1,721,012 research outputs found
Weaning from mechanical ventilation
No full textABSTRACT
Weaning from mechanical ventilation could be defined as the gradual process of transferring the respiratory work of breathing from the ventilator to the patients. The primary goal of weaning is timeliness, which implies that weaning should be started neither too late nor too early. Discontinuation of mechanical ventilation and removal of artificial airway are easily obtained in the majority of patients since about 70-80% of the patients are extubated when routine clinical criteria are fulfilled. This, however, is not always the case. In fact, about 20-30% of the patients present a difficult weaning. Patients require mechanical ventilation support when the ventilatory and/or gas exchange capabilities of their respiratory system fail. This respiratory failure can be the results of impairment between the load imposed on the respiratory system and the capacity of the respiratory muscle to perform this increased work of breathing. Shortly, the factors that limit the weaning process can be summarized as follows: 1) oxygenation, 2) respiratory load (table 1) and capacity of the respiratory muscle to accomplish this load, 3) cardiovascular performance, 4) psychological factors. To quantify these factors a great number of weaning indices has been proposed. However, none has been demonstrated to able to predict the weaning success, apart in patients with chronic obstructive pulmonary disease. Furthermore, the probability of remaining under mechanical ventilation is statistically higher in patients undergoing uncontrolled clinical practice when compared to a fixed protocol previously agreed
La tutela del consumatore. Principio di verità e aspetti particolari della comunicazione commerciale
No full textAnalisi delle disposizioni contenute nel Codice di Autodisciplina della Comunicazione Com-merciale che specificano il divieto generale di ingannevolezza, con riferimento ad alcuni aspetti specifici e ad ambiti che presentano problemi particolari di tutela del consumatore i campi "sensibili"(come il consumo di alcol o l'uso di farmaci o prodotti cosmetici, l'uso di integratori alimentari). Il commento delle disposizioni è accompagnato da un'analisi della giurisprudenza del Giurì di autodisciplina
La tutela dell'impresa
No full textIl capitolo analizza le norme del Codice di autodisciplina della comunicazione commerciale e la giurisprudenza del Giurì che sono poste a tutela dell'impresa (imitazione della pubblicità, denigrazione del concorrente e disciplina della pubblicità comparativa)
Can metabolic and hepatic abnormalities be improved by intragastric balloon treatment for obesity?
No full textPurpose: In obesity, a cluster of metabolic alterations (Metabolic Syndrome, MS) is often associated with Fatty Liver (FL). The bright liver at abdominal ultrasonography (US) and, in most cases, increased levels of hepatic enzymes, alanine aminotransferase (ALT) and gamma-glutamyltranspeptidase (GGT), are considered the hallmarks of Nonalcoholic Fatty Liver Disease (NAFLD) in obese patients. Insulin resistance (IR) is the main link among obesity, FL and MS. Bioenterics Intragastric Balloon (BIB, Inamed Health, Santa Barbara, Ca., USA) is considered a safe procedure to prepare patients to the bariatric surgery. The aim was to evaluate if the weight loss induced by BIB can improve both IR and liver enzymes.
Methods: From March 2003 through April 2007 in our digestive endoscopy service, 100 patients (F 65; age 20-63 yrs) with obesity and severe obesity (BMI 32-62) underwent BIB insertion. The BIB was placed under endoscopic control and removed 6 months later. US, clinical and routine laboratory investigations were performed before and after BIB. IR was calculated by the Homeostasis Model Assessment (HOMA-IR), as fasting serum insulin ( U/ml) x fasting plasma glucose (mmol/l)/22.5; values >2.5 indicate a state of IR. Exclusion criteria: HBV(+), HCV(+), alcohol consumption >20g/day, known drugs in the history.
Results: BMI decreased significantly after BIB (42.7 5.6 vs. 38.4 5.3; p10%) was observed in 50 patients (pts.). US showed FL in the majority (70%). In FL pts. ALT U/L (48.8 46.5 vs. 31.1 26.9) and GGT U/L (41.5 38.9 vs. 29.5 20.9) significantly decreased after treatment (p2.5 were recorded in 86% FL and in 74% noFL pts. Values significantly decreased after treatment both in FL (6.03 4.47 vs. 4.21 3.35; p<0.05), and in noFL pts. (4.71 2.62 vs 2.89 1.39; p<.001). FL and noFL pts. with BMI<10%, HOMA-IR, ALT, GGT values did not significantly change after BIB. Before BIB in FL pts. a weak correlation (r=0.37) was found between GGT and HOMA-IR values. Hypertriglyceridemia in 42.3%, HDL cholesterol levels <40mg/dL in 32.4% did not significantly change after BIB.
Conclusion: Weight loss induced by intragrastric balloon reduces IR. The ALT and GGT decrease suggests an improvement of hepatic lobular inflammation. The benefit depends on a decrease of BMI higher than 10%. We confirm the pivotal role of IR in FL
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Get PDFWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
- …
