1,721,344 research outputs found
The most difficult and painful decision: When there is nothing to do anymore, when is better to do nothing
Full text linkChronic limb-threatening ischemia (CLTI) is a state of severe malperfusion of the lower limb. Patients with diabetes, end-stage renal disease, or very elderly, are particularly involved and at risk of a major cardiovascular event, sudden death, and amputation.
Decision-making in CLTI is based on the initial choice, if attempting limb salvage or proceeding with a major amputation to minimize surgical stress in these fragile patients at risk of perioperative death.
It is always important to establish what is their basal functional status, as well as the extent of all their comorbidities, before suggesting a limb revascularization surgery. We should try to understand whether the patient can derive a substantial benefit from a perfectly successful revascularization intervention.
Patency or limb salvage should not always be aimed for at any cost: while most patients will benefit from an aggressive limb salvage approach, others will benefit from a primary amputation, and others will benefit from palliative care with no invasive intervention. Therapeutic risk stratification is crucial, and the inability to recover from major stress must be foreseen. We should answer these three questions: Is our patient dying?
What is the expected ambulatory capacity of our patient? Is the foot severely infected? Major amputation can also represent the best therapeutic option and, as such, it must be planned and executed with accuracy.
Only after this elaborate decision-making process, we can inform our patient to ask for consent to the treatment
Editorial: Targeting the Optimal Design and Operational Flexibility of Steam Cycles and Steam Networks
Full text linkPetrarchismo (e manierismo) in Accademia: Nicolò Martelli e Benedetto Varchi
No full textIl contributo si sofferma sulla vita culturale della Firenze a cavaliere di metà Cinquecento, soggetta a un controllo culturale sempre più rigido da parte del potere mediceo, in cui si assiste al consolidamento del modello linguistico e stilistico petrarchesco, pur tra resistenze e polemiche: che si accendono, in particolare, sulla soluzione proposta dal Bembo. Affermazione e reazione trovano il loro luogo deputato nell’Accademia Fiorentina, braccio operativo della volontà recuperare al volgare cittadino l’antico primato. Al centro dell'interesse stanno le discussioni che a margine dell'esercizio poetico e della pratica figurativa e artistica si animarono durante la reggenza di due consoli dell’Accademia, l’ottavo e il nono, Nicolò Martelli e Benedetto Varchi
Venous distal bypass should be considered as the gold standard to finally attempt limb salvage in patients with severe critical limb ischemia and diabetic foot, or under dialysis
No full textParametric thermal-hydraulic analysis of the EU DEMO Water-Cooled Lithium-Lead First Wall using the GETTHEM code
No full textThe system-level code GETTHEM is applied to the thermal-hydraulic analysis of an entire segment of the Water-Cooled Lithium-Lead (WCLL) First Wall (FW) of the EU DEMO reactor, parametrically varying the heat load of the FW and the coolant mass flow rate. The results show that the WCLL FW design can tolerate variations of the distribution of the heat flux with respect to the design value, without requiring modifications. The top inboard and the bottom outboard regions are identified as most critical from the point of view of the cooling of the FW. Finally, the largest possible extent of the WCLL FW surface where the peak heat load can be safely applied is identified through a parametric analysis, performed on the critical regions, to understand which is the limit of the cooling capacity of the system. © 201
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
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
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