29 research outputs found
Perioperative albumin ratio is associated with post-operative pancreatic fistula
No full textBackground: Despite improvements in surgical techniques and perioperative management, post-operative pancreatic fistula (POPF) remains a serious complication after pancreaticoduodenectomy (PD). The aim of this study was to evaluate the role of perioperative clinical variables of patients, including albumin level, in predicting pancreatic fistula. Methods: A total of 86 patients underwent PD for pancreas cancer between 2011 and 2017 at our institution. We prospectively investigated the relation between patient's characteristics and the incidence of clinically relevant (CR)-POPF. Perioperative albumin ratio was defined as post-operative day 1 (POD1) albumin level/preoperative albumin level. Results: A total of 23 patients (26.7%) developed CR-POPF. At univariate analysis POPF correlated with soft pancreas (P=0.045), low POD1 albumin (P=0.02), POD1 and POD3 amylase levels in drainage fluid (P=0.003 and P=0.014, respectively) and perioperative albumin ratio (0.58±0.10 versus 0.69±0.12 in patients without POPF; P=0.003). No significant correlations with POPF were demonstrated for surgical time, serum amylase levels and preoperative albumin levels. At multivariate analysis POD3 amylase level in drainage fluid and perioperative albumin ratio were the only significant independent parameters (P=0.027 and P=0.047, respectively). Conclusions: Perioperative albumin ratio can predict POPF after PD. © 2017 Royal Australasian College of Surgeons
Zilia e Cénie: la donna come figura dello 'straniero' nell'opera di Françoise de Graffigny
No full textThe private correspondence between Françoise de Graffigny and Antoine-François Devaux allows us to trace the genesis of the epistolary novel Lettres d'une Péruvienne and the five-act play Cénie, two works considered best-sellers of the 18th century. These letters help us understand her working methods (self-censorship, her conception of the female author, her relationship with her main characters, her surrounding environment, etc.) as well as the motivations behind her writing (primarily the need for money), to the extent that they can be considered drafts of both works. The interplay between Françoise de Graffigny's biography and her fictional female characters is evident from the start, and the reconstruction of the genesis of these works demonstrates how literary creation becomes a means of self-reflection and the creation of a feminine self. This contribution will seek to demonstrate how, in her two most well-known works, Graffigny uses the figure of the stranger, in all its senses, to highlight the difficulties women faced in 18th-century society, showing through the cases of Zilia and Cénie that women were considered 'like' foreigners in their own country, in their own homes
Cultural Nomadism By Dany Laferrière
No full textDany Laferrière, a member of the Académie Française since December 2013, is a native Haitian writer who moved to Montreal during the period of the dictatorship of Duval and now lives in Miami. His first novel, Comment faire l'amour avec un Nègre sans se fatiguer, published in 1985, after having taken almost nine years to complete, was a great success. Starting with this novel, the next three, Eroshima (1987), Cette Grenade dans la main du jeune Nègre ou est-elle une arme à fruit? (1993), and Chronique de la dérive douce (1994), also address the problems of a Haitian's adaptation in North America.
Laferrière, who is so multi-faceted and complex, the author of several novels, but also a journalist and radio reporter, highlights the various shocks he underwent when beginning to write in French in a foreign and English-speaking country, embodying the figure, rather than of the "migrant writer", of the "nomadic" writer, who deterritorializes so as to resist a definitive identity or a localization.
