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In this project the authors use a narrative medicine (NM) approach to assess the promotion of trust in the relationship between physicians and their asthma patients. Following a NM educational course for physicians, a research was carried out in which at least 5 written narratives (parallel charts) for each participating physician were collected and qualitatively analysed according to Bury’s classification and the Grounded Theory. The results of this study were of speculative and clinical interest. In particular, 66 participants wrote 314 narratives (246 on adult and 68 on paediatric patients). As a result of applying the NM approach, when the relationships remained problematic, many physicians wrote with a moral style about their adult (67%), and paediatric patients (33%) - especially in cases of asthmatic children’s or adolescents’ overprotective or absent families (40%) -. On the contrary, physicians who were able to listen to their patients with empathy (35%) made more shared decisions with patients, even with those they initially had a bad relationship. The used words of welcome, interest and acceptance were promoting patients’ trust that lead to restoring their activities in 45% of cases, according to physicians self-reporting. These approaches of NM are useful in daily clinical practice, with the goal of improving the quality of life (QOL) of patients with severe asthma, even in cases in which the doctor-patient relationship isn’t initially good.

Recently, a new methodological approach to empirics of economic dynamics based on nonparametric analysis has been proposed. The approach contemplates the presence of mechanisms of polarization and spatial linkage affecting the spatial characteristics of growth that are ruled out by the basic neoclassical approach while being the starting point of core-periphery models. A nonparametric investigation on the geographical distribution of local labor markets performances in Italy is presented, summarized by the employment rate. The analysis provides empirical support to the prediction that the behavior of the entire cross-section distribution of Italian employment rate can be mainly explained by proximity, and therefore by spatial spillover. The analysis is carried out on a very disaggregated territorial level: the area units considered are the 784 Local Labour Systems (LLSs), defined as “travel-to-works” areas by the National Statistical Institute (Istat). The basic idea is that distribution dynamics changes whenever conditioned with respect to spatial closeness of LLSs. I investigated the distribution dynamics of employment rate in LLSs over the 1971 to 1996 period by using transition matrices and the stochastic kernel approach. The results show that the employment rate distribution across LLSs has a strong polarization, but it vanishes if it is conditioned to the closer neighbors' employment rate. The analysis suggests that the local labor market performances inside Italy do not present strong territorial discontinuities. This is related to the geographical position of the country with respect to the relevant markets, and it is consistent with the predictions of the core-periphery model.

Detection and ultrastructural localization of aspartyl proteinase (Sap) in Candida albicans experimentally infecting rat vagina were studied. Two Sap-positive (Sap+) and one Sap-negative (Sap-) strains of the fungus, endowed with high and low experimental vaginopathic potential, respectively, were used. Both Sap+ strains produced consistent Sap levels in the rat vagina, while the Sap- strain did not produce any measurable Sap. Electron microscopy of thin sections of chemically-fixed vaginal scrapings showed clear evidence of hyphae of proteolitic strains of C. albicans invading the keratinized epithelial cell layer of the vagina. The fungal cells exhibited a pronounced fibrillar layer on the cell wall with a marked intermixing of fungal and vaginal materials especially pronunced at the hyphal tip. Post-embedding immunogold techniques with the use of anti-Sap polyclonal and the specifically generated monoclonal antibody GF1 showed that Sap was essentially localized in the cell wall of C. albicans early during infection, in a cytological pattern mirroring Sap localization in C. albicans cells grown in Sap-inductive media in vitro. In summary, the data offer a new biochemical and ultrastructural evidence that Sap is actively secreted during experimental rat vaginitis by C. albicans. Cell wall localization of Sap is probably inherent to this active secretion process.

The aim of this work was to study possible differences in the humoral response against autologous and heterologous (bacterial and mammalian) ssDNA in children with diffuse connective tissue diseases (DCTD) compared with age matched controls. We found that IgM anti ssDNA were significantly increased in systemic lupus eritematosus (SLE) and in juvenile arthritis (JA), but not in juvenile dermatomyositis (JDM). IgG anti ssDNA were significantly elevated only in children with SLE. We next evaluated the binding specificity to human and bacterial ssDNA by inhibition assays. We found that SLE and JA sera recognised epitopes shared in common to endogenous and bacterial ssDNA. In contrast, in normal subjects IgG binding to bacterial DNA was not inhibited by human DNA, while IgG anti human ssDNA were cross reactive with the bacterial antigen.These data suggest that natural antibodies (IgM) producing cells are activated in some but not all DCTD, and that normal children have different reactivity against autologous and heterologous ssDNA with respect to SLE and JA patients.

The aim of this study is to identify a class of models that appropriately describe the wind power production in wind farms and to provide reliable forecasts in a 72-hour horizon. The activity of the turbines in a wind farm determines the total power produced at a point in time. Their functioning depends on climatic conditions and on electrical and/or mechanical breaks. The latter can be either controlled (in case of maintenance) or uncontrolled (in case of dysfunctions). Therefore, both the uncertainty related to the climate (wind speed, direction, air density etc.) and to the functioning of turbines affect the total power generation in the wind farm. We propose a new approach for modeling these sources of variability, focusing on the average power production rather than on the overall wind farm power production, like the previous literature. The advantage of this strategy is to reduce the high variability of the total power, separating the climatic component from the mechanical functioning of the turbines. We propose several models, all in the form of a dynamic system of equations, of increasing complexity due to the number of variables that have to be estimated in the system.