bluuebunny/crossref_metadata_2025 huggingface dataset:
Intrapleural fibrinolytic therapy for complicated pleural effusions
Authors: Monroe BS , Warner D
Published: November 2019

Intrapleural administration of fibrinolytic agents can be used to degrade the fibrin present in complicated pleural effusions, thus decreasing viscosity of the fluid and enhancing evacuation of the pleural space via chest tube drainage. Patients who may otherwise need surgical intervention could benefit from this treatment. As more knowledge is gained through clinical experience and research studies, patients' outcomes may show major improvement.
Music therapy in critical care: indications and guidelines for intervention
Authors: Chlan L , Tracy MF
Published: November 2019

Music therapy is an effective intervention for critically ill patients for such purposes as anxiety reduction and stress management. The therapy is readily accepted by patients and is an intervention patients thoroughly enjoy. The MAIT is one resource that nurses caring for critically ill patients can use to implement music therapy in clinical practice. Patients can be given the opportunity to select a musical tape they prefer and to negotiate with the nurse for uninterrupted music-listening periods. Allowing patients control over music selection and providing uninterrupted time for music listening gives the patients an enhanced sense of control in an environment that often controls them.
Implementation of a pet visitation program in critical care
Authors: Giuliano KK , Bloniasz E , Bell J
Published: November 2019

We have no quantitative research data to document that these visits are actually helpful to patients in any measurable way, although we certainly hope to have some soon. However, observations of staff members and evaluations from participants in the program have been quite positive thus far. The program has been in place for more than 2 years, and about 30 pets have visited so far, including 28 dogs and 2 cats. Implementing a pet visitation program for critically ill patients affords healthcare providers the opportunity to offer a unique and humanistic therapeutic intervention to appropriate patients. Although it is a time-consuming endeavor, it has been well received by those patients and families that have participated in pet visits. Critically ill patients are often denied many simple pleasures because they are in physiological crisis. Such patients experience loneliness, isolation, depression, and lack of emotional support. Pet visitation is one way to address these common problems of ICU patients. For this reason, pet visitation will remain a therapeutic option for the support of our critically ill patients.
The expanding role of signal-averaged electrocardiography
Authors: Gant RH , Henkin R , Morton PG
Published: November 2019

Signal-averaged electrocardiography is a valuable diagnostic tool for determining which patients recovering from myocardial infarction are at risk of sudden death due to ventricular arrhythmias. Additionally, the value of this technique in determining which patients with ischemic heart disease and unexplained syncope are likely to have inducible sustained ventricular tachycardia has been established. This noninvasive screening procedure has shown promise in other clinical situations, but more investigation is needed before definitive recommendation can be made. Critical care nurses can help promote the success of signal-averaged electrocardiography by educating patients, promoting acquisition of a quality recording, helping allay patients' concerns, and participating in research activities.
Caring for critically ill infants: strategies to promote physiological stability and improve developmental outcomes
Authors: Taquino LT , Lockridge T
Published: November 2019

Promoting organization and delivering developmentally supportive care leads to improved outcomes for infants and their families. Critical care nurses must function as catalysts to expand the thinking of caregivers from a dimension consisting primarily of physiology to one that embraces the emotional and cognitive growth and well-being of the patient, the patient's family, and staff members. For critically ill infants, developmentally supportive care that is relationship based and that promotes the balance of organized neurobehavioral and physiological function is an avenue to achieve that end. Beneficial or adverse outcomes of nursing care used during this critical period can persist long after an infant is discharged from the intensive care setting.
Targeting Sepsis as a Performance Improvement Metric
Authors: Kleinpell Ruth , Schorr Christa A.
Published: November 2019

Sepsis is the body’s systemic response to infection that can be complicated by acute organ dysfunction and is associated with high mortality rates and adverse outcomes for acute and critically ill patients. The 2012 Surviving Sepsis Campaign guidelines advocated for implementation of evidence-based practice care for sepsis, with a focus on quality improvement. Nurses are directly involved in identification and management of sepsis. Implementing performance improvement strategies aimed at early recognition and targeted treatment can further improve sepsis care and patient outcomes. This article presents an overview of the process of implementing performance improvement initiatives for sepsis care, highlighting the significant contribution of nursing care.
Ventilator-Associated Pneumonia Bundle
Authors: Munro Nancy , Ruggiero Margaret
Published: November 2019

The ventilator-associated pneumonia (VAP) bundle is a focus of many health care institutions. Many hospitals are conducting process-improvement projects in an attempt to improve VAP rates by implementing the bundle. However, this bundle is controversial in the literature, because the evidence supporting the VAP interventions is weak. In addition, definitions used for surveillance are interpreted differently than definitions used for clinical diagnosis. The variance in definitions has led to lower reported VAP rates, which may not be accurate. Because of the variance in definitions, the Centers for Disease Control and Prevention developed a ventilator-associated event algorithm. Health care institutions are under pressure to reduce the VAP infection rate, but correctly identifying VAP can be very challenging. This article reviews the current evidence related to VAP and provides insight into implementing a suggested revision of the care of patients being treated with mechanical ventilation.
Synopsis and Review of the American College of Cardiology Foundation/American Heart Association 2013 ST-Elevation Myocardial Infarction Guideline
Authors: Brown Helen F.
Published: November 2019

