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P.Oxy. 1.5 and the Codex Sangermanensis as ‘Visionary Living Texts.’ Visionary Habitus and Processes of ‘Textualization’ and/or ‘Scripturalization’ in Late Antiquity
No full textRecent studies stress, with varied perspectives and nuances, that much of the corruption of proto-Christian accounts are products of the “orthodox” Tendenzen intending to safeguard the holy texts from possible depredations of “heretical” parties (see the studies by Ehrman, Head, Hernández Jr., Royse, etc.). In this view, every re-reading of the text is to some extent a re-writing of the text: the variants produced by ancient scribes show us what they thought the text said, i.e., what it really meant. This approach implies the necessity to gain knowledge of an individual scribe’s copying habits, highlighting that particular readings reveal scribal specificities. This paper aims at analysing two cases of individual scribal interventions on visionary texts of late antiquity: the papyrus from Oxhyrhynchus n. 1.5 (3rd-4th cent. CE), specifically a text containing a passage from Hermas’ Mand. 11.9—10, and a manuscript of IV Ezra, the so-called Codex Sangermanensis (9th cent. CE). Both the cases reveal figures of entrepreneurs (the scribe? Or the customer?) engaged in related typologies of individual acquisition/intervention, appropriation, modification, and transposition: P.Oxy. 5 offers a very interesting case of interpolation, completely absorbed in the text of the Shepherd of Hermas, concerning a prophetiké taxis; the Codex Sangermanensis presents the ablation of an entire section of 4 Ezra 7 for specific ideological reasons. This paper also aims at analysing the process of reformulation connected to a specific late-antique religious habitus, i.e. the visionary habitus, a socio-cultural pattern that results into processes of exegesis, interpretation and re-proposition of previous authoritative accounts in and for specific environments
Antiplatelet therapy in acute coronary syndromes. Lights and shadows of platelet function tests to guide the best therapeutic approach
No full textThe key role of platelets in pathophysiology of Acute Coronary Syndromes (ACS) has been well recognized. Platelet activation and aggregation, together with tissue factor-pathway activation, lead to acute thrombus formation in the coronary vessels at sites of plaque rupture. Thus, antiplatelet therapy with drugs able to interfere with platelet activation/aggregation represents a cornerstone of ACS treatment in intensive care units and catheterisation labs. Several observational studies have described that residual high platelet reactivity, despite antiplatelet therapy, is associated with increased risk of nonfatal Myocardial Infarction (MI), definite/probable stent thrombosis and cardiovascular mortality. Thus, assessment of platelet function with reliable and reproducible platelet function tests might be crucial to identify patients at high risk of thrombosis or not responding to ongoing antiplatelet strategies. How-ever, despite this promising background, some randomized clinical trials have failed to demonstrate improvement in outcomes when using platelet function tests for clinical decision-making. This review, after describing platelet biology and pathophysiology of ACS, briefly considers the drugs currently ap-proved for use in patients with ACS or treated by the percutaneous coronary intervention (PCI). Finally, we provide an updated overview of the current methods to evaluate platelet reactivity in the clinical setting of ACS illustrating their potential advantages/limitations in current clinical practice
Recurrence of spinal meningiomas: analysis of the risk factors
No full textObjective: Spinal meningiomas are slow-growing tumors with low recurrence rate after complete resection. The aim of this study is to investigate the risk factors correlated to the recurrence. Material and Methods: Six patients with spinal WHO grade I meningiomas which recurred after complete resection were reviewed and compared to 50 patients with no recurrence; the data were also compared with those of 50 intracranial meningiomas which recurred and 50 which did not recur after complete resection. The investigated factors included age and sex, tumor location and size, type of arachnoid interface, entity of resection (Simpson I or II), tumor consistency and vascularity, histological type, Ki-67 MIB-1, progesterone receptor (PR) and estrogen receptor (ER) expression. The data were statistically analyzed with the Kaplan-Meier method. Results: The statistical analysis showed that the presence of arachnoidal invasion (p = 0.023) and higher Ki-67 LI (p < 0.0001) were