1,721,035 research outputs found
Endocrine and metabolic response to surgical stress in the elderly
No full textDisease (νοσοσ) is not only suffering (παθοσ): it is also toil (πονοσ). Hippocrates Introduction Reacting when facing a threat to homeostasis is a common and primeval pattern of behavior in living beings, that involves a number of complex endocrine and metabolic functions. The reaction to surgical stress is an example of this primordial behaviour. Stress response is also the pathway along which both aging and illnesses occur. Surgery for which older patients are scheduled can be more or less invasive and more or less demanding in terms of energy expenditure, thus causing stressing effects that go beyond that of the underlying surgical condition. On the other hand, aging processes, the way in which functional reserves are affected by aging, and the number and severity of associated conditions substantially modulate the effectiveness of the individual response to surgical aggression. When intense and prolonged external stressors superimpose on a state of vulnerability induced by aging processes and comorbidity, severe post-operative complications may originate, such as myocardial ischemia, post-operative delirium, respiratory insufficiency, deep metabolic alterations, intense deconditioning and consequent functional impairment. As a consequence of both the stress intensity and duration and the effectiveness of defensive reaction, different trajectories are possible. Stress response: stages and determinants The concept of stress as general adaptation syndrome (GAS) was defined by Seyle in the last century (Seyle 1936). Since its definition, the conceptual model of stress as GAS has provided a paradigm for interpreting and understanding this complex defensive reaction under multiple aspects. Essentially, in an attempt to counteract aggression, the organism starts providing extraordinary performance, continues opposing strong resistance and, when the aggression persists for too long, ends up self-harming. Stages of stress Independently from the nature of the stressor applied, Seyle individuated a typical sequence in biological answers to stress: alarm, resistance and exhaustion. Important endocrine mechanisms are involved. Alarm During the “alarm” stage, the stressor is recognized as a threat. Stress hormones are produced in response, such as adrenaline, noradrenaline and cortisol. This enables the body to perform extraordinary activities, but at the cost of heavy energy consumption and consequent tissue damage
Negative and Positive Noninvasive Pressure Ventilation
No full textMechanical ventilation replaces or supplements the respiratory muscles’ activity. Invasive mechanical ventilation is performed using a device that bypasses the upper airways, such as the nasal/orotracheal tube or the tracheostomy tube. Noninvasive mechanical ventilation (NIV), on the other hand, uses an interface that does not bypass the upper airways, thus avoiding some of the complications associated with intubation and improving patient comfort. Noninvasive ventilation techniques can be used using positive or negative pressure ventilators. Negative pressure ventilation, most widely used during the first half of the twentieth century, had some disadvantages such as patient discomfort, difficult ventilation in subjects with variable anatomical conformations, and poor handling of the equipment. This led to a progressive replacement, after the 1970s, of negative pressure ventilators with new positive pressure ventilation systems
Associazioni (nella sezione 'Lessico lagunare - Glossario')
No full textÈ quasi un luogo comune che a Venezia ci siano più associazioni che abitanti. Che sia vero o meno, fa eco ad un altro luogo comune, quello dell'assoluta eccezionalità di Venezia, come se tutte le altre città del mondo fossero tutti uguali (e in questo caso meno “ricche” per quanto riguarda i propri tessuti civici). Non a caso, entrambi alimentano un notevole interesse da parte di giornalisti e studiosi di tutto il mondo, spesso alla ricerca di un onnipresente quanto teorico “diritto alla città”. Oltre allo sfondo pittoresco che offre, la laguna è senz'altro al centro delle pratiche promosse dalle associazioni veneziane, anche da quelle di Terraferma, e non solo da quelle legate al remo. Questa centralità è stata determinante per la sottoscrizione da parte di numerose associazioni ed enti locali del Contratto di Area Umida per la Laguna Nord, che lascia intravedere la possibilità che un coordinamento in questo senso – certo relativamente “modesto” – possa concretizzarsi prima di un'effettiva concertazione tra gli enti competenti ai diversi livelli di governo
L’accuratezza del Registro Mesoteliomi Lombardia: comparazione con il database autoptico dell’Università di Pavia|Accuracy of the Lombardy Mesothelioma Registry: comparison with the autopsy database of Pavia University (Lombardy Region, Northern Italy)
No full textOBJECTIVES: to evaluate the accuracy (completeness of case recording and diagnostic quality) of the Lombardy Mesothelioma Registry (Registro Mesoteliomi Lombardia, RML) through a comparison with the autopsy database of Pavia University (years 2000-2016). DESIGN: validation study. SETTING AND PARTICIPANTS: all mesothelioma records with incidence date between 01.01.2000 and 16.09.2016 were extracted from the RML. They were cross-referenced with deaths from any asbestos-related disease subjected to a forensic autopsy extracted from the archive of the Department of Public Health, Experimental and Forensic Medicine of Pavia University. MAIN OUTCOMES MEASURES: using the postmortem diagnosis by Pavia University as the gold standard, RML sensitivity and specificity and their 95% confidence intervals (95%CI) were calculated using the Agresti-Coull formula. RESULTS: based on 141 deaths, the RML showed very good accuracy: specificity was 100% (95%CI 87%-100%; 32/32 deaths) and sensitivity 94% (95%CI 87%-97%; 102/109 deaths). The 7 false negative cases either were missed by the RML (N. 4) or had been wrongly classified as non-mesotheliomas (N. 3) because the diagnosis was made or confirmed only postmortem after a forensic autopsy. CONCLUSIONS: RML accuracy (completeness and diagnostic quality) was very high. No false positive was found and the few false negatives were due to lack of notification of mesotheliomas diagnosed postmortem to the registry. Forensic pathologists should be made aware that mesothelioma notification to the regional mesothelioma registry is important and compulsory
EFFECTS OF TRANSDERMAL BUPRENORPHINE ON TESTOSTERONE SERUM LEVELS IN WOMEN WITH CHRONIC NON-CANCER PAIN
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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
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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