37,140 research outputs found
Dexmedetomidine for LISA procedure in preterm infants: a pilot study
No full textreservedPresupposti. La LISA (Less Invasive Surfactant Administration) è la tecnica di somministrazione di surfattante attualmente raccomandata dalle Linee Guida Europee per la gestione della RDS nei neonati pretermine in respiro spontaneo supportati con CPAP. Tale tecnica comprende l’esecuzione di una laringoscopia, che è una procedura dolorosa, comportando quindi la necessità di un’adeguata analgosedazione. Il farmaco ideale in tale contesto dovrebbe avere un rapido onset e una breve durata d’azione, oltre a non impattare sul drive respiratorio ed essere sicuro nel breve e lungo termine. Finora sono stati studiati diversi farmaci per l’analgosedazione durante LISA, ma nessuno di essi è risultato ottimale a causa dell’aumentato rischio di depressione respiratoria osservato nei pazienti sedati. La dexmedetomidina, un agonista adrenergico α2-selettivo dall’effetto analgesico e sedativo con impatto minimo o assente sul drive respiratorio, potrebbe rappresentare un’opzione adatta alla premedicazione per LISA.
Obiettivi. Lo scopo di questo studio è indagare l’efficacia della dexmedetomidina in termini di analgesia e sedazione durante la procedura LISA e la sua sicurezza nei neonati pretermine.
Materiali e metodi. È stato condotto uno studio osservazionale longitudinale prospettico su neonati pretermine di età gestazionale compresa tra 26+0 e 36+6 settimane con RDS e necessità di terapia con surfattante, ricoverati presso una TIN di terzo livello. I pazienti sono stati inoltre suddivisi in due gruppi in base all’età gestazionale (< o ≥ 32 SG). La dexmedetomidina è stata somministrata in bolo lento alla dose di 1 μg/kg prima della LISA. Gli outcome primari sono stati l’efficacia della dexmedetomidina nel fornire adeguate analgesia e sedazione, misurate rispettivamente tramite gli score NIPS e N-PASS, e la sicurezza di tale farmaco in termini di effetti sul drive respiratorio (comparsa di apnea/desaturazione e necessità di intubazione) e di effetti collaterali cardiovascolari (bradicardia e ipotensione).
Risultati. Sono stati arruolati 47 neonati, di cui 30 di età compresa tra 26+0 e 31+6 SG e 17 di età tra 32+0 e 36+6 SG. La mediana (IQR) di età gestazionale e peso alla nascita è stata rispettivamente 29+6 (28+5, 33+1) SG e 1421 (1069, 2074) g. L’analgesia è stata adeguata, con il 76% dei pazienti con NIPS ≤ 4 durante la laringoscopia e percentuali maggiori, attorno al 90%, negli altri momenti della procedura. La sedazione, invece, è stata tardiva e prolungata, con solo 10 neonati (23%) al livello di sedazione desiderato (N-PASS tra -2 e -5) all’inizio della LISA, stato che si è protratto per almeno 60 minuti dopo la procedura. Sono stati rilevati cinque casi (11%) di apnea/desaturazione e sei pazienti (13%) hanno richiesto intubazione entro le 72 ore dalla procedura. Nessun paziente ha presentato bradicardia, mentre si è verificata ipotensione in tre neonati (6%).
Conclusioni. La dexmedetomidina ha garantito un’analgesia adeguata e permesso un’agevole esecuzione della procedura, senza causare al contempo effetti avversi gravi. Non ha, tuttavia, permesso di raggiungere il livello desiderato di sedazione al momento della LISA, dimostrando un effetto sedativo tardivo e prolungato nel tempo. La premedicazione con dexmedetomidina non sembra, quindi, ideale per la procedura LISA, che richiede un farmaco con un più rapido onset e una più breve durata d’azione.Background. Less invasive surfactant administration (LISA) is the surfactant administration method currently recommended by the European Guidelines for the management of respiratory distress syndrome (RDS) in preterm neonates spontaneously breathing on CPAP. This technique involves a laryngoscopy, a painful procedure that requires appropriate analgesia and sedation. The ideal drug for this purpose should have a rapid onset and a short duration of action, should not affect respiratory drive, and should be safe in both the short and long term. Several drugs have been tested for analgesia and sedation during LISA, but none have proven ideal due to an increased risk of respiratory depression. Dexmedetomidine, a selective α2-adrenergic agonist with analgesic and sedative effects and minimal or no impact on respiratory drive, seems a promising option for LISA premedication.
Objectives. This study aimed to evaluate the efficacy of dexmedetomidine for analgesia and sedation during the LISA procedure, as well as its safety in preterm neonates.
Methods. This prospective observational study enrolled preterm neonates with a gestational age between 26+0 and 36+6 weeks diagnosed with RDS and requiring surfactant therapy, admitted to a level III NICU. Patients were further divided into two groups based on gestational age (<32 or ≥32 weeks). Dexmedetomidine was administered as a slow bolus at a dose of 1 μg/kg before LISA. Primary outcomes were the efficacy of dexmedetomidine in providing adequate analgesia and sedation – evaluated using the Neonatal Infant Pain Scale (NIPS) and the Neonatal Pain, Agitation, and Sedation Scale (N-PASS), respectively – and its safety, determined by the lack of side effects, both respiratory (apnea/desaturation and need of intubation) and cardiovascular (bradycardia and hypotension) ones.