The “2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines” is a major revision of the 2004 guideline. This article provides a synopsis and review of the guideline focusing on changes in patient care and implementing processes to ensure quality care. The implementation of this guideline provides nursing with a unique opportunity to affect patients and families primarily by recognition of the event and education about lifestyle modification and disease management. Regionalization of emergency systems provides a novel situation for nursing to develop interdepartmental and system protocols
Differential Diagnosis: Correctly Putting the Pieces of the Puzzle Together
Authors: Scordo Kristine Anne
Published: November 2019

Each day, we generate hypotheses about our environment—our perceptions of people, our expectations of events, and our interpretation of images. These hypotheses provide a framework by which we interpret our experiences. The same is true for differential diagnosis by which health care practitioners develop hypotheses or diagnoses from a set of cues provided during an encounter with a patient. For clinicians to be successful at differential diagnosis, they must use a multidimensional and complex process involving nonanalytic and analytic cognitive processes and metacognition—thinking about thinking. Our conclusions, however, can lead to errors in diagnosis. Many of these errors are due to errors in cognition. The purpose of this article is to discuss this complex process, identify common errors in cognition, and offer strategies to prevent these common errors in differential diagnosis.
Acute Nontraumatic Weakness
Authors: Yeager Susan , Miller Chad
Published: November 2019

Depending on the causative agent, the differential diagnosis for acute nontraumatic weakness presentation can range from life threatening to trivial. Practitioners’ comfort and experience with the rapid identification and evaluation of presenting neurological deficits vary widely. Given this fact and the reality that neurological presentation of weakness is common, the potential for missed diagnosis increases. To enhance knowledge of potentially life-threatening or morbidity-inducing complications, this article provides a systematic framework for physical and diagnostic evaluation of the most common differentials for acute causes of nontraumatic weakness.
The Challenge of Diagnosing Dyspnea
Authors: Croucher Beth
Published: November 2019

Dyspnea is a subjective and nonspecific symptom, yet very distressing for those who experience it. Acute onset dyspnea and exacerbation of chronic dyspnea from heart or lung disease significantly add to the number of emergency department visits and inpatient admissions. Although dyspnea may appear to be a simple condition to evaluate and manage, it is actually complex in description and quality. As such, dyspnea is the first symptom of many diseases. The onset of dyspnea can be due to a new acute disease, the exacerbation of an existing chronic illness, or a new disease compounding a chronic illness. Finding the cause of dyspnea is generally more difficult than it originally may appear. Therefore, the purpose of this article is to discuss the differential diagnoses associated with dyspnea.
Using a Scorecard to Demonstrate Clinical Nurse Specialists’ Contributions
Authors: Jepsen Stacy
Published: November 2019

Clinical nurse specialists (CNSs) have the expertise to influence change at the patient, nurse, and system levels. They are clinical experts who understand the challenges of the current health care environment: decreasing costs, ensuring high-quality care, and achieving outcomes. Evidence has demonstrated CNSs’ influence on improving patient outcomes. Although CNSs often lead the work, they can be invisible when the outcomes are presented. A scorecard to display this work could be invaluable to the CNS role, as it would bring transparency to the evidence-based work done. This article describes the development of a CNS scorecard in a 627-bed tertiary hospital.
Caring for Dying Patients in the Intensive Care Unit
Authors: Campbell Margaret L.
Published: November 2019

Critically ill patients receiving palliative care at the end of life are at high risk for experiencing pain, dyspnea, and death rattle. Nearly all these patients are at risk for the development of delirium. Patients who are alert may experience anxiety. Advanced practice nurses and staff nurses are integral to detecting and treating these symptoms. Pain, dyspnea, and anxiety should be routinely assessed by patient self-report when possible. Routine behavioral screening for delirium is recommended. Behavioral observation tools to detect pain and dyspnea and proxy assessments guide symptom identification when the patient cannot provide a self-report. Evidence-based interventions are offered for both prevention and treatment of pain, dyspnea, anxiety, and delirium. Death rattle does not produce patient distress, and current pharmacological treatment lacks an evidence base. Pain management has a robust evidence base compared to management of dyspnea, anxiety, and delirium among this population; well-designed, adequately powered studies are needed.
Procalcitonin-Guided Antibiotic Therapy Duration in Critically Ill Adults
Authors: Walker Caroline
Published: November 2019

Procalcitonin is a promising biomarker for antibiotic therapy because its levels rise and fall quickly with bacterial infections. A multi-database literature search was reviewed with 3 primary prospective randomized control trials used in further analysis. The results indicated that a procalcitonin-guided antibiotic protocol reduces the number of days a patient has to take antibiotics while having no effect on mortality when compared with control groups. Short-term studies did not show a difference in the intensive care unit length of stay, infection relapse rate, super-infection rate, or multidrug-resistant bacteria rate between the procalcitonin-protocol and control group. Because procalcitonin-guided antibiotic therapy has been shown to reduce the duration of treatment with antibiotics in critically ill patients without worsening the mortality rate or other outcomes, the implementation of a procalcitonin-guided antibiotic therapy should be considered for patients with proven or highly suspected bacterial infections in the intensive care unit.
Ebola at the National Institutes of Health
Authors: Johnson Susan S. , Barranta Neil , Chertow Dan
Published: November 2019

