1,720,961 research outputs found
Burns: Classification and Treatment
No full textBurns are the most devastating form of trauma that has afflicted mankind since ancient times, and their short- and long-term consequences leave severe sequelae in the patients involved. The costs they generate to health systems are very high, and at present there are only few hospital centers specialized in the treatment of these affections. A burn is defined as an injury to the skin or other organic tissue primarily caused by heat or flame (>90%) or due to radiation, radioactivity, electricity, friction, or contact with chemicals (10%). Burn severity classification is determined by the patient’s age; the percentage of total body surface area burned; depth of burn; type of burn; whether it is associated with gas inhalation; or specific body parts involved. The majority of burn injuries are minor and either do not require treatment or can be treated by any caregiver. On the other side, severe burns (>20% TBSA) can result in clinically significant morbidity as they cause not only significant injury at the local burn site but also a systemic response throughout the body. Inflammatory and vasoactive mediators such as histamines, prostaglandins, and cytokines are released causing a systemic capillary leak, intravascular fluid loss, and large fluid shifts. Failure to properly treat these injuries will lead to rapid development of organ failure and death. The initial approach of the severely burned patient in the shock phase is critical for patients’ survival; the main pillars of the treatment are fluid resuscitation, airway distress management, and surgical debridement. A multidisciplinary team is essential for a proper management
Commento all'art. 9
No full textLo sportello dei contratti pubblici relativi a lavori, servizi e forniture, altro non è che un plesso organizzativo, specializzato nelle relazioni col pubblico degli "operatori economici": chiamato ad assolvere al compito di ottimizzare il flusso d'informazioni relativo alle procedure di gara, sottese all'affidamento dei contratti pubblici relativi a lavori, servizi, forniture. La soluzione legislativa, d'istituire tale Ufficio, si è rivelata contrastata, specie per una lamentata sovrapposizione coi compiti affidati a pre-esistenti "osservatori" regionali nonché, per le perplessità suscitate da una soluzione organizzativa che si prevedeva (pretendeva) esente da oneri finanziari. Da qui, la tendenza a "relegare" le corrispondenti disposizioni fra quelle di tipo "programmatico": prevalentemente rivolte alle realtà amministrative più complesse; per il resto, valendo come impulso verso processi di adeguamento, percorribili autonomamente. A questa stregua, il principio di buon andamento deve assumersi quale parametro non solo della funzionalità dell'Ufficio (adibizione di personale idoneo, oggetto di adeguato aggiornamento professionale, etc.), ma (prima ancora) della sua stessa istituzione.
Il rilievo giuridico dell'istitutzione di tale tipo di Ufficio, evidentemente, non risiede nelle menzionate sfaccettature (propriamente di scienza dell'amministrazione); piuttosto, in ciò che, accanto ad un contributo meccanico (all'insegna della pubblicità e della trasparenza), lo Sportello può essere chiamato ad assolvere anche ad un apporto costruttivo (es. interpretazione "autentica" della lex specialis di gara). Non per caso, su questo punto (quale investente profili di competenza) si registrano opinioni divergenti
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe 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
Cost Analysis of a Novel Enzymatic Debriding Agent for Management of Burn Wounds
Full text linkIntroduction. Given its efficacy and safety, NexoBrid⢠(NXB) has become part of our therapeutic options in burns treatment with satisfactory results. However, no cost analysis comparing NXB to the standard of care (SOC) has been carried out as of today. Aim. To assess the cost of treatment with NXB and compare it to the SOC cost. Methods. 20 patients with 14-22% of TBSA with an intermediate-deep thermal burn related injury were retrospectively and consecutively included. 10 of these patients were treated with the SOC, while the other 10 with NXB. The cost analysis was performed in accordance with the weighted average Italian Health Ministry DRGs and with Conferenza Stato/Regioni 2003 and the study by Tan et al. For each cost, 95% confidence intervals have been evaluated. Results. Considering the 10 patients treated with NXB, the overall savings (total net saving) amounted to 53300 euros. The confidence interval analysis confirmed the savings. Discussion. As shown by our preliminary results, significant savings are obtained with the use of NXB. The limit of our study is that it is based on Italian health care costs and assesses a relative small cohort of patients. Further studies on larger multinational cohorts are warranted
Management of Toxic Epidermal Necrolysis with Plasmapheresis and Cyclosporine A: Our 10 Years' Experience
Full text linkBackground: The management of toxic epidermal necrolysis (TEN) is controversial and there is no uniform strategy. Objective: To share our 10 years' experience in treating severe TEN with a novel protocol based on the association of cyclosporine A and plasmapheresis. Methods: In this case series, we retrospectively collected and assessed the 12 cases of severe TEN treated from 2005 to 2015 at the Burn Unit of the University of Bari Policlinico hospital. Results: Average body surface area was 77; average SCORETEN was 4.3. The 12 patients had been treated with culprit drug withdrawal, systemic corticosteroids, and/or cyclosporine A with no response. The protocol was successfully administered in all 12 cases. Average time to response from protocol start was 4.9 days. Average time to remission from protocol start was 22 days; average hospital stay at our unit was 24.8 days. Four patients developed severe complications; 1 patient died. No complications linked to the protocol therapeutic measures were observed. The relatively small number of cases given the rarity of the condition is a limitation of this report. Conclusion: Our protocol based on the association of cyclosporine A and plasmapheresis is safe and efficacious in treating severe TEN
Variations on the Author
Full text link“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
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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