145 research outputs found
Impact of COVID-19 pandemic waves on changes in surgical urgency volumes and severity in the regional hospital network of Trento (Northern Italy): a descriptive epidemiological analysis
No full textOBJECTIVES: to analyse both direct and indirect impacts on surgical admissions, surgical rates, and clinical picture severity of the two COVID-19 pandemic waves in a hospital network covering an entire province (Trento, located in TrentinoAlto Adige Region, Northern Italy).DESIGN: retrospective epidemiological study.SETTING AND PARTICIPANTS: data regarding the patient load of the Surgical Urgencies/Emergencies flows (SUEs) of the Local Health Authority of the Autonomous Province of Trento derived from the Hospital Discharge Record (HDR) information flow. The population in study was that of patients hospitalized in the entire Province of Trento. This study compares the volume and characteristics of urgent/emergency surgery during the 2020 COVID-19 pandemic with the homologous period in 2019, subdividing the analysed pandemic period in 3 separated groups: phase I (March-May 2020); phase II (June-August 2020); phase III (October-December 2020). The 3 groups represent, respectively: the 1st pandemic wave proclamation of national lockdown from 9 March to 18 May; the summer pandemic remission; the 2nd pandemic wave with partial restrictions on circulation and commercial activities. Clinical and surgical records of SUE population among these 3 periods (March-May; June-August; October-December) of both 2020 and 2019 were analyzed and compared.MAIN OUTCOME MEASURES: the overall number of admissions and surgical rates for SUEs in the study periods were chosen as primary outcomes. The same outcomes were analysed for the most represented diagnoses in the SUEs population: diverticulitis, intestinal obstruction, appendicitis, cholecystitis, gastrointestinal (GI) perforations, pancreatitis, traumas. To assess the degree of clinical picture severity, variables coming from the hospital discharging charts, commonly associated to worst outcomes in term of mortality and morbidity, such as age, length of hospital stay, DRG weight, and patients not discharged at home were extrapolated from the electronic database. A numerical weight was then assigned to each variable, obtaining a scoring system from 0 to 15 (severity index).RESULTS: the number of admissions for SUEs in the studied period showed a sinusoidal trend, with a dramatic decrease in phase I and III (-46.6% and -31.6%, respectively). This trend was also observed even by stratifying admissions for the most frequent pathologies, except for gastrointestinal perforations and pancreatitis. The surgical rate among hospitalised patients for SUEs was 35.2% in phase, significantly higher than that of 2019 (25.6%). Considering the most frequent diagnoses individually, some had a progressive increase in the surgical rate in phases I and II (diverticulitis, bowel obstructions, cholecystitis), others showed an initial decrease and then settled on values not far from those of 2019 (GI perforations and appendicitis), others again had an initial significant increase and then gradually returned to values similar to those of 2019 in phase III (traumas). The mean patients age was significantly higher in phase I than in 2019 (p-value <0.001) and in phase II (p-value <0.05). Consistently with the trend of the number of urgent admissions, even the severity index calculated on the SUEs population showed a sinusoidal trend with and evident increase during the two pandemic waves.CONCLUSIONS: the effect of the COVID-19 pandemic on SUEs was mainly indirect, manifesting itself with a significant reduction in surgical admissions, particularly in phases I and III. Conversely, in the same phases, the surgical rate showed a significant increase compared to 2019.The stratified analysis confirmed these findings for the most frequent diagnoses except for GI perforations and pancreatitis. The clinical pictures were more severe in the two pandemic waves than in the reference period of 2019. Although with a slight numerical attenuation, in general, the second pandemic wave confirmed the first one findings
Changes in volumes and severity of surgical urgencies during the first two COVID-19 pandemic waves in a regional hospital network