This study aims to examine the cultural contribution of Laferrière, who has always tried to avoid materializing a social identity, embodying rather a dynamic identity, and returning, in this way, to a concept dear to Edouard Glissant: identité rhizome. That is, an identity that does not have a single root, but a multiplicity of roots that come together. His status as a permanent exile can be seen as an obstacle: he is not exactly a Haitian but neither is he a Canadian. He calls himself "Américain", i.e. an inhabitant of the American continent; "un écrivain américain à qui il est arrivé tout simplement d'écrire en français", emphasizing that he belongs to a plural America because Petit-Goâve, Port-au-Prince, New York, Miami, and Montreal, are on the same continent. This America is synonymous with the New World, "un monde à la fois réel et rêvé", a plural world
Beyond Subordination: Four Arguments
No full textThe thesis of the paper is that labour law is, and above all must be, a law related to work in general. It is therefore necessary to overcome the binary system in which all social guarantees are in the field of subordination and no social protection is in that of self-employment. The Author use four arguments to support this thesis: a sociological argument, a historical-juridical argument, an economic argument, and a comparative argument. These arguments have different disciplinary bases and have different functions, but they converge in the belief that labour law is currently, and should be in the future, the law of the work “in gen- eral” and not only that of employment
Impact of Age on Short- And Long-Term Outcomes after Pancreatoduodenectomy for Periampullary Neoplasms
No full textBackground. Although mortality and morbidity of pancreatoduodenectomy (PD) have improved significantly over the past years, the impact of age for patients undergoing PD is still debated. This study is aimed at analyzing short- and long-term outcomes of PD in elderly patients. Methods. 124 consecutive patients who have undergone PD for pancreas neoplasms in our center between 2012 and 2017 were analyzed. Patients were divided into two groups: group I (<75 years) and group II (≥75 years). Demographic features and intraoperative and clinical-pathological data were collected. Primary endpoints were perioperative morbidity and mortality; complications were classified according to the Clavien-Dindo Score. Secondary endpoints included feasibility of adjuvant treatment and overall survival rates. Results. A total of 106 patients were included in this study. There were 73 (68.9%) patients in group I and 33 (31.1%) in group II. Perioperative deceases were 4 (3.6%), and postoperative pancreatic fistulas were 34 (32.1%). Significant difference between two groups was demonstrated for the ASA Score (p=0.004), Karnofsky Score (p=0.025), preoperative jaundice (p=0.004), and pulmonary complications (p=0.034). No significance was shown for diabetes, radicality of resection, stage of disease, operative time, length of stay, postoperative complications according to the Clavien-Dindo Score, postoperative mortality, pancreatic fistula, and reoperation rates. 69.9% of the patients in group I underwent adjuvant treatment vs. 39.4% of the older ones (p=0.012). Mean overall survival was 28.5 months in group I vs. 22 months in group II (p=0.909). Conclusion. PD can be performed safely in elderly patients. Advanced age should not be an absolute contraindication for PD, even if greater frailty should be considered. The outcome of elderly patients who have undergone PD is similar to that of younger patients, even though adjuvant treatment administration is significantly lower, demonstrating that surgery remains the main therapeutic option
Dynamical control of engineered stimuli-responsive materials: synthesis and optimization of active micro-vesicles
No full text2018 - 2019The aim of this PhD project is the combination of a pH clock reaction (the enzymatic
urea-urease reaction) with pH-responsive materials to generate a chemo-mechanical coupling.
A clock reaction is characterized by a latent period during which no significant change takes
place in the mixture, and then a change occurs suddenly. The urea-urease reaction, is a biocompatible pH sensitive reaction frequent in numerous cellular systems and used by bacteria
H.pylori to raise the local pH according to the overall stoichiometry. .. [edited by Author]XXXII cicl
Repas de famille dans Impala de Carole David ou la déconstruction du stéréotype maternel
No full textIn this analysis of Carole David’s 1994 novel, "Impala", the author examines how food
is deeply entangled with the complex reconstruction of the life of
a mother of Italian origin (Connie Ferragamo) and her daughter
(Louisa). David revisits well-established stereotypes: Connie is not
the traditional motherly nurturing figure, while domestic meals are
associated with fighting
Towards New Metrics for the Characterisation of the Dynamic Performance of Adaptive Façade Systems
No full textTraditional façade characterisation metrics such as U-value and g-value are of limited value in the design process of buildings with adaptive façades. This issue is particularly important for adaptive façade components that have the capability of controlling thermal energy storage in the construction thermal mass. Building performance simulations can help to analyse the performance of buildings with adaptive façades, but such studies usually only provide information about the energy and comfort performance at room level. Consequently, there is a need for development and testing of new façade-level performance metrics that can be used to compare the performance of different adaptive façade components. This paper presents experiences and lessons learned from four European R&D projects that have introduced novel metrics to capture the dynamic performance of adaptive opaque façades. Characteristics of the different metrics are described, and their similarities and differences are compared and contrasted. The paper highlights the main benefits of metrics that can capture dynamic effects, and concludes by providing directions for future work.publishedVersionThis work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. Author(s) hold their copyright without restrictions
The decline of serum albumin levels after pancreaticoduodenectomy predicts postoperative pancreatic fistula
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