Drastic Solutions Research Articles

First national analysis of severe obesity hospitalizations in Italy: insights from discharge card database.

Obesity is associated with numerous severe diseases necessitating intensive healthcare for diagnosis and treatment. Most patients with obesity, especially in its severe form, require at least one hospitalization. However, few studies in Italy have assessed the burden of obesity on the National Health System. This study aims to routinely estimate the 'disease burden' by analyzing hospital admissions related to severe obesity. We analyzed the medical records of the Italian national hospital discharge database, including all patients older than 18 years discharged with the diagnosis of 'severe obesity'.' We included patients who underwent bariatric surgery, even without an explicit obesity code, such as laparoscopic restrictive gastric procedures, other stomach operations, and high gastric bypass. Special focus was given to those who underwent abdominal reshaping surgery. The cross-sectional survey PASSI in Italy served as an additional data source to estimate. The phenomenon was described using appropriate indicators, including rates and ratios between rates. Linear regression was employed to analyze trends in standardized rates over time. Between 2014 and 2021, a total of 243,325 patients were discharged with a severe obesity code in Italy. Among these patients, 36.8% underwent at least one bariatric surgery procedure. We investigated the types of bariatric surgery procedures performed. The most frequent procedure was "other operations on the stomach," where sleeve gastrectomy is included which also appears to be steadily increasing during the study period together with the gastric bypass, while the gastric bondage is decreasing over time. These findings underscore the significant burden of severe obesity on Italy's healthcare system, a burden that is progressively increasing. The growing utilization of bariatric surgery suggests an escalating trend toward adopting drastic solutions to combat this health issue.

What Is life? Rethinking Biology in Light of Fundamental Parameters.

Defining life is an arduous task that has puzzled philosophers and scientists for centuries. Yet biology suffers from a lack of clear definition, putting biologists in a paradoxical situation where one can describe at the atomic level complex objects that remain globally poorly defined. One could assume that such descriptions make it possible to perfectly characterize living systems. However, many cases of misinterpretation put this assumption into perspective. In this article, we focus on critical parameters such as time, water, entropy, space, quantum properties, and electrostatic potential to redefine the nature of living matter, with special emphasis on biological coding. Where does the DNA double helix come from, why cannot the reproduction of living organisms occur without mutations, what are the limitations of the genetic code, and why do not all proteins have a stable three-dimensional structure? There are so many questions that cannot be resolved without considering the aforementioned parameters. Indeed, (i) time and space constrain many biological mechanisms and impose drastic solutions on living beings (enzymes, transporters); (ii) water controls the fidelity of DNA replication and the structure/disorder balance of proteins; (iii) entropy is the driving force of many enzymatic reactions and molecular interactions; (iv) quantum mechanisms explain why a molecule as simple as hydrocyanic acid (HCN) foreshadows the helical structure of DNA, how DNA is stabilized, why mutations occur, and how the Earth magnetic field can influence the migration of birds; (v) electrostatic potential controls epigenetic mechanisms, lipid raft functions, and virus infections. We consider that raising awareness of these basic parameters is critical for better understanding what life is, and how it handles order and chaos through a combination of genetic and epigenetic mechanisms. Thus, we propose to incorporate these parameters into the definition of life.

Technological imagination to stay within planetary boundaries. Seven necessary transitions

Technological imagination and innovation processes have always been at the basis of economic growth and the expansion of human domination over other species. Nevertheless, something seems to have got stuck. Can the leaps in technological development that make it possible to “reset” the clock to start growing again in a sustained form really be infinite? Or are we facing something different, a limit in the structural stability of the ecosystem itself? The worsening of the polycrisis – certainly also energetic – will require drastic solutions but should also finally allow the (re)emergence of radical ideas of renewal and transformation, as well as concrete proposals for spatial organisation associated with the new lifestyles they prefigure.

