A five-year survey for plastic surgery malpractice claims in Rome, Italy

(1) Introduction: Medical malpractice claims against both health institutions and physicians are a crucial topic in Italy, as well as in other countries, particularly regarding civil proceedings. Our study reports an analysis of all of the malpractice judgments concerning plastic surgery decided in the Civil Court of Rome between 2012 and 2016. (2) Methods: the database of the Observatory Project on Medical Responsibility (ORMe) was analyzed, which collects all of the judgments of the Civil Court of Rome, that is, the first instance district court. Therefore, neither the jurisprudence of the second level court nor that of the Supreme Court was taken into account. (3) Results: 144 judgments concerning plastic surgery were delivered in the five-year period of 2012–2016 (corresponding to 10.6% of total professional liability verdicts of the Civil Court of Rome in the same period). In 101/144 cases (70.14%), the claim was accepted. A total of €4,727,579.00 was paid in compensation for plastic surgery malpractice claims, with a range from a minimum amount of €1555.96 to a maximum amount of €1,425,155.00 and an average compensation of €46,807.71 per claim that was significantly lower compared to other surgical disciplines. (4) Conclusions: Our data confirm that the analyzed branch has a high litigation rate, with a prevalence of convictions for cosmetic procedures over reconstructive ones, both for malpractice and for violation of the informed consent. Plastic surgery is also confirmed among those branches in which the professionals are more frequently sued compared to health institutions

Istituzioni di Medicina Legale e di Diritto per le Professioni Sanitarie

La medicina legale è un argomento di studio fondamentale in tutti i corsi di laurea delle professioni sanitarie, con questo manuale si intende fornire uno strumento per la didattica ma anche una guida aggiornata, che possa essere utile a chi già esercita la professione. Vengono trattati i temi principali della medicina legale generale e quelli inerenti i principi generali di diritto. Nel manuale sono trattati svariati temi: la responsabilità dell'infermiere in genere (le norme di riferimento per l'esercizio della professione, le conseguenze penali in caso di condotta non rispettosa di talune norme), la relazione con la persona, la cartella clinica infermieristica, il consenso, il segreto professionale. La parte finale si completa con una ricca appendice legislativa di utilità per il professionista sanitario, comprendente tra tutti, il codice deontologico dell’infermiere aggiornato.The forensic medicine is a subject of study fundamental in all degree programs professions health, with this manual is intended to provide a instrument for teaching but also a guide updated, which may be useful to those already holding the profession. It covers the main themes of forensic general and those related to the principles general law. This manual covered many themes: the responsibility of the nurse in general (the rules reference for the exercise of the profession,legal consequences in case of conduct that respects certain standards), the relationship with the person, the folder clinical nursing, consent, confidentiality professional. The final part is completed with a rich Appendix legislative utility for professionals health, including all of the code of ethics nurse updated

Obesity as a social phenomenon: A narrative review

BACKGROUND: obesity is one of the most prevalent diseases all over the world. Because of its high social impact, the broadest possible approach on several levels - and not limited only to clinical aspect - is needed to better understand and face the challenges obesity poses to public health. OBJECTIVES: to analyse, through the main evidence, the so- cial impact of weight excess in the general population and the actions aimed at mitigating its negative effects. DESIGN: narrative review. SETTING: data obtained from the sources included in the study were gathered and analyzed in five macroareas: Health Inequality, Society, Work, Impact on Social Medicine (focused on the Italian model), and Social Costs. RESULTS: each category showed a bilateral relationship with obesity having a significant impact for the community. CONCLUSIONS: for each field, various actions should be taken at institutional level. Many recommendations and actions have already been taken worldwide, but they alone seem to be not enough. This work points out that, in order to combat obesity and bring about a slowdown of this pandemic, the en- tire scientific community and institutions must work together to identify and design programmes that are truly effective

Generating socially appropriate tutorial dialog

Analysis of student-tutor coaching dialogs suggest that good human tutors attend to and attempt to influence the motivational state of learners. Moreover, they are sensitive to the social face of the learner, and seek to mitigate the potential face threat of their comments. This paper describes a dialog generator for pedagogical agents that takes motivation and face threat factors into account. This enables the agent to interact with learners in a socially appropriate fashion, and foster intrinsic motivation on the part of the learner, which in turn may lead to more positive learner affective states