Infectious disease events were in the headlines in 2014. West Africa experienced the worst Ebola virus disease (EVD) outbreak ever recorded. The world was stunned when the deadly virus began to spread to other countries. The health care system in the United States responded by designating specialized centers to care for patients with EVD. All health care workers must understand the isolation processes involved in caring for these patients. Using personal protective equipment is imperative and requires adjustments in how care is provided. Staffing patterns must be altered to provide safe care, while maintaining safety of health care workers. This article provides perspectives of the critical care nurse manager and bedside nurse who participated in the development of the care processes for patients with EVD at the National Institutes of Health to help health care colleagues better understand issues experienced and to help prepare them if they encounter patients with EVD.
Left Ventricular Assist Device Driveline Infections
Authors: Angud Marc
Published: November 2019

Heart failure is a chronic progressive disease that affects millions of people in the United States. Although medical management of heart failure has helped improve quality of life and survival, end-stage heart failure ultimately requires a heart transplant or long-term left ventricular assist device (LVAD) support. With more patients awaiting transplant, the demand for hearts outweighs the supply of donor hearts. The use of LVADs is increasing in patients with advanced heart failure as a treatment option for those awaiting a heart transplant or as a long-term solution if they are ineligible for a transplant. Although the LVAD is a marvel of modern medicine, infection is a cause of concern because today’s LVADs are powered externally through a percutaneous driveline that can be a major source of infection.
Understanding the Continuous Renal Replacement Therapy Circuit for Acute Renal Failure Support
Authors: Boyle Martin , Baldwin Ian
Published: November 2019

Delivery of renal replacement therapy is now a core competency of intensive care nursing. The safe and effective delivery of this form of therapy is a quality issue for intensive care, requiring an understanding of the principles underlying therapy and the functioning of machines used. Continuous hemofiltration, first described in 1977, used a system where blood flowed from arterial to venous cannulas through a small-volume, low-resistance, and high-flux filter. Monitoring of these early systems was limited, and without a machine interface, less nursing expertise was required. Current continuous renal replacement therapy machines offer user-friendly interfaces, cassette-style circuits, and comprehensive circuit diagnostics and monitoring. Although these machines conceal complexity behind a user-friendly interface, it remains important that nurses have sufficient knowledge for their use and the ability to compare and contrast circuit setups and functions for optimal and efficient treatment.
The Value of Certification
Authors: Kaplow Roberta
Published: November 2019

Certification is defined in the nursing literature in several ways; no one consistent definition of certification exists. Nursing specialty certification programs are intended for consumer protection. Certification protects the public by enabling consumers to identify competent people more readily. However, benefits for stakeholders other than patients and families are also described in the literature. This article describes the value of specialty certification from the perspective of the patient and family, nurse, and employer.
APRN Regulation
Authors: Hartigan Carol
Published: November 2019

This article describes the development of a new regulatory model for advanced practice nursing. The history of nursing licensure is detailed to provide a perspective of the differences in the way that advanced practice roles evolved as a result of external forces and patient needs without the direct control of regulators and the resulting variations in the interpretation and implementation of the roles nationwide. Key provisions of the new consensus model for regulation are detailed, along with implications for each of the main stakeholder groups: licensure, accreditation, certification, and education.
Non–ST-Segment Elevation Acute Coronary Syndrome
Authors: Housholder-Hughes Susan D.
Published: November 2019

Of the nearly 1.4 million hospitalizations for acute coronary syndromes in 2006, approximately two-thirds were for unstable angina (UA) or non–ST-segment elevation myocardial infarction (NSTEMI). Given the high risk for in-hospital ischemic events and late mortality in patients with UA/NSTEMI, it is critical to accurately and rapidly diagnose these patients, stratify their level of risk, and provide appropriate pharmacologic and nonpharmacologic treatment that maximizes anti-ischemic benefit and minimizes risk of bleeding. Appropriate in-hospital care following intervention is critical for optimizing both short- and long-term outcomes. However, evidence suggests that up to 26% of opportunities to provide guidelines-recommended care are missed. Nurses can play a critical role in ensuring that patients receive guidelines-based care. This review examines the most recent recommendations for the diagnosis and pharmacologic management of patients with UA/NSTEMI and discusses ways in which nursing staff can contribute to minimizing patient risk and optimizing patient benefit.
A System-Level Approach to Improving the Care of the Older Critical Care Patient
Authors: Boltz Marie
Published: November 2019