Study on Migration Path of Climate Refugees Based on Grey Prediction and Analytic Hierarchy Process

Earth is undergoing climate changes that are affecting our environment. Some of these changes are easy to adjust to, however, some changes of the climate are severe and require immediate drastic solutions. In this paper, we present a solution to dangers posed by rising sea levels in the Maldives. It is a tropical paradise, but it is vulnerable to storms and tsunamis, and due to slowly rising sea levels it could one day disappear completely! The Maldivians will eventually need to migrate to higher ground somewhere. First, we identify the metrics that will influence the process of the transfer of EDPs, while enabling the preservation of culture and language. Then we establish a grey prediction model to predict future changes in population, and identify when the chosen host country will be completely unfit for human habitation. Next we use the Analytic Hierarchy Process combining with the objective situation and subjective thoughts of EDPs to determine the relationship between factors represented by each variable. Finally, we propose policies considerate of all the possibilities so as to maximize the benefits for all involved parties.

The European enigma of pharmaceutical pricing: still solvable?

The attempt to regulate pharmaceutical pricing has a long tradition in Western European countries and various solutions have been experienced in recent decades to try to control public pharmaceutical spending. Nonetheless, drug prices have become increasingly out of control and unsustainable even in the richest European countries. In a situation of "market failure" such as the pharmaceutical one, in fact, two totally opposite needs collide: the main objective of the health authorities of universal access to essential drugs, versus the aim of the pharmaceutical industry to maximize turnover in order to guarantee high returns on investments. We are therefore convinced that the growing threat of drug prices that are too high must be solved with drastic solutions. The goal of this contribution is therefore to first summarize the current situation of pharmaceutical pricing in Western European countries, then debate the main issues currently discussed and finally propose a radically alternative scenario that moves from prices to the budget.

Potential and perspectives for establishing protected areas in El-Jabal El-Akhdar region, northeast Libya; an overview and example from ‘El-Abyar area’

This study was conducted in El-Abyar area in El-Jabal El-Akhdar region, northeast Libya. The aim was to study the environmental settings and the potential and possibility of establishing a protected area in this important region from a historical, biological, social, and economic point of view. The methodology included an intensive literature review, distribution of 300 questionnaires, soil and water analysis, fauna and flora survey, in addition to extensive field observation during the period from 2011 to 2021. The study highlighted the significant representative state of the study area for the whole El-Jabal El-Akhdar region in terms of environmental conditions and inappropriate anthropogenic pressure. Although the area has been severely degraded due to the arid climate coupled with decades of mismanagement, it still has remarkable ecological and environmental features and there is a feasible possibility of being converted into an effective protected area for biodiversity conservation with sustainable use of its natural resources by the local population (Category VI on the International Union for Conservation of Nature Classification for protected areas). The remaining barriers for which drastic solutions need to be implemented are a lack of awareness, a lack of protected areas guidelines and national perspectives, interest conflict with local people, a lack of constant funding, and failure of legislation enforcement.

Lane-Free Artificial-Fluid Concept for Vehicular Traffic

Vehicular traffic has evolved as a crucial means for the transport of persons and goods, and its importance for the economic and social life of modern society cannot be overemphasized. On the other hand, recurrent vehicular traffic congestion, which appears on a daily basis, particularly in metropolitan areas, around the globe, has been a (increasingly) serious, in fact threatening, problem that calls for drastic solutions. Traffic congestion causes excessive travel delays, substantial fuel consumption and environmental pollution, and reduced traffic safety. Conventional traffic management measures are valuable [1]-[3] but not sufficient to address the heavily congested traffic conditions, which must be addressed in a more comprehensive way that exploits gradually emerging and future ground-breaking capabilities of vehicles and the infrastructure.

How COVID-19 Changed the Information Needs of Italian Citizens.

Italy was the first European country to be affected by COVID-19, facing an unprecedented situation. The reaction required drastic solutions and highly restrictive measures, which severely tested the trust of the Italian people. Nevertheless, the effectiveness of the introduced measures was not only linked to political decisions, but also to the choice of the Italian people to trust and rely on institutions, accepting such necessary measures. In this context, the role of information sources was fundamental, since they strongly influence public opinion. The central focus of this research was to assess the information seeking behavior (ISB) of the Italian citizens, to understand how they related to information and how their specific use of information influenced public opinion. By making use of a survey addressed to 4260 Italian citizens, we identified extraordinarily virtuous behavior in the population: people strongly modified their ISB in order to address the most reliable sources. In particular, we found a very high reliance on scientists, which is particularly striking, if compared to the past. Moreover, starting from the survey results, we used social simulation to estimate the evolution of public opinion. Comparing the ISB during and before COVID-19, we discovered that the shift in the ISB, during the pandemic, may have actually positively influenced public opinion, facilitating the acceptance of the costly restrictions introduced.

