1,721,195 research outputs found
The contribution of ethical reflection during the Coronavirus pandemic. A comparative analysis
No full textThe Coronavirus pandemic has deeply marked all ordinary health care activities and has dictated matters usually faced by the medicine of disasters. The most critical and dramatic dilemma has been the triage and the urge to select patients for Intensive Care Unit (ICU) because there was no place for all at the same time. The need to decide in a very short time has made this decision even more complex. The data of the Italian situation and namely of Lombardia reveal it clearly. Worldwide, there have been many different views on triage, sometimes with very peculiar emphasis. In this paper we will illustrate the contributions of the Unites States compared to the European ones. We have critically analyzed different views and we have highlighted that nevertheless there are several shared elements such as clinical criteria, if we consider only them we might underestimate the uniqueness of the patient, including vulnerable ones. There is a huge gap between the US view and the European view when it comes to the appointment of the final decision maker in triage. We propose the criteria of proportionality as a guide line to take decisions in triage because it allows to integrate collective public health objectives and the principle of ensuring protection for the individual patient. Finally, we envisage the potential role of ethics consultation in this pandemic scenario
Lumbar plexus terminal branch block, a safe alternative for transfemoral aortic valve implantation. Case report
No full textTranscatheter aortic valve implantation is an alternative treatment for patients with severe aortic stenosis, it is conventionally performed under general anaesthesia or local anaesthesia plus sedation. We present the first case of trans-femoral, trans-catheter aortic valve implantation, performed in our hospital in a patient with severe aortic stenosis, who was a high surgical risk. Anaesthesia consisted of a combination of bilateral selective blockade of the iliohypogastric, ilioinguinal and genitofemoral nerves with the patient awake without sedation, using an ultrasound-guided approach. Transcatheter aortic valve implantation was successful and passed without incident, the patient remained immobile, calm, did not report pain, and sedation or hypnotics were not necessary during dilation of the vascular accesses with the introducer. Standard monitoring demonstrated haemodynamic stability, without cardiovascular repercussions and did not necessitate vasopressor or inotropic drug support. After the intervention, the patient was sent to the Cardiac Intensive Care Unit, where he remained asymptomatic and stable. Subsequently, the patient was admitted to the cardiology ward from where he was discharged without complications
An integrated approach to prevent and treat respiratory failure in brain-injured patients.
No full textSDSS J222428.53+261423.2: unique emission lines properties unveil a sub-kiloparsec dual AGN candidate
No full textIn this paper, we presented a detailed analysis of the Sloan Digital Sky Survey optical spectrum of a new sub-kpc scale dual AGN candidate SDSS J222428.53+261423.2 (=SDSS J2224). The target is one of the few AGNs with all the optical narrow emission lines characterized by double-peaked profiles and with peak separations in velocity units of about 930 km s-1. If the double-peaked narrow emission lines (DPNELs) are due to a dual AGN in SDSS J2224, the estimated physical separation between the two cores is about 500 pc. Meanwhile, three alternative explanations are also discussed in this paper, however, we can not find solid evidence to completely rule them out. Our results support the presence of a sub-kpc dual AGN with DPNELs in all lines, indicating a key episode of galaxy merging evolution at sub-kpc scale
Dual and binary supermassive black holes
No full textWe review recent results focused on dual and binary active galactic nuclei (AGN) obtained by our collaboration. Our research, conducted at both low and high redshifts, involves statistical analyses of known AGN pairs (less than 100 kpc of separation), identification of new samples of dual AGN at sub-kpc/kpc scale separation at z>0.5, and investigation of binary AGN candidates (sub-pc separation). Studying these systems over a wide range of frequencies and redshifts contributes to understanding supermassive black hole (SMBH) formation and evolution, and galaxy-SMBH co-evolution, with great relevance for gravitational-wave (GW) experiments. Our findings, consistently with simulations, suggest that galaxy interactions and mergers are likely to induce perturbations that enable the gas to be funneled towards the central nuclear regions and to be accreted efficiently, thus increasing the amount of absorption at close pair separations and possibly the AGN luminosity. We introduced innovative selection techniques, such as the Gaia Multi Peak method, to identify kpc-scale dual AGN beyond the low-redshift Universe, and we addressed challenges in detecting obscured dual AGN. As for binary systems, we identified two highly promising candidates exhibiting possible X-ray periodicity and, in one case, a potential double-peaked iron emission line
The role of hemodynamic monitoring in the diagnosis of a rteriovenous fistulas following penetrating abdominal trauma
No full textVascular injuries after penetrating gunshot wounds can result in arteriovenous fistulas, whose principal anatomical locations are the upper and lower extremities, whereas abdominal vessels are rarely involved. The aim of this paper is to report a case of penetrating abdominal trauma with evidence of visceral damage in which the analysis of hemodynamic data was a useful tool in the early diagnosis of intrarenal and aortocaval fistulas
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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