the only two significant risk factors for recurrence for both spinal and intracranial meningiomas. Large tumor size (p = 0.012), Simpson grade II resection (p = 0.03) and the absence of PR expression (p < 0.0001) were significant risk factors for recurrence of intracranial but not spinal meningiomas. Finally, age and sex, tumor location, consistency and vascularity, histological type, and ER expression were not correlated to recurrence for both localizations. Conclusions: The proliferation index Ki-67 and the arachnoid invasion are the risk factors for recurrence of spinal meningiomas, whereas tumor size, dural resection and PR expression are not significant. The small tumor size and the limited dural invasion may contribute to explain the lower recurrence rate
Pharmacological and molecular docking assessment of cryptotanshinone as natural-derived analgesic compound
No full textMedicinal plants from traditional chinese medicine are used increasingly worldwide for their benefits to health and quality of life for the relevant clinical symptoms related to pain. Among them, Salvia miltiorrhiza Bunge is traditionally used in asian countries as antioxidant, anticancer, anti-inflammatory and analgesic agent. In this context, several evidences support the hypothesis that some tanshinones, in particular cryptotanshinone (CRY), extracted from the roots (Danshen) of this plant exhibit analgesic actions. However, it is surprisingly noted that no pharmacological studies have been carried out to explore the possible analgesic action of this compound in terms of modulation of peripheral and/or central pain. Therefore, in the present study, by using peripheral and central pain models of nociception, such as tail flick and hot plate test, the analgesic effect of CRY in mice was evaluated. Successively, by the aim of a computational approach, we have evaluated the interaction mode of this diterpenoid on opioid and cannabinoid system. Finally, CRY was dosed in mice serum by an HPLC method validated according to European Medicines Agency guidelines validation rules. Here, we report that CRY displayed anti-nociceptive activity on both hot plate and tail flick test, with a prominent long-lasting peripheral analgesic effect. These evidences were indirectly confirmed after the daily administration of the tanshinone for 7 and 14 days. In addition, the analgesic effect of CRY was reverted by naloxone and cannabinoid antagonists and amplified by arginine administration. These findings were finally supported by HPLC and docking studies, that revealed a noteworthy presence of CRY on mice serum 1 h after its intraperitoneal administration and a possible interaction of tested compound on μ and k receptors. Taken together, these results provide a new line of evidences showing that CRY can produce analgesia against various phenotypes of nociception with a mechanism that seems to be related to an agonistic activity on opioid system
A fast-moving target: achieving marine conservation goals under shifting climate and policies
No full textIn the Anthropocene, marine ecosystems are rapidly shifting to new ecological states. Achieving effective conservation of marine biodiversity has become a fast-moving target because of both global climate change and continuous shifts in marine policies. How prepared are we to deal with this crisis? We examined EU Member States Programs of Measures designed for the implementation of EU marine environmental policies, as well as recent European Marine Spatial Plans, and discovered that climate change is rarely considered operationally. Further, our analysis revealed that monitoring programs in marine protected areas are often insufficient to clearly distinguish between impacts of local and global stressors. Finally, we suggest that while the novel global Blue Growth approach may jeopardize previous marine conservation efforts, it can also provide new conservation opportunities. Adaptive management is the way forward (e.g., preserving ecosystem functions in climate change hotspots, and identifying and targeting climate refugia areas for protection) using Marine Spatial Planning as a framework for action, especially given the push for Blue Growth
Invasive functional assessment of coronary artery stenosis using fractional flow reserve