Introdução de “Elites e trabalho no Brasil e no Uruguai: as origens do debate atual”

Este livro é uma reflexão sociológica sobre o posicionamento das elites parlamentares brasileiras e uruguaias em relação as leis trabalhistas no começo do século XX. É uma contribuição para o debate atual e polêmico sobre como conduzir uma sociedade no qual há cada vez menos exigências de trabalho humano e as crises econômicas empurram a soluções drámaticas como fim de leis trabalhistas. O tema das leis de trabalho atualmente retorna como uma tragicomédia de busca de soluções para a crise nas quais presenciamos o inusitado da defesa dos trabalhadores pelo emprego a qualquer preço a qualquer situação. Retornar ao começo do século XX e às polêmicas para implantação das primeiras leis trabalhistas contribui para perceber vis a vis o drama atual da sociedade latinoamericana e em especial Brasil e Uruguai.

The Need for Financial Incentive towards Joining Weight Loss Program among Malay Obese Married Women in Malaysia

Background: Abundant of health problem issues related to obesity nowadays require drastic solutions to prevent them from becoming worst. Therefore, one of supportive measure is by applying financial incentives. Previous studies suggested that financial incentives were effective to be applied to solve health problems among human being. However assessing the need for financial incentives among obese married women to join a weight loss program in order to combat with obesity in Malaysian context will need a slight review regarding their acceptability of financial incentives so as to ensure the successfulness of the intervention. Giving financial incentive for public is a huge investment so issues related to it should be considered. Methodology: An online survey was done among 30 respondents of married or ever married women who is currently having excess weight or obese. The survey was conducted by Survey Monkey to determine their acceptability about financial incentive through a weight loss program. The study was analysed in SPSS and the results were discussed in three aspects: age, types of occupation, and duration of being obese. Results and Discussion: The result shows that all different range groups of these obese married women agree to accept the idea of giving financial incentive by joining weight lost programs. However, the acceptance varies among different age, career status and how long has been obese. Conclusion: The need for financial incentive is a must and should be proceed immediately to encourage obese married women to join weight lost program in order to combat obesity in Malaysia.

Risk assessment of antimicrobial resistance along the food chain through culture-independent methodologies.

Antimicrobial resistance (AMR) represents a major challenge for Public Health and the scientific community, and requires immediate and drastic solutions. Acquired resistance to certain antimicrobials is already widespread to such an extent that their efficacy in the treatment of certain life‐threatening infections is already compromised. To date, the emergence and spread of AMR has been attributed to the use, misuse or indiscriminate use of antibiotics as therapeutic drugs in human, animal and plant health, or as growth promoters in veterinary husbandry. In addition, there is growing concern over the possibility of AMR transmission via the food chain. Food processing environments could act as potential hotspots for AMR acquisition and spread. Indeed, biocide use and exposure to food‐related stresses and food processing technologies could presumably act as selection pressures for increased microbial resistance against clinically relevant antibiotics. Global AMR surveillance is critical for providing the necessary information to form global strategies and to monitor the effectiveness of public health interventions as well as to detect new trends and emerging threats. Surveillance of AMR is currently based on the isolation of indicator microorganisms and the phenotypic characterisation of the strains isolated. However, this approach provides very limited information on the mechanisms driving AMR or on the presence and spread of AMR genes. Whole genome sequencing (WGS) of bacterial pathogens is a powerful tool that can be used for epidemiological surveillance, outbreak detection and infection control. In addition, whole metagenome sequencing (WMS) allows for the culture‐independent analysis of complex microbial communities, providing useful information on the occurrence of AMR genes. Both approaches can be used to provide the information necessary for the implementation of quantitative risk assessment of AMR transmission routes along the food chain.

