84 research outputs found
Puerperio: conoscenze da parte delle ostetriche e informazione alle donne sul self-care
No full textIl puerperio è il periodo di tempo che inizia subito dopo l'espulsione o estrazione della placenta e termina con la ripresa dell'attività ciclica ovarica.
Convenzionalmente si assegna al puerperio una durata di 6-8 settimane, poiché in tale intervallo nonnalmente si completa la regressione della maggior parte delle modificazioni gravidiche a carico dei vari organi e apparati.
Questo lavoro si prefigge l'obbiettivo di verificare le conoscenze che le ostetriche e le donne del puerperio hanno riguardo al self-care e di constatare la comunicazione di tali informazioni.
È molto importante che la donna riceva dei consigli che la rendano autonoma rispetto a tutte le tematiche che riguardano il self-care in puerperio, quali:
igiene, lochi, rapporti sessuali, contraccezione, allattamento, abitudini e allattamento, attivita' fisica, ginnastica perineale e psicologia.
L'analisi conoscitiva è stata effettuata tramite somministrazione di questionari in forma anonima a 12 ostetriche e 76 puerpere dei due puerperi (fisiologico e a solvenza) della clinica Mangiagalli di Milano.
I questionari erano costituiti da domande a risposta multipla in cui bisognava indicare le frasi corrette per gli argomenti sopra citati.
La conoscenza delle ostetriche è risultata buona rispetto alla maggior parte degli argomenti presi in analisi e non sono state evidenziate particolari differenze tra ostetriche del puerperio fisiologico e ostetriche del puerperio a solvenza.
Per quanto riguarda le puerpere, queste hanno delle conoscenze che possono essere definite insufficienti ad eccezione di due argomenti: allattamento e igiene personale.
Quasi tutte le ostetriche affennano di educare la donna sulla maggior parte degli argomenti considerati, mentre le donne affermano che l'ostetrica non è un'importante fonte di informazione. La maggior parte di queste, infatti, afferma di non ricevere indicazioni durante la degenza in puerperio riguardo al self-care. L'unico argomento in cui le puerpere riconoscono un ruolo come educatrice all'ostetrica è l'igiene personale mentre l' allattamento viene trattato soprattutto dalla puericultrice
Abduzione e interpretazione. Abbiamo davvero ascoltato Peirce?
No full textQuesto saggio indaga sia a livello filologico che a livello teoretico due concetti centrali del pensiero di Peirce, che sono stati al centro della sua fortuna nella tradizione semiotica, e cioè quelli di abduzione e interpretazione. Ripercorrendo una serie di passaggi non sempre tenuti in sufficiente considerazione dai commentatori peirceani, il saggio prova a sostenere una svolta non logica dell'abuzione all'interno del pensiero peirceano, svolta che è legata all'idea di musement e a quella di "legge della libertà". In questo modo si prova a ripensare radicalmente l'idea di interpretazione, che nella tradizione semiotica è sempre stata connessa al concetto di abduzione
Apporti del pensiero pitagorico alla dottrina dell'anima e dell'aldilà nel Fedone di Platone,pp. 219-258.
