239 research outputs found
Enrico IV ovvero il potere salvifico dell’immaginazione
No full textAmong the writings published by Umberto Artioli a year before his sudden death in July 2004, there is a study on Luigi Pirandello’s Enrico IV. Abandoning the usual realistic interpretation of the text, the scholar highlights the allegorical path underneath its conception and a number of references related to the evangelical Last Supper. The core of Pirandello’s hero teachings identifies in the theatrical imagination the way to salvation. Although the initiation of his disciples fails, the Author outlines the characteristics of a new type of artist and his ideal relationship with the public; a figure that will inspire Bontempelli’s ideas on an extremely versatile and eclectic interpreter to be driven on stage like a puppet
Tracheostomy procedures in the intensive care unit: an international survey
No full textINTRODUCTION:
Percutaneous dilatational tracheostomy (PDT) is one of the most frequent procedures performed in the intensive care unit (ICU). PDT may add potential benefit to clinical management of critically ill patients. Despite this, no clinical guidelines are available. We sought to characterize current practice in this international survey.
METHODS:
An international survey, endorsed and peer reviewed by European Society of Intensive Care Medicine (ESICM), was carried out from May to October 2013. The questionnaire was accessible from the ESICM website in the 'survey of the month' section.
RESULTS:
429 physicians from 59 countries responded to this survey. Single step dilatational tracheostomy was the most used PDT in ICU. Almost 75 % of PDT's were performed by intensive care physicians. The main indication for PDT was prolonged mechanical ventilation. Tracheostomies were most frequently performed between 7-15 days after ICU admission. Volume control mechanical ventilation, and a combination of sedation, analgesia, neuromuscular blocking agents and fiberoptic bronchoscopy were used. Surgical tracheostomy was mainly performed in ICU by ENT specialists, and was generally chosen when for patients at increased risk for difficult PDT insertion. Bleeding controlled by compression and stoma infection/inflammation were the most common intra-procedural and late complications, respectively. Informed consent for PDT was obtained in only 60 % of cases.
CONCLUSIONS:
This first international picture of current practices in regard to tracheostomy insertion demonstrates considerable geographic variation in practice, suggesting a need for greater standardization of approaches to tracheostomy insertio
Percutaneous dilatational tracheostomy with a double-lumen endotracheal tube: A comparison of feasibility, gas exchange, and airway pressures
No full textOBJECTIVE: Gas exchange and airway pressures are markedly altered during percutaneous dilatational tracheostomy (PDT). A double-lumen endotracheal tube (DLET) has been developed for better airway management during PDT. Th e current study prospectively evaluated the in vivo feasibility, gas exchange, and airway pressures during PDT with DLET compared with a conventional endotracheal tube (ETT). METHODS: According to eligibility criteria, patients were divided into a case group (those receiving PDT with DLET) and a control group (those receiving PDT with a conventional ETT). Th e Ciaglia single-dilator technique was used for PDT in both groups. Th e primary end point of this study was the feasibility of tracheostomy with DLET. Th e secondary end points were a comparison of gas exchange, airway pressures, minute volume, and tidal volume before, during, and aft er PDT performed with DLET and conventional ETT. RESULTS: Ten patients meeting the inclusion criteria were assigned to each group. PDTs were performed without diffi culties in nine patients in the DLET group and 10 patients in the conventional ETT group. During PDT, gas exchange, airway pressures, and minute ventilation remained more stable in the DLET group and were signifi cantly diff erent from those in the conventional ETT group. CONCLUSIONS: PDT with DLET can be performed safely without diffi culties limiting the technique. Furthermore, during PDT, the use of the DLET resulted in more stable gas exchange, airway pressures, and ventilation than PDT with a conventional ETT. TRIAL REGISTRY: ClinicalTrials.gov; No.: NCT01691222; URL: www.clinicaltrials.gov
Neuromonitoring during general anesthesia in non-neurologic surgery
No full textCerebral complications are common in perioperative settings even in non-neurosurgical procedures. These include postoperative cognitive dysfunction or delirium as well as cerebrovascular accidents. During surgery, it is essential to ensure an adequate degree of sedation and analgesia, and at the same time, to provide hemodynamic and respiratory stability in order to minimize neurological complications. In this context, the role of neuromonitoring in the operating room is gaining interest, even in the non-neurolosurgical population. The use of multimodal neuromonitoring can potentially reduce the occurrence of adverse effects during and after surgery, and optimize the administration of anesthetic drugs. In addition to the traditional focus on monitoring hemodynamic and respiratory systems during general anesthesia, the ability to constantly monitor the activity and maintenance of brain homeostasis, creating evidence-based protocols, should also become part of the standard of care: in this challenge, neuromonitoring comes to our aid. In this review, we aim to describe the role of the main types of noninvasive neuromonitoring such as those based on electroencephalography (EEG) waves (EEG, Entropy module, Bispectral Index, Narcotrend Monitor), near-infrared spectroscopy (NIRS) based on noninvasive measurement of cerebral regional oxygenation, and Transcranial Doppler used in the perioperative settings in non-neurosurgical intervention. We also describe the advantages, disadvantage, and limitation of each monitoring technique
The Fractal Structure of the Universal Steenrod Algebra: An Invariant-theoretic Description
No full textAs recently observed by the second author, the mod2 universal
Steenrod algebra Q has a fractal structure given by a system of nested
subalgebras Qs, for s > N, each isomorphic to Q. In the present paper
we provide an alternative presentation of the subalgebras Qs through
suitable derivations s, and give an invariant-theoretic description of
