102,218 research outputs found
La Gestione Ottimale degli Impianti di Depurazione
No full textViene presentata una metodologia innovativa per la valutazione della vulnerabilità del funzionamento di un impianto di depurazione nei confronti di eventi che potrebbero comportare il superamento dei limiti di normativa nei reflui trattati, basata su un modello matematico finalizzato alla stima del rischio di fuori-servizio. Il modello viene proposto come strumento di partenza per approntare un piano di manutenzione dell’impianto su base predittiva, e per ottimizzare l’approvvigionamento del magazzino scorte. Per mostrarne la funzionalità ed i limiti di utilizzo, il modello viene applicato ad un impianto di depurazione per reflui civili di dimensioni medio/piccole ubicato nella provincia di Napoli, illustrando ecommentando la significatività dei risultati ottenibili
Direct oral anticoagulants use in elderly patients with non valvular atrial fibrillation. state of evidence
No full textNon-valvular atrial fibrillation (NVAF) increases the risk of stroke by three-to five-fold, especially in elderly patients, creating a huge burden on medical system as well as a negative impact on patients' lives. Balancing efficacy and bleeding risk is a challenge when considering anticoagulation therapy in elderly patients, because of their frequent high risk of both stroke and bleeding. Real world data reveal the underuse of anticoagulation in the elderly, especially due to physicians' fear of bleeding, often neglecting the thromboembolic risk. Care of elderly patients with NVAF is often complicated by factors including adherence, cognitive impairment, health literacy, risk of falling, adverse effects, involvement of caregivers, and patient-physician relationship. Therefore, shared decision making and conversations between clinicians and patients are crucial. In addition, elderly patients often suffer from multiple comorbidities, requiring multiple concomitant medications, with an increased risk of drug interactions. Four non-Vitamin K antagonist oral anticoagulants, the so-called direct oral anticoagulants (DOACs) - dabigatran, rivaroxaban, apixaban and edoxaban - have been approved for reducing the risk of stroke and systemic embolism in patients with NVAF. Clinical trials and real-world data show the advantages of this class of drugs compared to conventional anticoagulation in the treatment of elderly patients with NVAF and identify subgroups of older patients who may be more suitable candidates for particular agents. However, there are conflicting opinions on the absolute benefit of DOACs use in elderly patients. A key factor to consider is that elderly patients frequently suffer from renal impairment and therefore dose adjustments according to creatinine clearance are mandatory for DOACs. As each DOAC comes with its own unique advantages and safety profile, a personalized case by case approach should be adopted to decide on the appropriate anticoagulation regimen for elderly patients after weighing the overall risks and benefits of therapy
Diagnosis of persistent left superior vena cava by multiplane transesophageal echocardiography
No full textSIEC Consensus Conference on the State of the Art of Contrast Echocardiography: Myocardial Perfusion
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"Ayy dimuqrātiyya li-ayy mujtami' madanī. Dawr al-'adāla al-ijtimā'iyya fī tanawwul al-nushatā' lil-dimūratiyya fī Misr"
No full textContrast echocardiography in coronary artery disease. Clinical application of quantitative analysis
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DNS of an oblique jet in a particle-laden crossflow: study of solid phase preferential concentration and particle-wall interaction
No full textA DNS study of the interaction between an oblique laminar jet and a particle-laden crossflow is presented. The delivery tube is included in the simulation and jet in crossflow blowing ratio is set equal to 0.5, typical for gas turbine film cooling applications. The solid phase is polydisperse and it is simulated by adopting a Lagrangian two-way coupling point-particle approach. Wall-particle interaction is also taken into account. The fluid flow in the jet outflow region was found to be dominated by a strong vorticity field and by hairpin shaped vortices that are shed periodically in the crossflow. Hairpin legs are associated to a counter-rotating vortex pair that persist in the far-field of the jet. The spatial distribution of the dispersed phase is strongly influenced by these large-scale coherent structures. A three-dimensional Voronoi analysis demonstrated a particle preferential concentration induced by hairpin vortices downstream from the jet exit. Volume fractions curves are presented as a function of the spanwise direction for different transversal sections of the crossflow region. A void particle region is induced by vortices in the central near-wall zone downstream of the jet exit. Particles tend to accumulate along two symmetric regions placed on the lateral side of the structures generated by the jet injection. By an analysis of particle impacts on the wall it was observed that particles characterized by lower values of the St number, whose response time is comparable with the characteristic time of the hairpin vortices, tend to impact on the wall on two symmetric side of the jet exit in the proximity of hairpin legs. This demonstrated that the generated large-scale coherent structures play a major role in the not homogeneous dispersion of the solid phase
"Which democracy for which civil society? The Role of Social Justice in Activists’ Representations of Democracy. The case of Egypt"
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