No full textBackground and aim This study analyses the impact of the first two pandemic waves on surgical urgencies/emergencies and their consequences on an entire provincial hospital network's surgical activities. Methods Clinical and epidemiological data of urgent/emergent surgical admissions and interventions in the Autonomous Province of Trento's hospital network were collected from the internal common electronic database. The investigation periods were March-May 2019 (reference period), March-May 2020 (phase-I), June - August 2020 (phase-II), and October - December 2020 (phase-III). The same data were divided and grouped for the six most represented diagnoses. Results: The number of admissions for surgical emergencies in the studied periods showed a sinusoidal trend. In the reference period of 2019, 957 patients were admitted in urgency, while in the three pandemic phases, urgent admissions were 511, 888 and 633 respectively (-47% in phase I, - 8% in phase II, -34% in phase III). This trend was also observed by stratifying admissions for single disease, except for gastrointestinal perforations and pancreatitis, which showed a slight increasing trend in phase-I. Among the studied population, the surgical rate was 35.2% in phase-I and 34.3% in phase-III; these data were significantly higher than in 2019 (25.6%). Conclusions The effect of the COVID pandemic on surgical emergencies and urgencies (SUEs) was mainly indirect, manifesting itself with a significant reduction in the number of surgical admissions, particularly in phases-I and-III. Conversely, in the same phases, the surgical rate showed a significant increase compared to 2019
El registro público del patrimonio cultural en el inah. 52. Arqueología
No full textEl presente artículo expone los fundamentos académicos y jurídicos bajo los cuales ha sido diseñado e implantado el Sistema Único de Registro Público de Monumentos y Zonas Arqueológicos e Históricos, creado con la fialidad de hacer más efiiente la protección del patrimonio cultural. Por ello se presentan las características tecnológicas que ostenta el sistema, así como sus funcionalidades y virtudes. También se explica cómo fue articulado cada uno de sus componentes y la manera en que se conformaron las fihas de monumentos arqueológicos e históricos muebles e inmuebles. Se hace una reflxión en torno al impacto positivo en cuanto a las prácticas tradicionales de control y resguardo del patrimonio con la puesta en marcha de dicho sistema, además de los retos que el inah aún debe encarar respecto a esta temática.Arizpe, Lourdes
2006. Culturas en movimiento. Interactividad
cultural y procesos globales. México, Porrúa/
unam/Cámara de Diputados.Bartra, Roger
1975. “La tipología y la periodificación en el método
arqueológico”. En Marxismo y sociedades antiguas
(pp. 45-92). México, Grijalbo (Colección No. 70).Caple, Chris
2006. Objects. Reluctant Witness to the Past.
Londres, Routledge.Carral y de Teresa, Luis
2005. Derecho notarial y derecho registral. México.
Porrúa.Chamberlain, Robert S.
1974. Conquista y colonización de Yucatán,
1517-1550. México, Porrúa.Chang, Kwang-Chih
1976. Nuevas perspectivas en arqueología. Madrid,
Alianza.“Código de Deontología del icom para los Museos
2004”
2013. Recuperado de com.museum/fileadmin/user_
upload/pdf/Codes/code_ethics2013_es.pdf.Cruces, Omar
2009. “De arquitectura de tierra menor: el caso de
Puroagüita, Guanajuato”. En S. Mesa, M.T. Castillo,
P.F. Sánchez Nava y M. Medina (eds.), Memoria del
Registro Arqueológicos en México. Treinta Años.
México, inah (Científica 548).
“Disposiciones Reglamentarias para la Investigación
Arqueológica en México” (mecanoescrito). Consejo
de Arqueología, inah, México. Recuperado de http://consejoarqueologia.inah.gob.mx/?page_id=9Dobres, Marcia-Anee y Christopher. R. Hoffman
1994. “Social Agency and the Dynamics of Prehistoric
Technology”. Journal of Archaeological Method
and Theory 1(3): 211-258.Esquivel, Laura
2009. “El registro de sitios arqueológicos en Baja
California Sur”. En S. Mesa, M.T. Castillo, P.F.
Sánchez Nava y M. Medina (eds.), Memoria del
Registro Arqueológicos en México. Treinta Años.
México, inah (Científica 548).Gardin, Jean Claude
1980. Archaeological Constructs. Cambridge,
Cambridge University Press.Jiménez Badillo, Diego
1997. Ofrendata. Aplicación de un sistema de datos
para controlar una colección arqueológica. México,
inah (Textos Básicos y Manuales).Juárez, Daniel
2009. “Apuntes para la discusión sobre delimitacionesen la selva: el caso Yaxchilán, Chiapas”. En S.Mesa, M.T. Castillo, P.F. Sánchez Nava y M. Medina
(eds.), Memoria del Registro Arqueológicos en
México. Treinta Años. (pp. 389-398). México, inah
(Científica 548).López Zamarripa, Norka
2013. Recuperación de bienes culturales. México,
Porrúa.Manzanilla, Linda
2009. “Algunas reflexiones sobre la protección de
Teotihuacan”. En S. Mesa, M.T. Castillo, P.F.