As the population continues to age, the specialized needs of older adult patients warrant the close attention of the critical care nurse. The combination of critical illness, age-related changes, multiple comorbidities, and the hospital environment can make the diagnosis and management of the older adult’s critical illness challenging. The NICHE (Nurses Improving Care for Healthsystem Elders) program provides a framework to create an aging-sensitive care environment in the critical care setting. The Geriatric Resource Nurse model is the foundation of the program. The goals of NICHE are to support nursing departments to (1) bring evidence- based geriatric practice to the bedside; (2) build patient- and family-centered environments; (3) cultivate healthy and productive practice environments aligned with meeting the specialized needs of older adults and their families (“geriatric nursing practice environments”); and (4) conduct comprehensive measurement of geriatric initiatives.
Use of Protocols in Older Intensive Care Unit Patients
Authors: Casey Colleen M. , Balas Michele C.
Published: November 2019

Increasing numbers of older adults are cared for in intensive care units (ICUs) across the country. These patients are disproportionately impacted by illnesses such as sepsis, ventilator-associated pneumonia, and infections. Their care and course of recovery are complicated by myriad factors, including their often-indistinct presentation of illness and issues related to pharmacotherapy. Increasingly, clinical practice guidelines are being used to facilitate the care of patients with select illnesses and presentations. However, these guidelines, protocols, or bundles, as they are known, generally have not been studied in an older population. This article describes the ventilator-associated pneumonia and sepsis bundles relative to the older critical care patient. Although an exhaustive discussion of every intervention within each bundle as it relates to older ICU patients is beyond the scope of this article, selected bundle parameters are presented, with examples of special considerations for the older ICU patient.
Managing Cancer-Related Pain in Critical Care Settings
Authors: Dolan Elisabeth A. , Paice Judith A. , Wile Sally
Published: November 2019

Pain is a common symptom experienced by individuals who are in treatment for cancer and becomes more prevalent for those with more advanced stages of malignancy. Critical care nurses are essential in the management of cancer-related pain, which is a challenging problem when individuals who have a cancer diagnosis are admitted to the intensive care unit for emergent conditions. Regular, thorough, and patient-appropriate assessments by experienced critical care nurses guide selection of treatment modalities, including pharmacologic and nonpharmacologic techniques. In addition, existential pain necessitates spiritual care intervention, and involvement of other appropriate interdisciplinary team members can result in improved management of all types of pain experienced by critically ill individuals with cancer.
Anticoagulation and Bleeding in Patients With Ventricular Assist Devices
Authors: Kurien Sudha , Hughes Kylie A.
Published: November 2019

A left ventricular assist device (LVAD) is a lifesaving therapy for end-stage heart failure, but it is associated with major complications such as bleeding and thrombosis. Anticoagulation is an important part of LVAD therapy; it requires meticulous management and monitoring for prevention of thromboembolic and bleeding events. Recommendations for thromboprophylaxis vary among pulsatile and nonpulsatile devices and require multiple pharmacological agents to achieve adequate anticoagulation. Patients expected to undergo LVAD implantation must have a comprehensive evaluation for underlying coagulopathies. During the perioperative period, all measures must be taken to prevent excessive bleeding and maintain hemostasis. Postoperative bleeding and thromboembolic episodes must be minimized to prevent significant complications of ventricular assist device therapy. Bleeding and thromboembolism are an impediment to a patient’s quality of life as they can result in multiple hospitalizations, along with serious consequences such as death and permanent disability.
Innovative Use of Tele-ICU in Long-term Acute Care Hospitals
Authors: Mullen-Fortino Margaret , Sites Frank D. , Soisson Michael , Galen Julie
Published: November 2019

Tele–intensive care units (ICUs) typically provide remote monitoring for ICUs of acute care, short-stay hospitals. As part of a joint venture project to establish a long-term acute level of care, Good Shepherd Penn Partners became the first facility to use tele-ICU technology in a nontraditional setting. Long-term acute care hospitals care for patients with complex medical problems. We describe describes the benefits and challenges of integrating a tele-ICU program into a long-term acute care setting and the impact this model of care has on patient care outcomes.
Incentive Spirometry in Postoperative Abdominal/Thoracic Surgery Patients
Authors: Rupp Michael , Miley Helen , Russell-Babin Kathleen
Published: November 2019

Background:

Postoperative patients have higher incidences of respiratory complications. Patients undergoing abdominal or thoracic surgical procedures are at greater risk of having such complications. Incentive spirometry is an inhalation-based prophylactic technique that encourages patients to mimic a natural deep sigh to periodically increase lung volume. As this technique is the prophylactic method of choice for many hospitals, several studies have tested its efficacy.

Methods:

Five articles, including 4 systematic reviews and 1 clinical practice guideline, are analyzed and summarized. Each article was reviewed by a multidisciplinary team of health care providers and is discussed herein. A clinical recommendation for practice change is provided on the basis of the results.