them
Trading arrangements and industrial development
No full textHow do different trading arrangements influence the industrialization process of developing countries? Can preferential trading arrangements (PTAs) be superior to multilateral liberalization, or at least an alternative when multilateral liberalization proceeds slowly? If so, what form should the PTAs take? Are developing countries better advised to seek PTAs with industrial countries or among themselves? Traditional analysis of these issues has been based on the idea of trade creation and trade diversion. The problem with this analysis is that it starts from assuming a pattern of comparative advantage of newly industrialized countries. The experience of these countries suggests the need for an analysis in which the pattern of comparative advantage is not set in stone but is potentially flexible, and in which less developed countries can develop and converge in both income and economic structure to industrial economies. The authors outline an alternative approach for analyzing the role of trade in promoting industrial development. There are few fundamental differences between countries that generate immutable patterns of comparative advantage. Instead the pattern of trade and development in the world economy is determined mainly by history. Cumulative causation has created concentrations of industrial activity in particular locations (industrial countries) and left other areas more dependent on primary activities. Economic development can be thought of as the spread of these concentrations from country to country. Different trading arrangements may have a major impact on this development process. By changing the attractiveness of countries as a base for manufacturing production they can potentially trigger or postpone industrial development. This approach explains why firms are reluctant to move to economies that have lower wages and labor costs, and shows how trade liberalization can change the incentives to become established in developing countries. It provides a mechanism through which import liberalization can have a powerful effect in promoting industrialization. And it suggests that import liberalization may create or amplify differences between liberalizing countries with the possible political tensions this may create. While these features are consistent with the world economy, they fall short of providing convincing empirical support for the approach. Using the approach, the authors derive number of conclusions about the effects of trade liberalization. First, that unilaterally liberalizing imports of manufactures can promote development of the local manufacturing industry. The mechanism is forward linkages from imported intermediates, but this may be interpreted as part of a wider package of linkages coming from these imports. Second, the gains from liberalization through PTA membership are likely to exceed those obtained from unilateral action. South-South PTAs will be sensitive to the market size of member states, and North-South PTAs seem to offer better prospects for participating Southern economies, if not for North and excluded countries. Third, the effects of particular schemes (such as the division of benefits between Southern economies) will depend on the characteristics of the countries and cross-country differences in these characteristics.Economic Theory&Research,Environmental Economics&Policies,Water and Industry,Labor Policies,Banks&Banking Reform,Economic Theory&Research,Environmental Economics&Policies,TF054105-DONOR FUNDED OPERATION ADMINISTRATION FEE INCOME AND EXPENSE ACCOUNT,Trade and Regional Integration,Water and Industry
Translating wordplay in The Bridge by Harold Hart Crane
No full textAbstract
This essay focuses on a new translation of the divisive poem The Bridge by
Harold Hart Crane. Published in the United States in 1930 and written
during a period of unprecedented literary creativity dominated by T.S. Eliot
and Ezra Pound, the poem encountered many obstacles in its
acknowledgment. Although Crane is now considered one of the major
modernist poets and The Bridge his masterpiece, the poem was originally
judged a failure. The reason for its negative reception depended on many
factors: the work did not conform to the canon of the age; the enthusiasm of
the author that created excessive expectations; its huge number of puns were
difficult to interpret and translate. In Italy the poem was translated at an
academic level for the first and last time in 1967 by Roberto Sanesi, although
a partial version appeared in a monograph by Pietro Spinucci published in
1966. Both have long been out of print. Considering that the translation
process of a text is related to context and time, a new rendering of The Bridge
into Italian has been proposed examining its puns.
Keywords: pun; translation; paradoxes; analogies; metaphors
Low-energy cooling of a medicine warehouse in a hot humid climate
No full textThe research was aimed at the definition of a design hypothesis for the construction of a pharmaceutical warehouse in a hot humid area of southern Sudan. The candidate hypotheses were based on an existing prefabricated single-storey pitched-roof steel structural systems 18 m long and 9 m wide and had to be constructible at a low cost and using local materials. At climatic level, the goal was that daily d.b. temperatures not exceeding 27-28 °C were reached by passive of very low-energy means, which was not easy to achieve in the given conditions. A construction hypothesis was made by the author adopting the following solutions: a) masonry for the walls, insulated from the outside and protected by rainscreens; b) a heavy concrete floor insulated from the outside and suspended upon a ventilated cavity; c) a ventilated and insulated metal-sheet pitched roof. Three passive cooling strategies based of the described solution have been tested by the author through the use of the ESP-r software tool: the first exploiting nightly stack effect ventilation, the second based on forced night-only fan ventilation, and the third based on night top-down ventilation activated by roof radiant cooling. The second and third hypotheses have been found to meet the thermal requirement and the second one was at last selected, because it seemed to guarantee lower construction costs and be less dependent from weather conditions
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