Secondary cytomegalovirus infections: How much do we still not know? Comparison of children with symptomatic congenital cytomegalovirus born to mothers with primary and secondary infection

congenital cytomegalovirus (cCMV) infection can follow primary and secondary maternal infection. growing evidence indicate that secondary maternal infections contribute to a much greater proportion of symptomatic cCMV than was previously thought. We performed a monocentric retrospective study of babies with cCMV evaluated from august 2004 to february 2021; we compared data of symptomatic children born to mothers with primary or secondary infection, both at birth and during follow up. among the 145 babies with available data about maternal infection, 53 were classified as having symptomatic cCMV and were included in the study: 40 babies were born to mothers with primary infection and 13 babies were born to mothers with secondary infection. Analyzing data at birth, we found no statistical differences in the rate of clinical findings in the two groups, except for unilateral sensorineural hearing loss (SNHL) which was significantly more frequent in patients born to mother with secondary infection than in those born to mother with primary infection (46.2 vs. 17.5%, P = 0.037). during follow up, we found a higher rate of many sequelae (tetraparesis, epilepsy, motor and speech delay, and unilateral SNHL) in the group of children born to mothers with secondary infection, with a statistical difference for tetraparesis and unilateral SNHL. otherwise, only children born to mothers with primary infection presented bilateral SNHL both at birth and follow up. Our data suggest that the risk of symptomatic cCMV and long-term sequelae is similar in children born to mother with primary and secondary CMV infection; it is important to pay appropriate attention to seropositive mothers in order to prevent reinfection and to detect and possibly treat infected babies

Prospects for the measurement of muon-neutrino disappearance at the FNAL-Booster

Neutrino physics is nowadays receiving more and more attention as a possible source of information for the long-standing problem of new physics beyond the Standard Model. The recent measurement of the mixing angle $\theta_{13}$ in the standard mixing oscillation scenario encourages us to pursue the still missing results on leptonic CP violation and absolute neutrino masses. However, puzzling measurements exist that deserve an exhaustive evaluation. The NESSiE Collaboration has been setup to undertake conclusive experiments to clarify the muon-neutrino disappearance measurements at small $L/E$, which will be able to put severe constraints to models with more than the three-standard neutrinos, or even to robustly measure the presence of a new kind of neutrino oscillation for the first time. To this aim the use of the current FNAL-Booster neutrino beam for a Short-Baseline experiment has been carefully evaluated. This proposal refers to the use of magnetic spectrometers at two different sites, Near and Far. Their positions have been extensively studied, together with the possible performances of two OPERA-like spectrometers. The proposal is constrained by availability of existing hardware and a time-schedule compatible with the CERN project for a new more performant neutrino beam, which will nicely extend the physics results achievable at the Booster. The possible FNAL experiment will allow to clarify the current $\nu_{\mu}$ disappearance tension with $\nu_e$ appearance and disappearance at the eV mass scale. Instead, a new CERN neutrino beam would allow a further span in the parameter space together with a refined control of systematics and, more relevant, the measurement of the antineutrino sector, by upgrading the spectrometer with detectors currently under R&D study.Comment: 76 pages, 52 figure

Versatile Coordination of Cyclopentadienyl-Arene Ligands and Its Role in Titanium-Catalyzed Ethylene Trimerization

Cationic titanium(IV) complexes with ansa-(η5-cyclopentadienyl,η6-arene) ligands were synthesized and characterized by X-ray crystallography. The strength of the metal-arene interaction in these systems was studied by variable-temperature NMR spectroscopy. Complexes with a C1 bridge between the cyclopentadienyl and arene moieties feature hemilabile coordination behavior of the ligand and consequently are active ethylene trimerization catalysts. Reaction of the titanium(IV) dimethyl cations with CO results in conversion to the analogous cationic titanium(II) dicarbonyl species. Metal-to-ligand backdonation in these formally low-valent complexes gives rise to a strongly bonded, partially reduced arene moiety. In contrast to the η6-arene coordination mode observed for titanium, the more electron-rich vanadium(V) cations [cyclopentadienyl-arene]V(NiPr2)(NC6H4-4-Me)+ feature η1-arene binding, as determined by a crystallographic study. The three different metal-arene coordination modes that we experimentally observed model intermediates in the cycle for titanium-catalyzed ethylene trimerization. The nature of the metal-arene interaction in these systems was studied by DFT calculations.