Results. A total of 47 neonates were enrolled, 30 aged between 26+0 and 31+6 weeks GA and 17 between 32 and 36+6 weeks GA. The median (IQR) gestational age and birth weight were 29+6 (28+5, 33+1) weeks and 1421 (1069, 2074) g, respectively. Analgesia was adequate, with 76% patients achieving a NIPS score ≤4 during laryngoscopy and around 90% at other time points during the procedure. However, sedation was delayed and prolonged, with only 10 neonates (23%) reaching the desired sedation level (N-PASS between -2 and -5) at the beginning of LISA, which persisted for at least 60 minutes after the procedure. Apnea/desaturation occurred in five cases (11%), and six patients (13%) required intubation within 72 hours. No episodes of bradycardia were observed, while hypotension occurred in three neonates (6%).
Conclusion. Dexmedetomidine provides adequate analgesia and good technical conditions without causing severe adverse effects. However, the desired level of sedation was not consistently achieved, due to a delayed and prolonged sedative effect. Therefore, dexmedetomidine may not be the optimal choice for LISA premedication, as this procedure requires a drug with a faster onset and shorter duration of action
Episode 48: Lisa Franchina – MA TESOL and Law
No full textIn this episode, listen to Lisa Franchina describe her experiences in the MA in TESOL program as she explored the English Language teaching field after years practicing law. Hear Lisa describe her memorable experiences in the program, including her support for the English language classes at the Central Florida Reception Center. Lisa still practices law at her practice, Franchina Law PA
Social networks: the future of marketing for small business
No full textPurpose – The authors review recent developments in online marketing strategy that demonstrate the growing power of online communities in building brand reputations and customer relationships. Design/methodologies/approach – This work draws upon the results of an ongoing research project that is investigating the use of new technologies by entrepreneurial growing businesses in the London area. A range of examples from our 30 case study businesses are drawn upon to illustrate some of the opportunities and threats associated with these new marketing priorities.<br/
Ma prière…
No full textEn hommage au Dr. Mukwege Ma prière… Seigneur mon Dieu, mon appui, mon refuge. Je te remercie pour la vie que tu renouvelles chaque jour. Je te remercie pour les sens que tu mets en éveil chaque matin.Et je te rends grâce pour la paix et la joie que tu déposes dans mon cœur jour après jour. Seigneur, tu connais tout de ma vie et je sais que rien n’est caché devant ta face. Tu sais quand je me lève, quand je me couche. Tu connais mes luttes, mes combats et je sais que tu es avec moi tous les ..
Riflessioni introduttive
No full textNoi siamo il cibo che mangiamo, l’aria che respiriamo, l’acqua che beviamo. Concetti come quello di inquinamento ambientale, acustico o elettromagnetico sono diventati per noi del tutto familiari. In ambito scientifico, il costruttivismo radicale e la fenomenologia ci hanno insegnato che noi siamo le parole che ascoltiamo. La nostra soggettività avrebbe dunque anche un fondamento discorsivo: una collezione di percezioni discontinue, come diceva David Hume.
Dalla scuola di Palo Alto abbiamo imparato che le parole nutrono e sostengono le identità individuali (ma anche quelle collettive) e che ci sono parole che fanno ammalare: ascoltarle a lungo in determinate condizioni (quelle del doppio vincolo, ad esempio) può condurre a disordini gravi della personalità, quali la schizofrenia. Ci sono parole dunque - o meglio strutture discorsive - capaci di minare la soggettività, capaci di inquinare irrimediabilmente la vita istituzionale di un’organizzazione o di una collettività. Ma questo vale soltanto per i discorsi? E le immagini come funzionano: sono potenti quanto le parole?
Nella società contemporanea infatti una delle risorse fondamentali con cui interpretiamo la realtà e con cui diamo significato alla nostra esistenza è costituita dalle immagini. In altri termini, potremmo ugualmente affermare che noi siamo anche le immagini che vediamo? Questa questione è peraltro epistemologicamente e cognitivamente complicata, perché se è pur vero che siamo anche ciò che vediamo, continua a valere anche l’esatto contrario: cioè, che vediamo ciò che siamo. In altri termini, il processo di attribuzione del senso non può mai essere indipendente dal soggetto che lo attualizza. Lo hanno detto i teorici della scuola di Costanza molti anni fa, ma continua a valere anche nella contemporaneità. Era il cosiddetto concetto di Erwartungshorizont di Jauss e Iser. Comunque, la questione che qui ci interessa concerne e investe lo statuto stesso dell’immaginario, in particolare di quello che si accompagna al testo parlato o scritto, come nel caso della televisione, del cinema, di internet, della pubblicità
Lisa au service du virtuel
No full textLe LISA ( Laboratory of Image Synthesis and Analysis) est un laboratoire de l'Ecole polytechnique de Bruxelles. Ses deux principaux thèmes de recherche sont l'analyse et la synthèse de l'image. Dans le domaine de l'analyse d'image et de la reconnaissance de formes, le Lisa aborde des problèmes 2D et 3D de segmentation et de suivi d'objets mobiles dans des séquences d'images. Les algorithmes développés sont adaptés à de nombreuses applications issues de domaines différents (trafic routier, bio..