Sánchez Nava y M. Medina (eds.), Memoria del
Registro Arqueológicos en México. Treinta Años
(pp. 659-664). México, inah (Científica 548).Mesa Dávila, Silvia
2009. “Responsabilidad y ética en las delimitaciones
de zonas arqueológicas”. En S. Mesa, M.T. Castillo,
P.F. Sánchez Nava y M. Medina (eds.), Memoria del
Registro Arqueológicos en México. Treinta Años
(pp. 659-664). México, INAH (Científica 548).
2009. “Propuesta metodológica para la inscripción
pública de colecciones arqueológicas”. En S. Mesa,
M.T. Castillo, P.F. Sánchez Nava y M. Medina (eds.),
Memoria del Registro Arqueológicos en México.
Treinta Años (pp. 681-697). México, INAH (Científica
548).Nalda, Enrique
2009. “El Proyecto Altas Arqueológico Nacional”.
En S. Mesa, M.T. Castillo, P.F. Sánchez Nava y M.
Medina (eds.), Memoria del Registro Arqueológicos
en México. Treinta Años (pp. 99-105). México, inah
(Científica 548).Pérez Fernández del Castillo, Bernardo
2007. Código civil, Reformas del 3 de marzo de
1979. Derecho registral. México. Porrúa.
2010. Derecho registral. México, Porrúa.Prieto Aceves, Carlos
2007. Inscripciones en el Registro Público de la
Propiedad. Errores subsanables. México, Porrúa/
Colegio de Notarios.
“Reglamento de la Ley Federal sobre Monumentos
y Zonas Arqueológicos, Artísticos e Históricos”.
Diario Oficial de la Federación, 8 de diciembre de
1975 (modificado por decreto el 5 de enero de 1993).Ribot G., Luis A.
2002. El patrimonio histórico-artístico español.
Madrid, Sociedad Estatal España Nuevo Milenio.Sánchez, Pedro
2009. “Registro, delimitaciones, declaratorias y
otras alternativas de protección del patrimonio
inmueble”. En S. Mesa, M.T. Castillo, P.F. Sánchez
Nava y M. Medina (eds.), Memoria del Registro
Arqueológicos en México. Treinta Años (pp. 591-
598). México, inah (Científica 548).UNESCO
1972. Convención sobre la protección del patrimonio
mundial, cultural y natural.
2003. Convención para la salvaguardia del patrimonio
cultural inmaterial.
1972. Ley Federal sobre Monumentos y Zonas
Arqueológicos, Artísticos e Históricos, publicada en
el Diario Oficial de la Federación el 6 de mayo de
1972
Sentiment Analysis: a comparison of feature sets for social data and reviews
No full textConsumers share their experiences or opinion about products or brands in various channels nowadays, for example on review websites or social media. Sentiment analysis is used to predict the sentiment of text from consumers about these products or brands in order to understand the tone of customers towards these products or brands. This thesis addresses sentiment analysis in the product domain on sentence level. In this thesis three data types are used which are collected by Unilever, review data which is text that contains the opinion of a customer towards a specific product. Social data, which can be tweets, Facebook messages, Instagram messages etc. and phone data which is a summary of a phone call of a customer about a specific product. When conducting sentiment analysis one solution is to extract features from the data which can be given to a machine learning algorithm together with sentiment labels given by human annotators. The machine learning algorithm will generate a classifier which can predict a label for sentences. In sentiment analysis literature it is often not clear why certain features are chosen or for which data type certain features will work well. In this research we compare the differences when using several feature sets for the different data types. We propose three feature sets for review data and three feature sets for social data. We focus on two aspects, comparing the different feature sets and comparing the data types. In our results we do not find significant differences in performance between the feature sets. The results suggest there might be feature sets which can improve sentiment analysis specifically for the data type, but a general feature set with standard features can be comparable to that result.Computer Science | Data Science and Technology | Information Architectur
La ironía en la narrativa de Virgilio Piñera: crítica individual y social