No full textvasa previa: systematic review of literature
No full textObjective: Type-III vasa previa (VP) is a rare form of VP, not necessarily associated with other placental or vascular anomalies, in which aberrant vessels run from the placenta to the amniotic membranes, near the internal cervical os, before returning to the placenta. Early diagnosis of Type-III VP is important but technically challenging. The objective of this study was to gather the current available evidence on the perinatal diagnosis and outcome of Type-III VP. Methods: A systematic review of the literature on the perinatal diagnosis of atypical Type-III VP was carried out in PubMed, MEDLINE and EMBASE accordingto PRISMA guidelines from inception to March 2023. Data extraction and tabulation were performed by two operators and checked by a third senior author. The quality of the included studies was evaluated using the National Institutes of Health tool for the quality assessment of case-series studies. Our local ultrasound database was searched for previously unreported recent cases. Characteristics of prenatally and postnatally diagnosed Type-III VP, including clinical features and perinatal outcomes, were summarized using descriptive statistics. Results: Eighteen cases of Type-III VP were included, of which 16 were diagnosed prenatally (14 cases were retrieved from 10 publications and two were unpublished cases from our center) and two were diagnosed postnatally (retrieved from two publications). All prenatal cases were diagnosed on transvaginal ultrasound at a mean gestational age of 29 weeks (median, 31 weeks; range, 19-38 weeks). Conception was achieved with in-vitro fertilization in 4/16 (25.0%) cases. There were no prenatal symptoms in 15/18 (83.3%) cases, while in two (11.1%) cases there was vaginal bleeding and in one (5.6%) preterm labor occurred. In 15/18 (83.3%) cases, at least one placental abnormality was observed, including low-lying insertion (9/17), succenturiate or accessory lobe (1/17), velamentous cord insertion (3/18) and marginal insertion (9/18). All prenatally diagnosed cases were liveborn and were delivered by Cesarean section before rupture of membranes at a median gestational age of 35 weeks (range, 32-38 weeks) without neonatal complications. Emergency Cesarean section was performed in 2/16 (12.5%) cases with a prenatal diagnosis and 1/2 (50.0%) cases with a postnatal diagnosis (P = 0.179). Among those with data available, an Apgar score of ≤ 7 was observed in the prenatally vs postnatally diagnosed group in 5/13 vs 1/1 cases, respectively, at the 1-min evaluation and 3/13 vs 1/1 cases, respectively, at the 5-min evaluation. Conclusions: The prenatal diagnosis of Type-III VP is challenging, with few cases reported in the literature; however, it is crucial for minimizing the risk of adverse outcome by enabling early-term elective Cesarean delivery prior to rupture of membranes. Given that clinical manifestations and risk factors are non-specific, and that Type-III VP cannot be excluded when there is a normal cord insertion or a singular placental mass, systematic screening by transvaginal ultrasound in the general pregnant population is recommended, particularly in those with a low-lying or morphologically abnormal placenta and those who conceived using assisted reproductive technology. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology
Correlazione tra variazioni periodiche e momento di insorgenza di eventi ischemici miocardici acuti : un anno di studio
No full textUn rivelatore di fase ad alta velocità e bassa tensione di alimentazione per applicazioni in sistemi di estrazione del sincronismo
No full textI contributi al Congresso sono su C
Saturation temperature effect on heat transfer coefficient during convective boiling in microfin tubes
No full textThe growing attention on environmental aspects puts severe constraints on HVAC technology, mainly involving the working fluids and energy efficiency. Both are related to the main limiting factor of HVAC system: the heat transfer process, which, frequently, involves boiling and condensation. To provide suitable tools for the HVAC system design, it is necessary to gather information on the heat transfer characteristics of the new refrigerants. Particular interest is focused on R1234ze(e), because it is one of the viable options to face the R134a phase out. Something similar can be repeated for the low temperature ORC systems using a refrigerant as working fluid. Using a specifically designed test rig, heat transfer coefficient and pressure drop measures were performed during flow boiling of R1234ze(e). The operating conditions were defined by four parameters: the evaporation temperature (5 °C, 35 °C and 45 °C), the mass flux (two values were considered: 160 kg/m2s and 220 kg/m2s), the average thermodynamic quality (which varies between 0.25 and 0.75) and the quality change (which was fixed to 0.2). The uncertainty affecting the pressure drop and the heat transfer coefficient resulted lower than 1% and 5% respectively. The results highlighted that the saturation temperature strongly affects the heat transfer coefficient and the pressure drop: as a consequence of the saturation temperature increase from 5 °C to 45 °C, it was observed up to 40% heat transfer coefficient increase and 90% pressure drop reduction
Darwinismo e pragmatismo. La filosofia evoluzionistica di Chauncey Wright
No full textThe Darwinian evolutionary theory was a real revolution, not only in biology and, generally, in scientific fields, but even in philosophical and epistemological thought. However, in the years that followed the publication of The Origin of Species (1859), virtually nobody, among scientists and philosophers, agreed with the principle of natural selection put forward by Darwin as the main explanation of the evolutionary process. This happened because Darwin’s theory was quite opposed to the “orthodox” view behind natural sciences and the philosophy of nature both in Europe and in America.
