Improvment of safety conditions of unstable rock slopes through the use of explosives

The paper discusses operations aimed at creating a safer natural or man made rock slope by artificially inducing the displacement of unstable elements by blasting. A detailed analysis of the problems with the use of explosives present when conducting these activities is carried out focusing on the advantages and disadvantages of this technology. The results of two examples of demolition of instable rock elements are presented and discussed thus providing suggestions for future blasting design

The Plains of Mars, European War Prints, 1500-1825

Over fifty original prints by renowned artists from the sixteenth through the early nineteenth century, including Albrecht Dürer, Lucas Cranach, Théodore Géricault, and Francisco de Goya, among many others, are featured inThe Plains of Mars: European War Prints, 1500-1825. On loan from the Sarah Campbell Blaffer Foundation at the Museum of Fine Arts, Houston, the works of art included in this exhibition examine the topics of war and peace, propaganda, heroism, brutal conflicts, and the harrowing aftermath of battle. Spanning from the Renaissance to the Romantic periods and encompassing a wide geographic scope including Italy, Germany, France, Spain, the Low Countries, England, and North America, the prints depict triumphant Renaissance soldiers, devastating scenes of violence, and satirical caricatures of political figures. Also on display is Goya’s compelling “Disasters of War” series, completed in response to the brutality of the Spanish War of Independence. Goya’s prints serve as a powerful testament to the horrors faced by both soldiers and civilians. Under the direction of Professor Felicia Else and Shannon Egan, Melissa Casale ‘19 and Bailey Harper ‘19 have researched and written didactic labels, catalogue essays, and created an interactive digital interface to complement the exhibition. Together, Melissa and Bailey will lead public tours of the exhibition. A Gallery Talk by Prof. Peter Carmichael will draw connections between the depictions of warfare on view in the Gallery with representations of the American Civil War. James Clifton, Director of the Sarah Campbell Blaffer Foundation at the Museum of Fine Arts, Houston, will be delivering a lecture in conjunction with the exhibition. Dr. Clifton, who also serves as curator of Renaissance and Baroque painting at MFAH, curated the exhibition in its first iteration and wrote the exhibition catalogue (published by Yale University Press). Dr. Clifton’s lecture not only will provide an overview of the exhibition, but also will focus on the concept of “mediated war.” A full-color catalogue with images and essays by Bailey Harper ’19 and Melissa Casale ’19, under the supervision of Profs. Felicia Else and Shannon Egan, is planned to accompany the exhibition.https://cupola.gettysburg.edu/artcatalogs/1028/thumbnail.jp

Prescription Stimulants: Preventing Misuse Among Adults with ADHD

Stimulant drugs are a cornerstone in the treatment of Attention Deficit and Hyperactivity Disorder (ADHD) and are being prescribed at increasing rates. The safe prescription and use of these drugs by providers and patients alike is critically important to appropriately treating ADHD and preventing misuse. This presentation discusses how patients can be educated on the uses of stimulants and provides information on what to do in case of overdose. Additionally, resources for providers are provided to continue improving awareness of at-risk patients and community resources available to them

Modelling the contribution of metacognitions and expectancies to problematic smartphone use

Abstract Background and aims In the current study we have sought to clarify the contribution of metacognitions concerning smartphone use relative to smartphone use expectancies in the relationship between well-established predisposing psychological factors and problematic smartphone use (PSU). We tested a model where psychological distress, impulsivity, and proneness to boredom predict metacognitions about smartphone use and smartphone use expectancies, which in turn predict PSU. Methods A sample of 535 participants (F = 71.2%; mean age = 27.38 ± 9.05 years) was recruited. Results The model accounted for 64% of the PSU variance and showed good fit indices (χ 2 = 16.01, df = 13, P = 0.24; RMSEA [90%CI] = 0.02 [0–0.05], CFI = 0.99; SRMR = 0.03). We found that: (i) when it comes to psychological distress and boredom proneness, negative metacognitions, and both positive and negative expectancies play a mediating role in the association with PSU, with negative metacognitions showing a dominant role; (ii) there is no overlap between positive expectancies and positive metacognitions, especially when it comes to smartphone use as a means for socializing; (iii) impulsivity did not show a significant effect on PSU Direct effects of the predictors on PSU were not found. Discussion and conclusions The current study found additional support for applying metacognitive theory to the understanding of PSU and highlight the dominant role of negative metacognitions about smartphone in predicting PSU

Is depression a real risk factor for acute myocardial infarction mortality? A retrospective cohort study

