Religion, Reason and Reconciliation in Louise Gluck’s The Wild Iris

In a world where reason is king, what is the role of faith? Louise Gluck does not claim to have an answer, but she does explore the question. The Wild Iris gives us a god who is utterly convinced of the singular appeal of faith, countered by a worshipper who finds their rational worldview too reasonable to abandon. Yet over the course of the text, neither is able to demonstrate the singular primacy of their point, both arguments leaving their arguers unsatisfied in one way or another. This paper will explore the debate between the human and divine speakers of The Wild Iris, using contemporary understandings of Christianity to define the natures of faith and reason within the text, and will ultimately attempt to explain the significance of this debate’s inconclusiveness

The influence of corporate board on non-financial disclosure according to the main organizational theories

This study aims to define a theoretical framework of the main organisational theories identifying how the board composition influences both CSR activity and disclosure. Based on a selective literature review, the analysis highlights the implications of each organisational theory on non-financial information disclosure and board’s role. Specifically, the research shows that the management’s influence on non-financial information practice of an organisation is not emphasized by all organizational theories. In addition, based on the research results, non-financial information can should be considered as an organizational tool to legitimise the firm performance and manage the perception of enterprises stakeholders. The study could be further developed by applying quantitative research methods, such as a multiple case study approach, which is useful to explore the dissemination of a new phenomeno

Exploring Tourist Preferences on the Visitor Management System: the Case Study of Plitvice Lakes National Park

This study aims to develop an online survey on the tourist perception of the visitor management system of the Plitvice Lakes National Park in Croatia. As tourists are particularly sensitive to organisational issues related to the Park management, a bottom-up approach based on visitors’ opinions has been applied. First of all, a brief chronology has been reconstructed that retraces the most significant stages of the Park. Subsequently, an online questionnaire was structured on the basis of the current Park Management Plan with a focus on the macro-topics concerning the visitor management system. The survey was distributed using the Google Form application. A total of 214 questionnaires were collected in the period between May and July 2022. The sample was statistically analysed to detect the main habits of the Park users. The Mann-Whitney-Wilcox U test and the Kruskal-Wallis test were applied to identify the differences in the priorities attributed by visitors to the various management actions. Among the main findings of the research, the authors identified that national visitors (i.e. Croatian) place a higher priority on the implementation of services and infrastructure than tourists from other countries. In addition, those who have visited the Park on multiple occasions have higher safety expectations than those who have only visited the Park once. This category of visitors also considers it more important to take into account the opinions of visitors. Furthermore, with regard to retail and souvenir shops, tourists are generally inclined to set a lower priority for intervention than that attributed to other management aspects. The results of this study can be of great value to Park managers, who should consider visitors as key stakeholders in the decision-making process that is the foundation for managing this important natural resource

Malignant ventricular arrhythmias induction by programmed electrical stimulation of the right ventricular outflow tract only during type 1 brugada ECG maximization

OBJECTIVE: The role of electrophysiology study in Brugada syndrome (BS) sudden cardiac death risk stratification remains controversial and seems to depend on the phenotypic expression of the channelopathy. Ajmaline has a key role in the diagnosis of BS. We observed that programmed electrical stimulation (PES) of the right ventricular outflow tract (RVOT), only when type 1 BS ECG is unmasked by ajmaline administration, induces ventricular arrhythmias. CASE REPORT: We describe a case of ventricular fibrillation induction by PES of the RVOT when type 1 BS ECG is revealed by ajmaline, in a patient with a baseline dynamic intermittent type 1 and 2 BS ECG. CONCLUSIONS: The heterogeneous clinical presentations of BS are due to the underlying mechanisms. PES of the RVOT during positive ajmaline test maximizes the channelopathy and therefore sudden cardiac death risk-stratification in BS

Morphologic grading of emphysema is useful in the selection of candidates for unilateral or bilateral reduction pneumoplasty

Objective: Radiologic morphology of emphysema proves useful in the selection of candidates for bilateral reduction pneumoplasty. We developed a simple morphologic grading system capable of identifying subsets of patients who had maximal functional improvement after unilateral or bilateral operation. Methods: Fifty-two patients who underwent unilateral (n = 34) or bilateral (n = 18) reduction pneumoplasty were evaluated. Emphysema morphology was visually scored by digital roentgenograms and high-resolution computed tomography. In each lung, severity of emphysema (ES), heterogeneity (DHT) and hyperinflation (DHF) degrees, were assessed. Asymmetric ratio of emphysema (ARE) between the lungs was expressed as: higher ES/lower ES scores. Morphometric data were correlated with absolute preoperative-postoperative FEV1 change (Delta FEV1). Results: No difference was found between the unilateral and the bilateral group for ES and DHT. DHF was greater in the bilateral group (3.1 vs. 2.7, P = 0.02) whereas ARE was greater in the unilateral group (1.29 vs. 1.05, P = 0.0001). Stepwise logistic regression extracted as best predictors of maximal Delta FEV1, ARE (odds ratio = 238, Wald test P = 0.04) in the unilateral group, and DHT (odds ratio = 24, P = 0.03) in the bilateral group. Unilateral group Delta FEV1 was greater in patients with ARE greater than or equal to 1.3 (0.44 vs. 0.241, P = 0.02). Bilateral group Delta FEV1 was greater in patients with DEET > 1 (0.50 vs. 0.31 1, P = 0.03). No difference was found when comparing Delta FEV1 resulting from unilateral RP and ARE greater than or equal to 1.3, and bilateral RP (0.44 vs. 0.41 1, not significant). Conclusions: This morphologic grading system identified subsets of patients who had maximal functional benefit from unilateral or bilateral reduction pneumoplasty and might be useful in the preoperative screening of candidates for either approach. (C) 2000 Published by Elsevier Science B.V