Construction of Architectural Structures in Cultural Heritage Protection Zones

The article raises issues of constructing contemporary architectural structures in cultural heritage protection zones, using the case study of a building located within the campus of the University of Warmia and Mazury in Olsztyn, Poland. Questions revolving around the construction of this building arise from the need to preserve the surrounding historic heritage, and deal with landscaping, architectural and construction solutions as well as interior design. All these problems grow in importance when dealing with such unique buildings like the discussed example of a laboratory building for the Civil Engineering Department, built on a site within a conservation zone of the university campus. The specific character of the building and the specialist equipment with which it was to be furnished (a resistance testing machine, a 17-meter-long wave flume) necessitated a series of analyses. In turn, the fact that the new building was to be erected in the conservation zone meant that collaboration with the Heritage Conservation Office had to be undertaken at the stage of making the plan and continued during the construction works.The Heritage Officer’s recommendations concerning the building’s shape, divisions, dimensions, materials used, etc., created a situation where the team of designers and architects had to become engaged in the process of landscape and spatial management. The above requirements concerned the functions of the building and its siting on a land parcel that was difficult to handle, also because of the protected trees growing there. Other constraints included the small size of this site, the developed surroundings, and the pre-defined programme of functions and use of the new building. All the above circumstances made the task difficult and demanded good coordination between individual teams of engineers and architects, both at the stage of making the plan and during the construction works.Many of the heritage protection zones are spoilt with inappropriate buildings and structures. The historic part of the university campus in Olsztyn, in the town’s suburb called Kortowo, is an example. Some of the architecture in this area present features characteristics for socialist realism, which causes disharmony with the remaining late-19th century buildings. This paper is dedicated to the question of how to harmonise new buildings with historic ones, and how to strive towards maintaining spatial order. The case discussed in this article proves that such efforts, even when drastic solutions like demolition are needed, can be successful.

BIAS IN COLLEGIATE COURTS

AbstractThis article addresses the issues attending common law collegiate courts' engagements with allegations of bias within their own ranks. It will be argued that, in such cases, it would be inappropriate to involve the collegiate panel or any member thereof in the decision, since such involvement inevitably encounters difficulties. The common law's dilemmas require drastic solutions, but the common law arguably is ill-equipped to implement the required change. The answer, it will be argued, is legislation.

A Preferable Approach for the Ninth Circuit

tions submitted to Congress by the Commission on Structural Alternatives for the Federal Courts of Appeals after its one-year study.2 The Commission found no persuasive evidence that the Ninth Circuit ... is not working effectively and clearly rejected bifurcation.3 However, the Commission recommended that Congress impose a divisional restructuring on the Ninth Circuit Court of Appeals and authorize the other appellate courts to adopt divisional arrangements when their caseloads increase.4 Because Congress is still considering both legislative proposals, they require careful assessment. This analysis reveals that the two bills do not adequately treat the concerns that animated the study; the bills actually contradict the Commission's goals5 and suggest drastic solutions for

Sustainability of the Juan Fernández lobster fishery (Chile) and the perils of generic science-based prescriptions

Lobster fishing is the main source of income for the people from the Juan Fernández Archipelago (population ca. 770), located more than 700km off central Chile. An artisanal fishery has operated uninterruptedly for more than a century with few harvest controls (season, size, no egg-bearing females). Access to the resource has long been regulated by an informal but well structured traditional sea tenure system, which has effectively constrained the growth of fleet size. Nevertheless, and in spite of a lack of impending crises, assessments conducted over the last 40 years have recurrently diagnosed that effort is well above the optimum level. On that basis, generic “solutions” (quotas, marine protected areas, closures) have been prescribed with no attention to their possible impacts on the users and on traditional tenure arrangements. We discuss the merit of those diagnostics and prescriptions, and conclude that the disruption created by their eventual implementation would threaten the sustainability of the fishery. An analysis of the entire social-ecological system is needed before drastic solutions are prescribed. We investigate the factors that favor sustainability using Ostrom's framework for the analysis of social-ecological systems. Those factors have to do with the resource system (a productive stock with well defined boundaries and divisibility of fishing spots among users), governance (traditional tenure and simple operational rules), the users (few, strongly dependent on the resource, and sharing a detailed mental model of the resource system), and interactions (self-organization and partnerships). The resilience of the system was tested by the devastating tsunami that hit the islands in February 2010. This case study illustrates the need to attend to the interactions among resources, users and institutions in the search for effective solutions and to avoid disruptive management interventions.