Incentive spirometry is only as effective as cough/deep-breathing regimens and other means of postoperative pulmonary prophylaxis. No single prophylactic technique clearly outperforms all others in preventing pulmonary complications. Future research is needed to determine the best method to prevent postoperative pulmonary complications.
Developing Grant Writing Skills to Translate Practice Dreams Into Reality
Authors: Lindquist Ruth , Hadidi Niloufar
Published: November 2019

In an era of health care reform and limited financial support, good ideas for changes in clinical practice may await the available time, resources, and attention that are required to test and implement them. Developing grant writing skills is a way to attract resources to explore the feasibility and potential efficacy of changes to improve patient outcomes or efficiencies of care. This article describes the purpose of grant writing by advanced practice nurses (APNs), discusses the needs for and benefits of grant writing, identifies types and sources of available grants, describes potential roles of APNs in grant writing, describes ways to overcome barriers to grant writing, and presents strategies for writing winning grants to develop and improve practice in acute and critical care settings. These strategies will help APNs get started and provide a guide to follow in writing their first grant or will refresh their existing grant writing skills.
Thyroid Gland Disorder Emergencies
Authors: Hampton Jessica
Published: November 2019

Although thyroid dysfunction will develop in more than 12% of the US population during their lifetimes, true thyroid emergencies are rare. Thyroid storm and myxedema coma are endocrine emergencies resulting from thyroid hormone dysregulation, usually coupled with an acute illness as a precipitant. Careful assessment of risk and rapid action, once danger is identified, are essential for limiting morbidity and mortality related to thyroid storm and myxedema coma. This article reviews which patients are at risk, explains thyroid storm and myxedema coma, and describes pharmacological treatment and supportive cares.
LE CRISI FINANZIARIE DALLA TULIPANOMANIA ALLA BOLLA DEL 1987: LEZIONI DALLA STORIA
Authors: De Luca Giuseppe
Published: November 2019

Human behavior played a crucial role in the evolution of financial crises over modern and contemporary age. This chapter sets out to show how irrational action â€“ from mania to panic, from euphoria to mass hysteria â€“ represents a key factor in the bubbles from the tulipmania of 1637 to the 1987 stock market crash. From the point of view of what really happened during the crises, investorsâ€™ rationality appears an a priori belief about the way the world should work rather than a true description of the way the world has actually worked. Indeed, the prevailing model of financial crises entails the boom and the ensuing bust and is based on the episodic nature of the manias and the subsequent crises. Hence, the lesson is that even if we canâ€™t prevent someone to make a foolish of himself, the historical understanding of financial crises teaches as that it is a possible to avoid that speculative and fraudolent financial businesses ruin the less aware investors.
CARMEN REINHART AND KENNETH ROGOFF IN A TIME OF FISCAL AUSTERITY: A CRITICAL ANALYSIS OF THE EXPANSIONARY AUSTERITY THEORY
Authors: Botta Alberto
Published: November 2019

In this paper, we provide a critical analysis of the theory of the expansionary austerity. We take the hotly debated contribution by Carmen Reinhart and Kenneth Rogoff on the supposedly negative relationship between public debt and economic growth (when the debt-to-GDP ratio overcomes the 90 percent threshold) as the starting point of our analysis. We then move to analyze those contributions that more directly point to the possible expansionary outcomes of tough fiscal retrenchments. We eventually criticize the main conclusions of the expansionary austerity theory by presenting a simple short-run theoretical model. We show that fiscal consolidation might have expansionary outcomes only under pretty extreme, or very specific and uncertain circumstances. Expansionary austerity would hardly take place in the context of monetarily sovereign economies, or in presence of an accommodative monetary policy like that implemented by the ECB since late 2011, or into economic systems that are poorly integrated on international goods markets.
Lâ€™EDIZIONE CRITICA DEI Â«PURITANIÂ» DI VINCENZO BELLINI: ALCUNI ASPETTI DI METODO
Authors: Della Seta Fabrizio
Published: November 2019

The critical edition of I Puritani, published in 2013, provides an opportunity for some reflections on the nature of the operatic score compared with that of the literary text. Unlike the latter, the written dramatic-musical text does not coincide with the artwork; rather, it is the premise to the creation of a complex event, the theatrical performance. Belliniâ€™s opera excellently exemplifies the point: the authorâ€™s thought is transmitted by multiple sources, each of which contains variants that are not in conflict with each other; they embody a compositional thought that contains within itself the flexibility of the performance. A case in point is offered by metronome markings: Bellini wrote up to four different indications for the same passage in different manuscripts. None of these should be considered to represent the authorâ€™s final idea; rather, they delimit the spectrum of options within which the interpreter is called to choose.
I MANOSCRITTI ARABI, PERSIANI E TURCHI DELLA BIBLIOTECA BRAIDENSE
Authors: Soldati Agostino
Published: November 2019

The paper offers a survey of the manuscripts in Perso-Arabic characters kept in the Biblioteca Nazionale Braidense, with a brief illustration of the most substantial items and some information on their diverse provenance. The author is preparing an exhaustive catalogue of this little-known fund.
EZIO VANONI: UNO STATISTA FRA ECONOMIA PUBBLICA E PROGRAMMAZIONE ECONOMICA
Authors: Beretta Silvio
Published: November 2019