Background: Depression has been associated with a higher risk of cardiovascular events and a higher mortality in patients with one or more comorbidities. This study investigated whether continuative use of antidepressants (ADs), considered as a proxy of a state of depression, prior to acute myocardial infarction (AMI) is associated with a higher mortality afterwards. The outcome to assess was mortality by AD use. Methods: A retrospective cohort study was conducted in the Veneto Region on hospital discharge records with a primary diagnosis of AMI in 2002-2015. Subsequent deaths were ascertained from mortality records. Drug purchases were used to identify AD users. A descriptive analysis was conducted on patients' demographics and clinical data. Survival after discharge was assessed with a Kaplan-Meier survival analysis and Cox's multiple regression model. Results: Among 3985 hospital discharge records considered, 349 (8.8%) patients were classified as AD users'. The mean AMI-related hospitalization rate was 164.8/100,000 population/year, and declined significantly from 204.9 in 2002 to 130.0 in 2015, but only for AD users (-40.4%). The mean overall follow-up was 4.64.1years. Overall, 523 patients (13.1%) died within 30days of their AMI. The remainder survived a mean 5.3 +/- 4.0years. After adjusting for potential confounders, use of antidepressants was independently associated with mortality (adj OR=1.75, 95% CI: 1.40-2.19). Conclusions: Our findings show that AD users hospitalized for AMI have a worse prognosis in terms of mortality. The use of routinely-available records can prove an efficient way to monitor trends in the state of health of specific subpopulations, enabling the early identification of AMI survivors with a history of antidepressant use

Hospitals and the Disruptive Health Care Practitioner - Is the Inability to Work with Others Enough to Warrant Exclusion?

The disruptive physician is, by definition, contentious, threatening, insulting and frequently litigious. Nonetheless, he or she may also be a clinically competent medical practitioner. In an earlier time, hospitals accepted or at least tolerated such disruptive behavior for a variety of reasons. Today, accepting or tolerating such behavior is increasingly difficult in view of the continuing expansion of the hospital\u27s corporate liability to answer for nearly all activity occurring within its walls. This article outlines the types of disruptive physician behavior that courts have found to provide a reasonable basis for responsive institutional action. In this regard, the authors stress the importance of artfully drafted medical staff bylaws and the recognition of disruptive behavior as a serious violation of those bylaws. While recognizing that the physician\u27s due process rights must be respected, the writers suggest that hospital management must be able to take appropriate and swift administrative action when confronted with disruptive behavior. They conclude that a harmonious environment with strong, intelligent and effective leadership, operated under sound and flexible bylaws is necessary to enable a hospital to comply with its legal mandate to provide consistent, high quality care

Disease burden and quality of life of in children with sickle cell disease in Italy: time to be considered a priority

The objective of the present article is to highlight the need for attention to Quality of Life of patients with Sickle Cell Disease living in Italy. The transformation of sickle cell disease from a severe life-threatening disease of childhood into a chronic, lifelong condition due to the significant improvements in care and treatment options, imposes increasing new challenges to health care providers and patients. Patients now face physical, psychosocial and emotional challenges throughout their lives. They generally have to receive chronic treatments and regular multidisciplinary monitoring which increase social and emotional burden rendering adherence to treatment sometimes complicated. A chronic disease impacts all aspects of patients’ lives, not only the physical one, but also the social and emotional aspects as well as the educational and working life. The entire “Quality of Life” is affected and recent evidence demonstrates the importance quality of life has for patients with chronic illness. The results of this review focus on emerging data regarding quality of life across the lifespan of patients with Sickle Cell Disease, and highlight the need for more action in this field in Italy, where recent immigration and improved care determine an increasing population of children with sickle cell disease being taken into long term care

5% lidocaine medicated plaster double effect in a case of orofacial localized neuropathic pain

Roberto Casale,1,2 Yuriy Romanenko,2,3 Massimo Allegri4–6 1Department of Clinical Neurophysiology and Pain Rehabilitation Unit, Foundation "Salvatore Maugeri", Research and Care Institute, IRCCS, Pavia, Italy; 2EFIC Montescano Pain School, Montescano, Italy; 3Department of Neurology, Lugansk City Hospital 4, Lugansk, Ukraine; 4Department of Clinical, Surgical, Diagnostic and Pediatric Sciences University of Pavia, Pavia, Italy; 5Pain Therapy Service Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; 6SIMPAR group, Pavia, Italy Abstract: Localized neuropathic pain (LNP) is a type of neuropathic pain that is characterized by “consistent and limited area(s) of maximum pain associated with negative or positive sensory signs and/or spontaneous symptoms characteristic of neuropathic pain”. This definition encompasses a huge number of neuropathic orofacial pain syndromes. We present a case report of a patient who was affected with sleep apnea syndrome treated with nocturnal oxygen mask delivery, in whom orofacial LNP hampered the wearing of a mask due to unbearable burning and throbbing pain. The application of 5% lidocaine medicated plaster during the night led to an impressive reduction of both the pain level and the size of the painful area due to the plaster's pharmacological mechanisms, which were associated with a secondary benefit due to its mechanical protective action. This case report shows how these two factors could be of clinical value and have to be considered more systematically in the treatment of LNP in reducing pain and the size of the painful area. Keywords: trigeminal pain, localized neuropathic pain, topical treatment, 5% lidocaine medicated plaste