1,720,967 research outputs found

    Transanal minimally invasive surgery (Tamis). New treatment for early rectal cancer and large rectal polyps-experience of an Italian center

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    Transanal endoscopic microsurgery (TEM) is a minimally invasive technique for excision of rectal tumors that avoids conventional pelvic resectional surgery along with its risks and side effects. Although appealing, the associated cost and complex learning curve limit TEM use by colorectal surgeons. Transanal minimally invasive surgery (TAMIS) has emerged as an alternative to TEM. This platform uses ordinary laparoscopic instruments to achieve high-quality local excision. The aim of the study is to assess reliability of the technique. From July 2012 to August 2013, 15 consecutive patients with rectal pathology underwent TAMIS. After a single-incision laparoscopic surgery port was introduced into the anal canal, a pneumorectum was established with a laparoscopic device followed by transanal excision with conventional laparoscopic instruments, including graspers, electrocautery, and needle drivers. Patient demographics, operative data, and pathologic data were recorded. Of the 15 patients, 10 had rectal cancers (six T1 lesions and four T2 after preoperative chemoradiotherapy). The remainder of patients had a local excision for voluminous benign rectal adenomas. The median length of the lesions from the anal verge was 7 cm (range, 4 to 20 cm). The median operating time was 86 minutes (range, 33 to 160 minutes). There was no surgical morbidity or mortality. The median postoperative hospital stay was two days (range, 1 to 4 days). TAMIS seems to be a feasible and safe treatment option for early rectal cancer. We believe that this new technique is easy to perform, cost-effective, and less traumatic to the anal sphincter compared with traditional TE

    I metodi di valutazione e fasi del ciclo di vita delle startup

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    Negli ultimi decenni, l’economia globale è stata caratterizzata dalla nascita e dallo sviluppo di aziende incentrate nell’erogazione di prodotti e servizi ad alto contenuto tecnologico; l’avvento di Internet ha costretto le imprese a ripensare alla propria strategia e a ricercare un posto nel web (Southwick, 2001). Il nuovo ciclo, definito della New Economy, che ha preso il via con la quotazione nel 1995 di Netscape Communications Inc., si è sviluppato rapidamente mediante le imprese operanti nel settore informatico definite Dot-com companies (De Long e Magin, 2006) per le quali il prezzo delle azioni era basato più sulle aspettative future che sui classici indicatori di bilancio. Nel marzo del 2000, con la pubblicazione dei bilanci delle Dot-com, che evidenziavano risultati deludenti, il mercato iniziò a comprendere che l’investimento, dopo anni di continua crescita, poteva rivelarsi non profittevole; molte delle imprese della nuova economia cessarono la propria attività o furono oggetto di operazioni straordinarie e, nel 2004, solo il 50% delle società che nel 2000 erano quotate sul mercato americano erano attive. Lo scoppio della bolla delle imprese tecnologiche ha evidenziato le debolezze dei metodi di valutazione applicati sino a quel momento ragion per cui la dottrina, che già si era occupata del fenomeno delle startup, ha iniziato a studiare più accuratamente le relative metodologie di stima del capitale economico senza giungere, però, alla definizione di un algoritmo condiviso ed universalmente riconosciuto. Infatti, le tecniche di valutazione comunemente utilizzate nella finanza aziendale si basano su rigidi presupposti e richiedono informazioni tipicamente non disponibili per le startup. Di conseguenza, la loro applicabilità è fortemente limitata nella valutazione delle imprese innovative soprattutto per quelle che si trovano nelle fasi iniziali di sviluppo dell’idea imprenditoriale. L’incertezza sulla fattibilità del progetto imprenditoriale e sulle dimensioni del mercato di riferimento conduce il valutatore ad avere un’insicurezza sul percorso di crescita e sul futuro sviluppo di tali tipologie di imprese con evidenti riverberi sull’affidabilità delle valutazioni poste in essere. L’importanza di una corretta stima del valore economico delle startup è direttamente collegata alla rilevanza di tali aziende nell’economia odierna; la corretta stima, infatti, in considerazione del fatto che consente di ridurre le asimmetrie informative tra investitori e imprenditori, appare essenziale per lo sviluppo dei progetti imprenditoriali e, di conseguenza, per la crescita dell’economia mondiale. In tale prospettiva, obiettivo del presente lavoro è: · analizzare la validità dei modelli di valutazione tradizionali e le opportunità di utilizzo dei metodi alternativi di più recente istituzione; · correlare le metodologie di stima con le varie fasi di crescita delle startup; · definire lo stato dell’arte delle metodologie di valutazione delle startup e fornire le linee guida per le future attività di ricerca

    Going Beyond Counting First Authors in Author Co-citation Analysis

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    The 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

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    “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

    Perceived warmth and competence of others shape voluntary deceptive behaviour in a morally relevant setting

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    The temptation to deceive others compares to a moral dilemma: it involves a conflict between the temptation to obtain some benefit and the desire to conform to personal and social moral norms or avoid aversive social consequences. Thus, people might feel different levels of emotional and moral conflict depending on the target of the deception. Here we explored, in a morally relevant setting, how social judgements based on two fundamental dimensions of human social cognition – ‘warmth’ and ‘competence’ – impact on the decision to deceive others. Results revealed independent effects for warmth and competence. Specifically, while people are less inclined to deceive for self-gain those individuals they perceive as warm, they also tend to lie more to highly competent others. Furthermore, the perceived warmth and competence modulated the general tendency to reduce deceptive behaviour when there was a risk of disclosure compared to when the lying was anonymous, highlighting the importance of these judgements in social evaluation processes. Together, our results demonstrate that the emotional costs and personal moral standards that inhibit engagement in deceptive behaviour are not stable but rather malleable according to the target and the consequences of the deception
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