Natural theology was taught in every school, academy, college, and it claimed that all the species in nature are created by God for a good purpose or a general design, are fixed in time, and they are already fitted to their environment from the beginning. Some theologians could account for organic forms by evolution to a certain degree, but all of them agreed on the “argument from design” and to the idea that man was «the glory and the supreme king of the natural realm», as Darwin ironically wrote.
One of the few that stood against this background and followed Darwin in his “struggle” against the teleological and anthropocentric interpretation of natural beings was an American philosopher from Cambridge whose name was Chauncey Wright.
Wright (1830-1875) was the well loved master of famous thinkers as William James, Charles Sanders Peirce, or Oliver Wendell Holmes at the “Metaphysical Club” in Cambridge, now considered the birth place of American Pragmatism. Wright started from the William Hamilton’s philosophy and then, in the 1860s, rejected it in favour of the utilitarianism of Bentham, James Mill and John Stuart Mill.
When Darwin’s Origin arrived to America, in 1860, he immediately became a firm supporter of the evolutionary theory. To him, the principle of natural selection was just an application of the Mills’ utilitarian philosophy and, moreover, it was even an improvement of it: e.g., the principle of natural selection could shed new light on the origin of different complex human feelings, ideas, behaviours, whereas the principles of mental association, which were the basis of the utilitarian ethics, were very vague and generic on these genetic problems.
For these reasons Wright thoroughly studied the Darwinian theory for ten years and then he wrote some articles on this topic in the early 1870s. Three of them aimed to take issue with Alfred Russell Wallace and George Mivart’s arguments against the principle of natural selection, and they were so well conducted that Darwin himself thanked Wright and decided to publish one of them in England as a pamphlet at his own expenses. The last of these articles on evolution, titled The Evolution of Self-Consciousness (1873), is the most important of the series. After the death of this author, in 1875, his friends collected almost all his published works in a book entitled Philosophical Discussions (1877) and most of his Letters (1878).
In general, until now, Chauncey Wright’s philosophy has been obscured by the more famous thought of the American Pragmatists, such as Peirce, James, Dewey. Not many scholars wrote on this philosopher and, among them, those who studied his philosophy were more interested in comparing it to the Pragmatist one, rather than in directly elucidating its basic principles and in deeply exploring its theoretical features. For these reasons Edward Madden, the most important Wright scholar, named him a “forgotten philosopher”. At present, only one of Wright’s articles (The evolution of self-consciousness, 1873) has been translated into Italian, and, in general, this thinker is almost unknown in Italy.
On the contrary, my work sets out to prove that Wright’s philosophy is not only fundamental to well understanding the origin and the roots of American Pragmatism, but it is also very important in order to focus on the most interesting philosophical implications of the Darwinian evolutionary theory. In particular, my thesis examines the new epistemology worked out by Wright, which, beginning from a deep analysis of Darwin’s theory, highlighted the still unseen importance of the principle of “the new uses for old functions”. In his stressing the significance of this principle, Wright showed to conceive the evolutionary process in a very similar way, in its main features, to the one advanced by some modern biologists, such as, for example, Gould, Eldredge or Lewontin.
As Wright did a century and a half ago, the above mentioned biologists highlight the importance of this mechanism of new uses for old functions, or, as they call this transformational principle, “exaptations”, in order to go beyond an “adaptationist” or “panselectionist” interpretation of the Darwinian theory.
This pluralistic view, as a working hypothesis, is very effective in its approach to the theoretical problems, especially when Wright applied it on the very classic philosophical question of the nature and of the origin of self-awareness. The main role of these new uses of old powers (like “memory” or “attention”) in relation to the new importance accorded by Wright to the habits and to the use of signs, establishes that Wright’s approach to the problem of the evolution of self-consciousness is a very new one, as it appears to be an interesting combination of an original (and modern) version of Darwinism and an incipient kind of Pragmatism. Nowadays, the solution developed by Wright in his approach to the question of the “human”, could be useful in philosophy and biology to better think and to shed new light on this very controversial and ancient riddle, namely, the origin of language and the evolution of human mind from an evolutionary point of view
Decompensated chronic heart failure: increased liver stiffness measured by means of transient elastography.