The note aims at highlighting the main aspects of the personality of Ezio Vanoni as a politician engaged to translate his scholarly experiences into government action, and particularly to design and support the tax reform known by his name. Social sensitivity, realism, rigor and therefore maximum attention to the organizational aspects of public institutions are essential features of his personality, and inspire his work as a politician, as well as a Catholic thinker and economic planner.
LE AGENDE GLOBALI DI SVILUPPO DELLE NAZIONI UNITE
Authors: Chiappero Enrica
Published: November 2019

In the last two decades the international community (or at least part of it) has shown an increasing awareness regarding the global challenges that either developed and developing countries are facing with: these challenges, which surely includes climate changes and international migrations, growing inequalities and persisting poverty, are raising serious concerns regarding the environmental, social and economic sustainability of the current model of development. On the basis of these arguments the UN system has promoted two main Agendas for development, in 2000 and 2015, setting goals and targets to be achieved. But do we really need an Agenda for development? What have we learnt from the MDGs and to what extent criticisms and weaknesses in the Agenda 2015 have been taken into account in designing the Agenda 2030? This short note is aimed to briefly touch some of these issues by comparing the two agendas.
“LE SOLITUDINI DEL MARE”: UN INEDITO TESTO PER MUSICA DI RICCARDO BACCHELLI
Authors: Bonomi Ilaria
Published: November 2019

The author present an unpublished text of Riccardo Bacchelli, a short poem entitled “Le solitudini del mare”, written by Bacchelli during ’60 years for the composer Bruno Bettinelli, who never set it to music. Different witnesses show revision both Bacchelli’s and Bettinelli’s. Text’s language show interesting literary quality, also in consideration of association with music.
Renal toxicity with mammalian target of rapamycin inhibitors: A meta-analysis of randomized clinical trials
Authors: Paluri Ravi K. , Sonpavde Guru , Morgan Charity , Rojymon Jacob , Hartzes Mar Anastasia , Gangaraju Radhika
Published: November 2019

A meta-analysis of randomized clinical trials (RCT) was done to determine the relative risk (RR) of acute kidney injury (AKI) with the use of mammalian target of rapamycin (mTOR) inhibitors. Citations from PubMed/Medline, clinical trials.gov, package inserts and abstracts from major conferences were reviewed to include RCTs comparing arms with or without mTOR inhibitors. The RR of all grade AKI in patients taking mTOR inhibitors compared to patients not on mTOR inhibitors was 1.55 (95% CI: 1.11 to 2.16, P=0.010). There was no significant difference in the risk of high-grade AKI for the two groups (RR=1.29, P=0.118, 95% CI: 0.94 to 1.77). There was no significant difference in the incidence rates for either all grade or high-grade AKI between the two groups. There was no publication bias and the trials were of high quality per Jadad scoring.
SPATIALLY HOMOGENEOUS MAXWELLIAN MOLECULES IN A NEIGHBORHOOD OF THE EQUILIBRIUM
Authors: Dolera Emanuele
Published: November 2019

This note deals with the long-time behavior of the solution to the spatially homogeneous Boltzmann equation for Maxwellian molecules, when the initial datum belongs to a suitable neighborhood of the Maxwellian equilibrium. In particular, it contains a quantification of the rate of exponential convergence, obtained by simple arguments.
MODELLI SPAZIO-TEMPORALI DI DIFFUSIONE, PREVISIONE E CONTROLLO DELLE EPIDEMIE DI COLERA: DAL SUDAFRICA AD HAITI
Authors: Gatto Marino , Mari Lorenzo , Rinaldo Andrea
Published: November 2019

Understanding, predicting and controlling the dynamics of cholera and other waterborne diseases are crucial goals of public health policies. Appropriate quantitative models to forecast epidemic development and to evaluate possible intervention scenarios would be specially needed during epidemic outbreaks, when preparedness and efficient allocation of resources are key to emergency management. Moreover, these tools ought to be spatially explicit, because waterborne disease epidemics usually display spatially inhomogeneous patterns. Here we describe spatially explicit epidemiological models and methods for real-time forecast of waterborne disease epidemics and design of intervention strategies for epidemic prevention and control. Applications to two cholera epidemics in South Africa and Haiti are briefly illustrated.
ON THE EXISTENCE OF THE UCP-BASIS IN COMPLEX SEPARABLE INFINITE DIMENSIONAL BANACH SPACES
Authors: Terenzi Paolo
Published: November 2019

Extension to the complex case of the generating biorthogonal systems and discussion on the possible extsnsion of the UCP-basis to the complex case.
BIOMOLECOLE DA BASIDIOMICETI COME SORGENTE DI POTENZIALI NUOVI FARMACI
Authors: Nasini Gianluca
Published: November 2019

We reported the isolation and structural characterization of a new biogenetical related compounds, produced in cultures by various strains of Basidiomycetes of the genera Armillaria, Laurilia, Clitocybe and Clavicorona . The isolated metabolites are sesquiterpenoids containing the protoilludane ring system and are even correlated with some biological activity and biogenetic steps. We have analyzed the chemistry of the melleolides, sulcatines, tsugicolines and clavilactones. In particular, the spirolaxine, isolated from cultures of Sporotrichum laxum, is active on the bacterium Helicobacter pylori and is a potent inhibitor of angiogenesis. Its structure was determined on the basis of chemical and spectroscopic evidence and confirmed by X-ray analysis.
ON THE REPRESENTATION OF MAPS BY LIE TRASFORMS
Authors: Giorgilli Antonio
Published: November 2019

