28 research outputs found

    Previdenza complementare: proiezioni di lungo periodo nell’ottica dell’analisi di sostenibilità

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    5noopenopenFersini, Paola; Barone, Gaia; Forte, Salvatore; Olivieri, Gennaro; Melisi, GiuseppeFersini, Paola; Barone, Gaia; Forte, Salvatore; Olivieri, Gennaro; Melisi, Giusepp

    Intraoperative fetal heart monitoring for non-obstetric surgery: A systematic review

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    Limited data are available on fetal monitoring during non-obstetric surgery in pregnancy. We performed a systematic review to evaluate the incidence of emergent cesarean delivery performed for non-reassuring fetal heart rate patterns during non-obstetric surgery. Electronic databases were searched from their inception until October 2018 without limit for language. We included studies evaluating at least five cases of intraoperative fetal heart rate monitoring -either with ultrasound or cardiotocography- during non-obstetric surgery in pregnant women at ≥22 weeks of gestation. The primary outcome was the incidence of intraoperative cesarean delivery performed for non-reassuring fetal heart rate monitoring. Non-reassuring fetal heart rate monitoring was defined by attendant personnel, meeting NICHD criteria for category II or III patterns. Data extracted regarded type of study, demographic characteristics, maternal and perinatal outcomes. Statistical analysis was performed for continuous outcomes by calculating mean and standard deviations for appropriate variables. Of 120 studies identified, 4 with 41 cases of intraoperative monitoring met criteria for inclusion and were analyzed. Most (66%) surgeries were indicated for neurological or abdominal maternal issues and were performed under general anesthesia (88%) at a mean gestational age of 28 weeks. Minimal or absent fetal heart variability was noted in most cases and a 10-25 beats per minutes decrease in fetal heart rate baseline was observed in cases with general anesthesia. No intraoperative cesarean deliveries were needed. The incidence of non-reassuring fetal heart rate monitoring was 4.9% (2/41) and were limited to fetal tachycardia during maternal fever. Two (4.9%) cases of non-reassuring fetal heart rate monitoring were noted within the immediate 48 h after surgery, necessitating cesarean delivery. A single case of intrauterine fetal demise occurred four days postoperatively in a woman who had neurosurgery and remained comatose. In conclusion, limited data exist regarding the clinical application of fetal heart rate monitoring at viable gestational ages during non-obstetric surgical procedures. Fetal heart rate monitoring during non-obstetric surgery at ≥22 weeks was not associated with need for intraoperative cesarean delivery, but two (4.9%) cesarean deliveries were performed for non-reassuring fetal heart rate monitoring within 48 h after surgery

    Understanding Factors Associated With Psychomotor Subtypes of Delirium in Older Inpatients With Dementia

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    Empirical mode decomposition of long-term polar motion observations

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    We use the Empirical Mode Decomposition (EMD) method to study the decadal vari- ations in polar motion and its long–term trend since year 1900. The existence of the so–called “Markowitz wobble”, a multidecadal fluctuation of the mean pole of rota- tion whose nature has long been debated since its discovery in 1960, is confirmed. In the EMD approach, the Markowitz wobble naturally arises as an empirical oscillatory term in polar motion, showing significant amplitude variations and a period of approxi- mately 3 decades. The path of the time–averaged, non–cyclic component of polar motion matches the results of previous investigations based on classical spectral methods. How- ever, our analysis also reveals previously unnoticed steep variations (change points) in the rate and direction of secular polar motion

    Anomalous secular sea-level acceleration in the Baltic Sea caused by isostatic adjustment

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    Observations from the global array of tide gauges show that global sea-level has been rising at an average rate of 1.5-2 mm/yr during the last ~150 years [Douglas 1991, Spada and Galassi 2012]. Although a global sea-level acceleration was initially ruled out [Douglas 1992], subsequent studies [Douglas 1997, Church and White 2006, Jevrejeva et al. 2008, Church and White 2011] have coherently proposed values of ~1 mm/year/century [Olivieri and Spada 2013]. More complex non-linear trends and abrupt sea-level variations have now also been recognized. Globally, these could manifest a regime shift between the late Holocene and the current rhythms of sea-level rise [Gehrels and Woodworth 2013], while locally they result from ocean circulation anomalies, steric effects and wind stress [Bromirski et al. 2011, Merrifield 2011]. Although isostatic readjustment affects the local rates of secular sea-level change [Milne and Mitrovica 1998, Peltier 2004], a possible impact on regional acceleration has been so far discounted [Douglas 1992, Jevrejeva et al. 2008, Woodworth et al. 2009] since the process evolves on a millennium time scale [Turcotte and Schubert 2002]. Here we report a previously unnoticed anomaly in the long-term sea-level acceleration of the Baltic Sea tide gauge records, and we explain it by the classical post-glacial rebound theory and numerical modeling of glacial isostasy. Contrary to previous assumptions, our findings demonstrate that isostatic compensation plays a role in the regional secular sea-level acceleration

    Previdenza complementare: Proiezioni di lungo periodo nell’ottica dell’analisi di sostenibilità