No full textIn Virgilio Pinera’s narrative, irony is presented as a modality of thought that responds to the critical and transgressive need of the Cuban writer, who resorts to the elusive nature of this literary figuration to create narrative texts that constantly question reality on a complex interpretive level, which mainly focuses on the critique of official culture, be it religion, the State, morality, literary canon, modern man. Through the phases of Pere Ballart's ironic minimum, some texts from Cuentos fríos and La carne de René are analyzed with the purpose of explaining irony as an articulating procedure or constructive principle in Virgilio Piñera's narrative, and, consequently, the individual and social critique that the author proposes.En la narrativa de Virgilio Piñera, la ironía es una modalidad del pensamiento que responde a la necesidad crítica y transgresora del escritor cubano, quien recurre a la naturaleza elusiva de esta figuración literaria para crear textos narrativos que cuestionan constantemente la realidad con un nivel interpretativo complejo, que sobre todo recae en la crítica a la cultura oficial, llámese religión, Estado, moral, canon literario, hombre moderno. Mediante las fases del mínimum irónico de Pere Ballart, se analizan algunos textos de Cuentos fríos y La carne de René con el propósito de explicar la ironía como procedimiento articulador o principio constructivo en la narrativa de Virgilio Piñera, y, por ende, la crítica individual y social que propone el autor
El cuerpo grotesco en la narrativa de virgilio piñera: Crítica y transgresión
No full textVirgilio Piñera’s poetics revolves around the symbol of the body, which is configured as a centripetal force in the cuban writer’s narrative, specifically in La carne de René and Cuentos fríos, literary works in which it is presented from the perspective of the grotesque —in its plastic and abstract planes— as lacerated, eroticized or disfigured with the intention of transgressing and degrading the literary canon of the time and the Official Institutions —the Church, the State, the Society, Culture and Art—. In the same way, the body is the reason for the historical criticism that the author proposes regarding the dictatorships in Latin America in the 20th century, as well as the criticism of the «strong men of history», religion, one’s own construction of man in modernity, the disorder of the world and the annulment of History.La poética de Virgilio Piñera gira en torno al símbolo del cuerpo, el cual se configura como fuerza centrípeta en la narrativa del escritor cubano, específicamente en La carne de René y en Cuentos fríos, obras en las que se presenta desde la perspectiva de lo grotesco —en sus planos plástico y abstracto— como lacerado, erotizado o desfigurado con la intención de transgredir y degradar el canon literario de la época, y a las instituciones oficiales —la Iglesia, el Estado, la Sociedad, la Cultura y el Arte—. De la misma manera, el cuerpo es el motivo para la crítica histórica que el autor propone con respecto a las dictaduras en América Latina en el siglo XX, así como la crítica a los «hombres fuertes de la historia», a la religión, a la propia construcción del hombre en la modernidad, al desorden del mundo y a la anulación de la Historia
Advancing immunosuppression in liver transplantation: A narrative review
No full textImmunosuppression is essential to ensure recipient and graft survivals after liver transplantation (LT). However, our understanding and management of the immune system remain suboptimal. Current immunosuppressive therapy cannot selectively inhibit the graft-specific immune response and entails a significant risk of serious side effects, i.e., among others, de novo cancers, infections, cardiovascular events, renal failure, metabolic syndrome, and late graft fibrosis, with progressive loss of graft function. Pharmacological research, aimed to develop alternative immunosuppressive agents in LT, is behind other solid-organ transplantation subspecialties, and, therefore, the development of new compounds and strategies should get priority in LT. The research trajectories cover mechanisms to induce T-cell exhaustion, to inhibit co-stimulation, to mitigate non-antigen-specific inflammatory response, and, lastly, to minimize the development and action of donor-specific antibodies. Moreover, while cellular modulation techniques are complex, active research is underway to foster the action of T-regulatory cells, to induce tolerogenic dendritic cells, and to promote the function of B-regulatory cells. We herein discuss current lines of research in clinical immunosuppression, particularly focusing on possible applications in the LT setting
Survival effect of first- and second-line treatments for patients with primary glioblastoma: a cohort study from a prospective registry, 1997-2010
No full textProspective follow-up studies of large cohorts of patients with glioblastoma (GBM) are needed to assess the effectiveness of conventional treatments in clinical practice. We report GBM survival data from the Brain Cancer Register of the Fondazione Istituto Neurologico Carlo Besta (INCB) in Milan, Italy, which collected longitudinal data for all consecutive patients with GBM from 1997 to 2010.
