short remarks on adjoint problems will introduce the framework in which the Computer Algebra techniques will be mainly used here., See also ADM001519. Published in proceedings, RTO-EN-022, p9-1 through 9-25, 2003. Presented at the RTO AVT Course on Intelligent Systems for Aeronautics held in Rhode-Saint-Genese, Belgium on 13-17 May 2002. The original document contains color images.

An application of hybrid optimization techniques to airfoil design with Navier-Stokes equations is here presented and discussed. The greatest obstacle in the use of Navier-Stokes equations with evolutionary optimization procedures is the huge computational effort required. To overcome this limit, several approaches have been suggested, that range ion% parallel genetic algorithms to approximated fitness evaluation to hybrid techniques. These three approaches can be profitably combined and an example will be here given related to transonic airfoil design. The lecture is organized as follows: an outline of hybrid optimization techniques will be given then the parallel hybrid genetic algorithm will be presented. Thereafter an application example will be reported, and finally some ongoing developments about the hybrid approach based on gradient computation through the adjoint to Navier-Stokes equations will be described., See also ADM001519. Published in proceedings, RTO-EN-022, p12-1 through 12-13, 2003. Presented at the RTO AVT Course on Intelligent Systems for Aeronautics held in Rhode-Saint-Genese, Belgium on 13-17 May 2002. The original document contains color images.

In this work a transonic wing design problem is faced by means of a multiobjective genetic algorithm, and using a full potential flow model. The applications here presented regard both planform and wing section optimization. It is shown how both geometric and aerodynamic constraints can be taken into account, and how the multiobjective approach to optimization can be an effective way to handle conflicting design criteria. An interpolation technique allowing a better approximation of Pareto fronts is described. Two possible ways of improving the computational efficiency of the genetic algorithm, namely a parallel implementation of the code and a hybrid optimization approach, are presented., Presented at Symposium of RTO Applied Vehicle Technology Panel (AVT) Canada, 18-21 Oct 1999, p22-1/22-12. This article is from ADA388284 Aerodynamic Design and Optimisation of Flight Vehicles in a Concurrent Multi-Disciplinary Environment (la Conception et l'optimisation aerodynamiques des vehicules aeriens dans un environnement pluridisciplinaire et simultane)