Variations on the Author
No full text“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
Folk tror foxtrot: MFA Graduation show 2022
No full textPamflett. Verksliste. Fotodokumentasjon. Fotograf: Istvan Virag.Avgangsutstilling, master i billedkunst, Avdeling Kunstakademiet 2022.
Studenter: Benedict Beldam, Patricia Carolina, Tansiyu Chen, Henrik Follesø Egeland, Chloe Elgie, Makda Embaie, Cirenia Escobedo Esquivel, Mattias Hellberg, Kaja Krakowian, Eli Mai Huang Nesse, Jonatan Nilsson, Hanne Nilsen Nygård, Lesia Vasylchenko, Hamid Waheed, Annalise Wimmer.
Kurator: Lisa Rosendahl.
Visningssted: Kunstnernes Hus, Oslo. Tidspunkt: 19. april - 1. mai 2022
Data for: Authoritarian apprehensions: Ideology, judgment, and mourning in Syria
No full textProject Summary
In Authoritarian Apprehensions, Lisa Wedeen draws on her decades-long engagement with Syria to analyze the revolutionary exhilaration of the Syrian uprising’s initial days and then the devastating violence that shattered hopes of any quick undoing of dictatorship. Developing a theoretical approach within the frame of emerging forms of authoritarianism worldwide, Wedeen asks: What led a sizable part of the Syrian citizenry to stick by the regime through one atrocity after another? What happens to political judgment in a context of pervasive misinformation? And what does the Syrian example tell us about how authoritarian leaders exploit digital media to create uncertainty, political impasses, and fractures among their citizens? Based on extensive fieldwork and drawing on material from a variety of Syrian artistic practices, Wedeen lays bare the ideological investments that sustain ambivalent attachments to established organizations of political power and contribute to the ongoing challenge of pursuing political change.
Data Abstract
The project contains three forms of data:
Selected video-clips from the popular television comedy series, Day`a daay`a (A Forgotten Village [2008, 2010]) and from the sketches Amal—ma fi (Hope—There Isn’t Any, [2004]) captioned in English by Lisa Wedeen with the help of Osama Esber, Sofia Fenner, and the staff at Sama Art International. These series are available without English subtitles at various sites online. The episodes are discussed in chapter two, “Humor in Dark Times.”
Statistical materials analyzed in the appendix to chapter 1 of the book.
A list of all URLs used in the book with archived versions of the links in perma.cc, webrecorder.io, or the Internet Archive
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Les cheveux dans "Ma tendre ennemie" de Lisa Bresner : la natte, le pinceau et le peintre castré
No full textLisa Bresner (1971‐2007) is a novelist, translator, and sinologist, who has dedicated her entire life to literary creation around China and Asia. Ma tendre ennemie is her second novel, published in 1994 by Gallimard. The themes of Lisa Bresner’s work have to do with body and sensation. As for Ma tendre ennemie, this symbolic role returns to the hair – the support of sexual seduction, of power, of fertility, and more particularly of this novel, of artistic creation. This article aims to analyse, how the notion of hair in the novel goes hand in hand with the ambiguous political and social stake of the wearing of the queue during the first Sino‐Japanese war, the deconstruction of the castration, the aesthetic of cruelty, and the reinterpretation of Asian eroticism.Lisa Bresner (1971‐2007) is a novelist, translator, and sinologist, who has dedicated her entire life to literary creation around China and Asia. Ma tendre ennemie is her second novel, published in 1994 by Gallimard. The themes of Lisa Bresner’s work have to do with body and sensation. As for Ma tendre ennemie, this symbolic role returns to the hair – the support of sexual seduction, of power, of fertility, and more particularly of this novel, of artistic creation. This article aims to analyse, how the notion of hair in the novel goes hand in hand with the ambiguous political and social stake of the wearing of the queue during the first Sino‐Japanese war, the deconstruction of the castration, the aesthetic of cruelty, and the reinterpretation of Asian eroticism.Lisa Bresner (1971‐2007) is a novelist, translator, and sinologist, who has dedicated her entire life to literary creation around China and Asia. Ma tendre ennemie is her second novel, published in 1994 by Gallimard. The themes of Lisa Bresner’s work have to do with body and sensation. As for Ma tendre ennemie, this symbolic role returns to the hair – the support of sexual seduction, of power, of fertility, and more particularly of this novel, of artistic creation. This article aims to analyse, how the notion of hair in the novel goes hand in hand with the ambiguous political and social stake of the wearing of the queue during the first Sino‐Japanese war, the deconstruction of the castration, the aesthetic of cruelty, and the reinterpretation of Asian eroticism
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