Survival data were obtained from 764 patients (aged16 years) with histologically confirmed primary GBM who were diagnosed and treated over a 7-year period (20042010) with follow-up to April 2012 (cohort II). Equivalent data from 490 GBM patients diagnosed and treated over the preceding 7 years (19972003) with follow-up to April 2005 (cohort I) were available for comparison. Progression-free survival (PFS) was available from 361 and 219 patients actively followed up at INCB in cohorts II and I, respectively.
Survival probabilities were 54 at 1 year, 21 at 2 years, and 11 at 3 years, respectively, in cohort II compared with 47, 11, and 5, respectively, in cohort I. PFS was 22 and 12 at 1 year in cohorts II and I. Better survival and PFS in cohort II was significantly associated with introduction of the Stupp protocol into clinical practice, with adjusted hazard ratios (HRs) of 0.78 for survival and 0.73 for PFS, or a 22 relative decrease in the risk of death and a 27 relative decrease in the risk of recurrence. After recurrence, reoperation was performed in one-fifth of cohort I and in one-third of cohort II but was not effective (HR, 1.05 in cohort I and 1.02 in cohort II). Second-line chemotherapy, mainly consisting of nitrosourea-based chemotherapy, temozolomide, mitoxantrone, fotemustine, and bevacizumab, improved survival in both cohorts (HR, 0.57 in cohort I and 0.74 in cohort II). Radiosurgery was also effective (HR, 0.52 in cohort II).
We found a significant increase in overall survival, PFS, and survival after recurrence after 2004, likely due to improvements in surgical techniques, introduction of the Stupp protocol as a first-line treatment, and new standard protocols for second-line chemotherapy and radiosurgery after tumor recurrence. In both cohorts, reoperation after tumor recurrence did not improve survival
Plasma Lipid Profiling Contributes to Untangle the Complexity of Moyamoya Arteriopathy
No full textMoyamoya arteriopathy (MA) is a rare cerebrovascular disorder characterized by is-chemic/hemorrhagic strokes. The pathophysiology is unknown. A deregulation of vasculogenic/ angiogenic/inflammatory pathways has been hypothesized as a possible pathophysiological mechanism. Since lipids are implicated in modulating neo-vascularization/angiogenesis and inflammation, their deregulation is potentially involved in MA. Our aim is to evaluate angiogenic/vasculogenic/ inflammatory proteins and lipid profile in plasma of MA patients and control subjects (healthy donors HD or subjects with atherosclerotic cerebrovascular disease ACVD). Angiogenic and inflammatory protein levels were measured by ELISA and a complete lipidomic analysis was performed on plasma by mass spectrometry. ELISA showed a significant decrease for MMP-9 released in plasma of MA. The untargeted lipidomic analysis showed a cumulative depletion of lipid asset in plasma of MA as compared to HD. Specifically, a decrease in membrane complex glycosphingolipids peripherally circulating in MA plasma with respect to HD was observed, likely suggestive of cerebral cellular recruitment. The quantitative targeted approach demonstrated an increase in free sphingoid bases, likely associated with a deregulated angiogenesis. Our findings indicate that lipid signature could play a central role in MA and that a detailed biomarker profile may contribute to untangle the complex, and still obscure, pathogenesis of MA
An overview of SARS-CoV-2 variants circulating in the 2020–2022 period in Lombardy.
No full textSince the beginning of the pandemic, SARS-CoV-2 has shown genetic variability. All the variants that have sustained pandemic waves have shown several mutations, especially in the Spike protein that could affect viral pathogenesis. A total of 15,729 respiratory samples, collected between December 2020 and August 2022, have been included in this study. We report the circulation of SARS-CoV-2 variants in the Lombardy region, Italy, in a 2-year study period. Alpha, Delta, and Omicron variants became predominant causing the majority of cases whereas Beta or Gamma variants mostly caused local outbreaks. Next-generation sequenc-ing revealed several mutations and few deletions in all of the main variants. For example, 147 mutations were observed in the Spike protein of Omicron sublineages; 20% of these mutations occurred in the recep-tor-binding domain region. (c) 2023 Elsevier Inc. All rights reserved
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