No full textPURPOSE: To analyze transient elastography-measured liver stiffness in patients
with acute decompensated heart failure to describe variations in liver stiffness
measurements and assess their relationship with the patients' clinical course and
laboratory data.
MATERIALS AND METHODS: This study was approved by the local institutional review
board, and all of the subjects gave verbal informed consent. Twenty-seven
hospitalized patients with heart failure with no signs of liver disease (mean
age, 79 years ± 12 [standard deviation]; 12 men [mean age, 78 years ± 11], 15
women [mean age, 80 years ± 12]) underwent liver stiffness and N-terminal proβ
brain natriuretic peptide (NTproβBNP) assessments at admission, and 24 patients
underwent stiffness measurements at discharge. (Three patients had failed
measurement at admission; two of whom did not undergo measurement at discharge
and one patient who died had only an admission value obtained.) The predefined
stiffness cutoff values were greater than 7.65 kPa for substantial fibrosis and
greater than 13.01 kPa for cirrhosis. The control subjects were 21 patients
unaffected by heart failure or liver disease. The two groups were compared by
using two-tailed Wilcoxon, Mann-Whitney, or t tests, as appropriate.
RESULTS: Among the patients with heart failure, median liver stiffness at
admission was 8.80 kPa (interquartile range, 5.92-11.90 kPa), greater than 7.65
kPa in 14 (58%) cases and greater than 13.01 kPa in five (21%). During
hospitalization, liver stiffness decreased in 18 patients (including all five
patients with baseline measurement > 13.01 kPa) and increased in five. Median
liver stiffness (P < .003) and NTproβBNP (P < .001) levels both significantly
decreased during hospitalization. Liver stiffness was less than 7.65 kPa in all
control patients and did not significantly change during hospitalization (P =
.261).
CONCLUSION: Most patients with acute decompensated heart failure have high liver
stiffness values which, like NTproβBNP levels, tend to decrease with clinical
improvement
3D reconstructions of gneiss quarries through long-range laser scanning for a quantitative volume estimation of dimension stones
No full textNowadays, the economic activities of dimension stone quarries are menaced by the increase of production costs due to (i) continuously changing demand because of the evolving dimension stone fashion and (ii) increasing administrative limits and rules acting to protect the environment. These costs add to the exploitation costs related to the geological phenomena such as fractures, faults and heterogeneous rocks that hinder the processing of the stone product. In Canton Ticino (Southern Switzerland), the exploitation of dimension stone, mostly gneisses, is an important activity of valley’s economies that is facing the aforementioned problems. Therefore, the sustainable development for the next decades of the dimension stone sector needs new and effective strategies to regulate and plan the quarries.
A fundamental step in this process is the building of a 3D geological model of the quarries to constrain the volume of commercial dimension stone and the volume of waste. In this context, we conducted Terrestrial Laser Scanning surveys of the quarries in the Maggia Valley to obtain a detailed 3D topography onto which the geological units were mapped. The topographic 3D model was obtained with a long-range laser scanning Riegl VZ4000 that can measure from up to 4 km of distance with a speed of 147,000 points per second. It operates with the new V-line technology, which defines the surface relief by sensing differentiated signals (echoes), even in the presence of obstacles such as vegetation.
Depending on the aesthetics of the gneisses, we defined seven types of dimension stones that, together with faults and joints, were mapped onto the 3D models of the exploitation sites. According to the orientation of the geological limits and structures, we projected the different rock units and fractures into the excavation front. This way, we obtained a 3D geological model from which we can quantitatively estimate the volume of the seven different dimension stones (with different commercial value) and waste (with low commercial value).
To verify the 3D geological models and to quantify exploited rock and waste volumes the same procedure will be repeated after ca. 6 months.
Finally, these 3D geological models can be useful to (i) decrease the exploitation costs because they yield the extraction potential of quarry, (ii) become more efficient in the exploitation and more dynamic in the market because they permit better planning and (iii) decrease the waste by limiting the excavation in regions with low-quality rocks
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