Prospect for Charge Current Neutrino Interactions Measurements at the CERN-PS

Tensions in several phenomenological models grew with experimental results on neutrino/antineutrino oscillations at Short-Baseline (SBL) and with the recent, carefully recomputed, antineutrino fluxes from nuclear reactors. At a refurbished SBL CERN-PS facility an experiment aimed to address the open issues has been proposed [1], based on the technology of imaging in ultra-pure cryogenic Liquid Argon (LAr). Motivated by this scenario a detailed study of the physics case was performed. We tackled specific physics models and we optimized the neutrino beam through a full simulation. Experimental aspects not fully covered by the LAr detection, i.e. the measurements of the lepton charge on event-by-event basis and their energy over a wide range, were also investigated. Indeed the muon leptons from Charged Current (CC) (anti-)neutrino interactions play an important role in disentangling different phenomenological scenarios provided their charge state is determined. Also, the study of muon appearance/disappearance can benefit of the large statistics of CC muon events from the primary neutrino beam. Results of our study are reported in detail in this proposal. We aim to design, construct and install two Spectrometers at "NEAR" and "FAR" sites of the SBL CERN-PS, compatible with the already proposed LAr detectors. Profiting of the large mass of the two Spectrometers their stand-alone performances have also been exploited.Comment: 70 pages, 38 figures. Proposal submitted to SPS-C, CER

4.5 years multi-wavelength observations of Mrk 421 during the ARGO-YBJ and Fermi common operation time

We report on the extensive multi-wavelength observations of the blazar Markarian 421 (Mrk 421) covering radio to gamma-rays, during the 4.5 year period of ARGO-YBJ and Fermi common operation time, from August 2008 to February 2013. In particular, thanks to the ARGO-YBJ and Fermi data, the whole energy range from 100 MeV to 10 TeV is covered without any gap. In the observation period, Mrk 421 showed both low and high activity states at all wavebands. The correlations among flux variations in different wavebands were analyzed. Seven large flares, including five X-ray flares and two GeV gamma-ray flares with variable durations (3-58 days), and one X-ray outburst phase were identified and used to investigate the variation of the spectral energy distribution with respect to a relative quiescent phase. During the outburst phase and the seven flaring episodes, the peak energy in X-rays is observed to increase from sub-keV to few keV. The TeV gamma-ray flux increases up to 0.9-7.2 times the flux of the Crab Nebula. The behavior of GeV gamma-rays is found to vary depending on the flare, a feature that leads us to classify flares into three groups according to the GeV flux variation. Finally, the one-zone synchrotron self-Compton model was adopted to describe the emission spectra. Two out of three groups can be satisfactorily described using injected electrons with a power-law spectral index around 2.2, as expected from relativistic diffuse shock acceleration, whereas the remaining group requires a harder injected spectrum. The underlying physical mechanisms responsible for different groups may be related to the acceleration process or to the environment properties.Comment: 17 pages, 9 figures, 5 tables, Accepted for publication in ApJ

The cosmic ray proton plus helium energy spectrum measured by the ARGO-YBJ experiment in the energy range 3-300 TeV

The ARGO-YBJ experiment is a full-coverage air shower detector located at the Yangbajing Cosmic Ray Observatory (Tibet, People's Republic of China, 4300 m a.s.l.). The high altitude, combined with the full-coverage technique, allows the detection of extensive air showers in a wide energy range and offer the possibility of measuring the cosmic ray proton plus helium spectrum down to the TeV region, where direct balloon/space-borne measurements are available. The detector has been in stable data taking in its full configuration from November 2007 to February 2013. In this paper the measurement of the cosmic ray proton plus helium energy spectrum is presented in the region 3-300 TeV by analyzing the full collected data sample. The resulting spectral index is $\gamma = -2.64 \pm 0.01$. These results demonstrate the possibility of performing an accurate measurement of the spectrum of light elements with a ground based air shower detector.Comment: 18 pages, 8 figures, preprint submitted to Phys. Rev.