The problem of representing a class of maps in a form suited for application of normal form methods is revisited. It is shown that using the methods of Lie series and of Lie transform a normal form algorithm is constructed in a straightforward manner. The examples of the SchrÃ¶derâ€“Siegel map and of the Chirikov standard map are included, with extension to arbitrary dimension.
NEURODEGENERATIVE DISEASES AND TAU: PATHOLOGICAL EVENTS AND MOLECULAR TARGETS
Authors: Seneci Pierfausto
Published: November 2019

The neuronal protein tau, and the related neurodegenerative diseases named tauopathies, are thoroughly described here. Tau is characterized in terms of its disorganized structure, of its isoforms, and of its structural domains. Tau mutations, and their consequences on the functions of tau (detachment from microtubules, aggregation into soluble oligomers and insoluble aggregates), are mentioned to introduce a set of â‰ˆ30 tauopathies. The pattern of post-translational modifications of tau is described, to explain its impact â€“ when disregulated â€“ on the folding and mislocalization of tau, followed by its aggregation. In details, tau hyper-phosphorylation (negative regulator, to be inhibited), N-Acetylglucosamine glycosylation and pT231-P232 cis-trans isomerization (positive regulator, to be stimulated) are described in terms of their connection to tau biochemical abnormalities, and of their exploitation as tauopathy-directed molecular targets.
FINITE-DIMENSIONAL GLOBAL ATTRACTOR FOR A NONLOCAL PHASE-FIELD SYSTEM
Authors: Grasselli Maurizio
Published: November 2019

We analyze a phase-field system where the energy balance equation is linearly coupled with a nonlinear and nonlocal ODE for the order parameter . The latter equation is characterized by a space convolution term which models long-range interactions and a singular configuration potential that forces to take values in the interval (ô€€€1; 1). We prove that the corresponding dynamical system is dissipative, i.e., it has a bounded absorbing set in a suitable phase space. Then we establish the existence of a finite-dimensional global attractor.
PLANT BIOLOGY, A RESOURCE FOR PROSPERITY
Authors: Kater Martin M.
Published: November 2019

Worldwide agriculture is facing many challenges. A fast growing world population, a changing climate and an increasing need for sustainability call for immediate solutions to guarantee environmental, social and economic stability. An important contribution will have to come from innovative plant research. However, despite that there is more and more scientific and political attention for problems related to agriculture, there is still little investment in this field of research. It will be important that this will change and that we start to realize that investing in plant research is an investment in the future of our society.
AVALANCHE DYNAMICS IN DISORDERED SYSTEMS
Authors: Rosso Alberto
Published: November 2019

We describe the complex dynamics of an interface (like a magnetic domain wall) on a disordered landscape. In presence of a small external drive (i.e. an external magnetic filed) the motion of the interface is slow and jerky. Two different regimes can be distinguished: the thermally activated regime where the interface spend most of the time in deep metastable states separated by large barriers (creep regime) and the avalanche regime where motion persists also at zero temperature, but it involves collective re-organizations (depinning). Our results shed light on the interplay between these two regimes and on the avalanche statistics.
NOTIZIE SU OPERE DEL â€˜500, RELATIVE ALLA MATEMATICA, DELLA BIBLIOTECA DELLâ€™ISTITUTO LOMBARDO
Authors: Landriani Giannantonio Sacchi
Published: November 2019

We introduce here some books belonging to the Library of the Istituto Lombardo. They are mathematical 16th century editions. The authors, considered at that time mathematician, were indeed devoted to fields of learning that can be barely classified with modern criterions. They studied the basics of numbers theory, of classical geometry, some optical measurements and other fields today belonging to independent branches of learning. Peculiarly some concepts such as the ones of logarithm or power (of a number) came from remote culture. Itâ€™s very important to remember that the still used roman numbering constituted an obstacle to the development of the numerical calculus. Essentially we want here to present some precious books very interesting for editorial quality and singularity of contents of some authors whose name are wellknown until today. What we really want/intend is to promote the drawing up of a critical catalogue of our antiquarian scientific library.
WHEN GENES ARE NOT ENOUGH: GENOMICS AND EPIGENOMICS
Authors: Pavesi Giulio
Published: November 2019

Sequencing technologies, that permit to determine the exact sequence of base pairs forming a DNA molecule, have been an historical breakthrough for all life sciences. Their large scale application to the sequencing of entire genomes, like the human genome, has on the other hand revealed some unexpected features of the organization of genes, as well as of the regulation of their expression. This article briefly summarizes how the post-genomic era, in which the whole genome could be studied, instead of the single parts composing it, has brought to the revision and the update of some of the most basic assumptions of classic genetics, as well as the discovery of the fundamental role of the epigenetic regulation of gene expression.
PREVISIONI INCERTE DECISIONI DIFFICILI
Authors: Grandori Elisa Guagenti
Published: November 2019