Drastic Solutions: A Comparative Study of Emergency Powers in the Commonwealth

Drastic Solutions: A Comparative Study of Emergency Powers in the Commonwealth

The Common Fisheries Policy: An enforcement problem

Marine populations in Europe are in decline due to the unsuccessful results of the Common Fisheries Policy. By combining data of scientific recommendations from ICES, TACs approved and reported landings with an age-structured model, the objectives of this paper are to investigate the level of compliance of the TAC regulation, and the level of enforcement and its economic impact on fishery resources. The results presented here suggest that while there does not exist a regular pattern between TAC proposal and TAC approved, there is a clear pattern between TAC approved and reported landings. As a consequence, there is a regular lack of enforcement at national fisheries authority level. The paper also presents results of the recovery plans for the Southern hake and the Atlantic cod fisheries as case studies to illustrate the level of enforcement based on collusion between national fisheries advisers and industry. The results from both cases studies analyzed here indicate that drastic solutions could generate positive results for the recovery of the stocks, but perhaps they are not always the best measure in fisheries management due to the high economic losses for fishermen and social effects on coastal communities in the short and medium term. Finally, this work demonstrates that if the recovery plans had been implemented, the net present profits for both fisheries would have increased over time.

The Unity of Intellect in Aristotle's De Anima

AbstractThe perennial problem in interpreting De Anima 3.5 has produced two drastic solutions, one ancient and one contemporary. According to the first, Aristotle in 3.5 identi fies the 'agent intellect' with the divine intellect. Thus, everything Aristotle has to say about the human intellect is contained mainly in 3.4, though Aristotle returns to its treatment in 3.6. In contrast to this ancient interpretation, a more recent view holds that the divine intellect is not the subject of 3.5 and that throughout the work Aristotle is analyzing the nature of the human intellect. But this view contends that the properties Aristotle deduces for this intellect, properties that have encouraged the view that Aristotle must be speaking about a divine intellect, are in fact to be discounted or interpreted in such a way that they do not indicate the immortality and immateriality of the human intellect. In this article I argue that close attention to the text and the sequence of argument supports the conclusion that Aristotle is speaking throughout De Anima of a uni fied human intellect, possessed of the properties Aristotle explicitly attributes to it. This intellect functions diff erently when it is and when it is not separate from the hylomorphic composite. I argue further that it is Aristotle's view that if we were not ideally or essentially intellects, we could not engage in the diverse cognitive activities of this composite.

Mechanics Of Traditional Connections WithMetal Devices In Timber Roof Structures

The preservation of ancient buildings (also if not monumental structures) has evolved, during recent years, from a mainly cultural issue into an economic opportunity and instrument of correct administration of the real estate. In this field the presence of wooden structures is significant. Structural timber, however, is affected by several problems related to the material itself. the structural elements and the connections. The arising of these difficulties often leads, in restoration design, to drastic solutions, such as the complete substitution of elements or whole sub-structures or, even worse? the use of elements made of other materials. Results, then, have been shown to be questionable not only from the aesthetic point of view but also from the strictly structural one. Justifications for similar interventions are very often related to the difficulty, complexity and burden of acquiring the understanding and knowledge about the existing structures. Within this framework, it appears necessary to struggle in deepening the methods to investigate mechanical and structural characteristics of existing structures, along with the techniques for effective restorations. This article reports the most recent results from the research held in Trento about connections typical of traditional timber roof structures (trusses) and especially about carpentry joints retrofitted with metal devices. The purpose of the specific research is to gain an understanding of the mechanisms and factors that influence the behavior of these connections and to set up synthetic models in order to characterize and verify the overall joint structural behavior.

Solving the Shortage of Primary Care Physicians-Reply

In Reply. —Drastic problems require the consideration of drastic solutions; if not sooner, more drastic later. Our imbalance of generalists and specialists has been developing for a long time. The new marketplace will correct it. The move back is just beginning nationally but is already advanced in some American locales. Our oversupply of many specialists and subspecialists will become apparent to nearly all in the very near future. Competent primary care physicians will be in great demand. What will happen to the physicians in the oversupplied specialties? The best ones will remain as specialists and subspecialists; the quick and lucky others will get first in line to retrain to become competent in and practice primary care in the new systems. The slow and the resisters will try to move geographically, buying some time. Early retirement or joblessness will then result for the unfortunate. Resistance will be extreme. Many specialists will