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    L’esigenza di una ricerca di questo tipo è nata dal contesto economico attuale. Il sistema pensionistico europeo è, e lo era ancor di più ai tempi della pubblicazione del Libro Verde (2010), sotto pressione a causa dell’invecchiamento della popolazione dovuto all'allungamento della vita media e alla contrazione dei tassi di natalità. Ciò rappresenta, per tutti gli Stati membri, una forte sfida anche in campo pensionistico, dal momento che questo invecchiamento demografico porterà nel 2060 ad avere due persone attive per ogni ultra-65 enne contro le attuali 4 (circa). Nel 2010 pertanto si era avviata un’ampia discussione su come il quadro pensionistico europeo potesse essere sviluppato al fine di fornire agli Stati membri un sostegno per garantire ai propri cittadini pensioni sostenibili ed adeguate. Il Libro Verde, in quanto tale, non presentava proposte specifiche per il raggiungimento dello scopo, ma racchiudeva in sé un’analisi delle cosiddette “grandi sfide” (invecchiamento demografico, evoluzione dei sistemi pensionistici degli Stati Membri ed effetti della crisi economica e finanziaria) e chiedeva sostanzialmente un parere alle parti in causa nell'Unione Europea su come sostenere gli Stati membri (il cui ruolo è assolutamente predominante nel legiferare sui sistemi pensionistici interni), al fine di creare sistemi pensionistici sostenibili ed adeguati. In tale contesto è nata l’esigenza di stimare a livello macro i prevedibili flussi in entrata e in uscita della previdenza complementare destinata ad assumere sempre maggiore importanza nella misura dell’adeguatezza del reddito da pensione; ciò in quanto la prestazione di base risultava (e risulta tuttora), da sola, sempre più insufficiente a garantire il mantenimento del tenore di vita nel passaggio allo stato di quiescenza

    A heuristic evaluation of long-term global sea level acceleration

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    none3noIn view of the scientific and social implications, the global mean sea level rise (GMSLR) and its possible causes and future trend have been a challenge for so long. For the twentieth century, reconstructions generally indicate a rate of GMSLR in the range of 1.5 to 2.0 mm yr−1. However, the existence of nonlinear trends is still debated, and current estimates of the secular acceleration are subject to ample uncertainties. Here we use various GMSLR estimates published on scholarly journals since the 1940s for a heuristic assessment of global sea level acceleration. The approach, alternative to sea level reconstructions, is based on simple statistical methods and exploits the principles of meta-analysis. Our results point to a global sea level acceleration of 0.54 ± 0.27 mm/yr/century (1σ) between 1898 and 1975. This supports independent estimates and suggests that a sea level acceleration since the early 1900s is more likely than currently believed.N/ArestrictedSpada, Giorgio; Olivieri, Marco; Galassi, GaiaSpada, Giorgio; Olivieri, Marco; Galassi, Gai

    Sea-level rise along the Emilia-Romagna coast (Northern Italy) in 2100: scenarios and impacts

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    As a consequence of climate change and land subsidence, coastal zones are directly impacted by sea-level rise. In some particular areas, the effects on the ecosystem and urbanisation are particularly enhanced. We focus on the Emilia-Romagna (E-R) coastal plain in Northern Italy, bounded by the Po river mouth to the north and by the Apennines to the south. The plain is  ∼ 130 km long and is characterised by wide areas below mean sea level, in part made up of reclaimed wetlands. In this context, several morphodynamic factors make the shore and back shore unstable. During next decades, the combined effects of land subsidence and of the sea-level rise as a result of climate change are expected to enhance the shoreline instability, leading to further retreat. The consequent loss of beaches would impact the economy of the region, which is tightly connected with tourism infrastructures. Furthermore, the loss of wetlands and dunes would threaten the ecosystem, which is crucial for the preservation of life and the environment. These specific conditions show the importance of a precise definition of the possible local impacts of the ongoing and future climate variations. The aim of this work is the characterisation of vulnerability in different sectors of the coastal plain and the recognition of the areas in which human intervention is urgently required. The Intergovernmental Panel on Climate Change (IPCC) Fifth Assessment Report (AR5) sea-level scenarios are merged with new high-resolution terrain models, current data for local subsidence and predictions of the flooding model in_CoastFlood in order to develop different scenarios for the impact of sea-level rise projected to year 2100. First, the potential land loss due to the combined effect of subsidence and sea-level rise is extrapolated. Second, the increase in floodable areas as a result of storm surges is quantitatively determined. The results are expected to support the regional mitigation and adaptation strategies designed in response to climate change.Published2271–22874A. Oceanografia e climaJCR Journa

    Historical and recent sea level rise and land subsidence in Marina di Ravenna, northern Italy

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    The regions facing the northern Adriatic Sea are particularly vulnerable to sea-level rise. Several trade ports are located there, and the area is important from social and economical viewpoints. Since tourism and cultural heritage are a significant source of income, an increase in sea-level could hinder the development of these regions. One of the longest sea-level time series in the northern Adriatic, which goes back to the late 1880s, has been recorded at Marina di Ravenna, in Emilia-Romagna region. The record is anomalous, showing a rate of increase that largely exceeds that observed in nearby stations. During the last few decades, geodetic campaigns based on geometric high precision leveling, SAR interferometry, and GPS have monitored the Ravenna area. In this work, tide gauge observations are merged with yet unpublished geodetic data, aiming at a coherent interpretation of vertical land movements. We confirm that land subsidence is the major cause of relative sea-level change at Marina di Ravenna, at least during the period allowing for a quantitative analysis (1990-2011). The rate of absolute sea-level change (2.2\ub11.3 mm yr 121 during the same time period), given by the difference between the rate of relative sea-level change and the rate of subsidence, is consistent with the rate of absolute sea-level change observed by altimetry in the northern Adriatic Sea
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