This work focuses on decision problems concerning risk reduction in the case of catastrophic events, which are scarsely predictable but associated to severe expected damage. A cryterium is outlined in order to judge the relative credibility of competing models. The knowledge-decision process is dissected in its components. The steps of the procedure from knowledge to final decision are analyzed. The effectiveness of short-term prediction and the choice of the acceptable risk are also discussed. A few case studies, related to earthquakes, landslides and pollution, are exposed.
SEMICONDUTTORI NANOSTRUTTURATI PER APPLICAZIONI TERMOELETTRICHE: UN CONCETTO INNOVATIVO DIMOSTRATO AL COMPUTER
Authors: Colombo Luciano
Published: November 2019

I will discuss the thermal transport properties of nanostructured silicongermanium alloys for thermoelectric applications. By means of atomistic simulations, I will show that it is in fact possible to design a nanocomposite with optimal thermoelectric performances, i.e. maximizing its figure of merit. In particular, computer experiments provide quantitative evidence that the phonon flux from hot to cold regions (phonons are the microscopic heat carriers) is dramatically affected by the network of grain boundaries present in the nanocomposite
Serious games in theology
Authors: Oliver Willem H.
Published: November 2019

In South Africa, the implementation of serious games and gamification (collectively referred to as gaming) in the design of curricula, being presented in schools and institutions of higher education, is mostly a novelty. As we are (should be) in a transitional phase with education, especially on two levels, namely, with the decolonisation of education and preparing education for the Fourth Industrial Revolution, it would be fitting and high time to fully implement gaming into the curricula. This article takes a look at the implementation of a serious game on an undergraduate level at a residential university. It focuses in a pragmatic way on applying the serious game on biblical languages – Greek, Hebrew and Latin – proposing that they should be presented to the student as paper behind the glass.
Evaluation of Undergraduate Orthodontic Courses at the Faculty of Dentistry in King Abdulaziz University
Authors: Alsulaimani Fahad F.
Published: November 2019

The undergraduate orthodontic courses at the Faculty of Dentistry, King Abdulaziz University are two and a half academic year, starting from the 4th year with an introduction to orthodontics. During the 5th year, students get exposed to different treatment modalities. During the 6th and final year, students are exposed to clinical cases. The aim of this study was to evaluate the content of these courses, teaching techniques, and the importance of teaching orthodontics to the undergraduate students. Nineteen questions were distributed to the graduating class of 2011-12 (40 male and 55 females). The topics covered were: 1) the importance of orthodontic teaching to the undergraduate students, 2) the importance of the laboratory projects, 3) the teaching methods, and 4) the competency of the student after finishing the orthodontic courses. Answers were analyzed according to gender and final grades. Pearson's chi-squared test was used to evaluate significance. There was no significant difference between male and female in all of the 19 questions. When analyzing the data according to the final grades, there were also no significant differences in most of the questions. Most of the graduating students were satisfied with the content of the orthodontic courses.
Estimating Human Exposure to Rat Lungworm (Angiostrongylus cantonensis) on Hawai’i Island: A Pilot Study
Authors: Jarvi Susan I. , Eamsobhana Praphathip , Quarta Stefano , Howe Kathleen , Jacquier Steven , Hanlon Alexandra , Snook Kirsten , McHugh Robert , Tman Zachariah , Miyamura Jill , Kramer Kuilei , Meyer McKayla
Published: November 2019

Angiostrongylus cantonensis is a zoonotic, parasitic nematode causing angiostrongyliasis or rat lungworm disease. Clinical diagnosis in humans is currently confirmed by detection of parasite DNA in cerebrospinal fluid. This study estimated human exposure to A. cantonensis in volunteer participants solicitated via public venues on east Hawai’i Island using blood-based tests. Antibodies were screened in sera by crude antigen ELISA, followed by a 31-kDa dot-blot test developed and validated in Thailand. Human participants (n = 435) donated blood samples and completed a questionnaire to self-report relevant symptomology or clinical diagnosis. Among symptoms reported by participants diagnosed by licensed clinicians, headaches, high eosinophil counts, stiff neck, fatigue, and joint pain were most severe during the initial 3 months of infection. ELISA results revealed 22% of the serum samples as positive, 46% as equivocal, and 32% as negative. A subset of 186 samples was tested by dot blot, with 30% testing positive and 70% testing negative. A significantly higher mean ELISA value was found among recently (2014–2015) clinically diagnosed participants as than among those with a diagnosis before 2010 (P = 0.027). All dot-blot positives were also ELISA positive and were significantly associated with higher ELISA values compared with dot-blot negatives (P = 0.0001). These results suggest that an ELISA using crude antigen isolated from adult A. cantonensis from Hawai’i may be an effective initial screening method for estimating exposure to A. cantonensis in Hawai’i and likewise suggest that dot-blot tests using the 31-kDa antigen exhibit efficacy as a diagnostic for exposure.