No full textThe presence of myocardial ischemia significantly affects prognosis of patients with coronary artery disease. The fractional flow reserve (FFR) allows interventional cardiologists to evaluate whether an equivocal coronary artery stenosis is associated or not with myocardial ischemia, and therefore deserve to be properly treated. The present article has the purpose to provide the readers with an overview about the role of FFR in the diagnosis and management of coronary artery disease, as well as the potential related controversies. The coronary physiology on the basis of this tool is also provided together with all the procedural aspects useful in the catheterization laboratory. In addition, the landmark trials on the basis of the FFR application in different clinical settings and coronary anatomies will be described, together with the main improvements aiming at favoring a more extensive use of this invasive tool
Asymptotic analysis of the high frequencies for the Laplace operator in a thin T-like shaped structure
No full textWe consider a spectral problem for the Laplacian operator in a planar T-like shaped thin structure Ωε, where ε denotes the transversal thickness of both branches. We assume the homogeneous Dirichlet boundary condition on the ends of the branches and the homogeneous Neumann boundary condition on the remaining part of the boundary of Ωε. We study the asymptotic behavior, as ε tends to zero, of the high frequencies of such a problem. Unlike the asymptotic behavior of the low frequencies where the limit problem involves only longitudinal vibrations along each branch of the T-like shaped thin structure (i.e. 1D limit spectral problems), we obtain a two dimensional limit spectral problem which allows us to capture other kinds of vibrations. We also give a characterization of the asymptotic form of the eigenfunctions originating these vibrations
The application of six sigma to reduce the pre-operative length of hospital stay at the hospital Antonio Cardarelli
No full textPurpose: The best treatment for femur fractures is the surgical one within 48 h from the admission to the hospital. These fractures have serious consequences, both in terms of morbidity and socio-economic impact. In the hospital A.O.R.N. Cardarelli of Naples in Italy, the mean pre-operative length of hospital stay (LOS) was nine days and just 4 per cent of patients was operated within the suggested time. Therefore, a diagnostic-therapeutic-assistance path (DTAP) was implemented to improve the process. Design/methodology/approach: This paper analyzes two groups of patients (534 and 562, respectively) before and after the introduction of DTAP, through six sigma (SS) based on define, measure, analyze, improve and control cycle. Age, gender, American Society of Anaesthesiologists (ASA) score, cardiovascular diseases, diabetes and allergies were used as independent subgrouping variables. The t-tests and chi-square were performed to compare the groups, tools of SS were used. Findings: The analyses were conducted considering overall patients and some subgroups. The overall reduction in LOS was about 54 per cent, patients without cardiovascular diseases and with a low ASA score had the highest reduction, more than 60 per cent. All the p-values proved a high statistically significant difference between the two groups. Research limitations/implications: The influence of the Italian health-care system is a minor limitation while, unfortunately, the lack of a follow-up did not allow quantifying the real gain in health of patients. A lean thinking analysis would suit this context. Practical implications: There are practical advantages for both hospital and patients: the hospital will have an increase in admissions and more beds available, while patients will benefit of a faster intervention and a shorter wait. Originality/value: This is the first analysis through SS of DTAP showing its positive influences in terms of both socio-economic impact and patients’ outcome. Policy leaders could use this study as an example to evaluate the introduction of the same clinical pathway in other health facilities
Physical activity and thrombophilic risk in a short series
No full textThe role of influence on protein C anticoagulant system and PC deficiency-related thrombophilic risk due to strenuous physical exercise is still under discussion. To investigate the modification of the protein C anticoagulant pathway after vigorous exercise, we measured ProC® Global assay, a protein C activity dependent clotting time, in 20 healthy subjects before and immediately after maximal treadmill exercise, and at 5, 15, 30 and 60 min in the recovery phase. The most evident change was a shortening of ProC® Global clotting time from the average basal value of 123 sec to 84 sec at 30 min in post-exercise. Our study shows that the coagulation unbalance observed after strenuous exercise and with no consequence in healthy individuals with normal PC level, could increase the thrombophilic risk in silent carriers of significant defects of the protein C system and occasionally trigger an episode of deep vein thrombosis