Solitary pulmonary nodules: Morphological and metabolic characterisation by FDG-PET-MDCT [Nodulo polmonare solitario: Caratterizzazione morfologico-metabolica mediante imaging integrato TCms/FDG-PET]

Purpose. This study was done to analyse the additional morphological and functional information provided by the integration of [18F]-2-fluoro- 2-deoxy-D-glucose positron emission tomography ([18F]-FDG-PET) with contrast-enhanced multidetector computed tomography (MDCT) in the characterisation of indeterminate solitary pulmonary nodules (SPNs). Materials and methods. Fifty-six SPNs, previously classified as indeterminate, were evaluated using a Discovery ST16 PET/CT system (GE Medical Systems) with nonionic iodinated contrast material and [18F]-FDG as a positron emitter. Images were evaluated on a dedicated workstation. Semiquantitative parameters of [18F]-FDG uptake and morphological, volumetric and densitometric parameters before and after contrast administration were analysed. Results were correlated with the histological and follow-up findings. Results. Twenty-six SPNs were malignant and 30 were benign. Malignant lesions at both PET/CT and histology had a mean diameter of 1.8±1.2 cm, a volume doubling time (DT) of 222 days, a mean standardized uptake value (SUV) of 4.7 versus 1.08 in benign lesions and a mean postcontrast enhancement of 44.8 HU as opposed to 4.8 HU in benign nodules. Malignant lesions had a significantly shorter doubling time and significantly greater postcontrast enhancement compared with benign nodules. Based on the SUV and using a cut-off value of >2.5, PET/CT had a sensitivity of 76.9%, specificity of 100%, diagnostic accuracy of 89.2%, positive predictive value (PPV) of 100% and negative predictive value (NPV) of 83.3%. Based on doubling time (cut off <400 days), it had a sensitivity of 76.9%, specificity of 93.3%, accuracy of 85.7%, PPV of 90.9% and NPV of 82.3%. Based on postcontrast enhancement (cut off >15 HU), it had a sensitivity of 92.3%, specificity of 100%, accuracy of 96.4%, PPV of 100% and NPV of 93.7%. Conclusion. PET/CT allows accurate analysis of anatomical/morphological and metabolic/functional correlations of SPN, providing useful data for identifying and locating the disease, for differentiating between malignant and benign nodules and for establishing the aggressiveness and degree of vascularity of pulmonary lesions. Therefore, partly in view of the considerable reduction in time and cost of the single examinations, we believe that PET/CT will gain an increasingly dominant role in the diagnostic and therapeutic approach to lung cancer, especially in the preclinical phase. © 2007 Springer-Verlag

Are there pulmonary sequelae in patients recovering from COVID-19?

It has been recently hypothesized that infection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may lead to fibrotic sequelae in patients recovering from coronavirus disease 2019 (COVID-19). In this observational study, hospitalized patients with COVID-19 had a HRCT of the chest performed to detect the extension of fibrotic abnormalities via Hounsfield Units (HU). At follow-up, the lung density significantly improved in both lungs and in each lobe of all patients, being in the normal range (- 950 to - 700 HU). This study provides preliminary evidence that hospitalized patients with mild-to-moderate forms of COVID-19 are not at risk of developing pulmonary fibrosis

Early and long-term results of pectoralis muscle flap reconstruction vs sternal rewiring following failed sternal closure.

OBJECTIVES: The aim of the study was to compare early and long-term results of pectoralis muscle flap reconstruction with those of sternal rewiring following failed sternal closure. Primary outcomes of the study were survival and failure rate. Respiratory function, chronic pain and quality of life were also evaluated. METHODS: In a propensity-score matching analysis, of 94 patients who underwent sternal reconstruction, 40 were selected; 20 underwent sternal reconstruction with bilateral pectoralis muscle flaps (Group 1) and 20 underwent sternal rewiring (Group 2). Survival and failure rates were evaluated by in-hospital records and at follow-up. Respiratory function measures, including vital capacity (VC), were evaluated both by spirometry and computed tomography (CT) volumetry. Chronic pain was evaluated by the visual analogue pain scale. RESULTS: At 85 ± 24 months of follow-up, survival and procedure failure were 95 and 90% in Group 1 and 60 and 55% in Group 2, respectively (P < 0.01, for both comparisons). Based on CT-scan volumetry, in Group 1, severe non-union and hemisternal paradoxical movement occurred less frequently (2 vs 7, P = 0.01). At spirometry assessment, postoperative VC was greater in Group 1 (3220 ± 290 vs 3070 ± 290 ml, P = 0.04). The same trend was detected by CT-scan in-expiratory measures (4034 ± 1800 vs 3182 ± 862 mm3, P < 0.05). Correspondingly, in Group 1, less patients presented in NYHA Class III (P < 0.05), and both chronic persistent pain score and physical health quality-of-life score were significantly better in the same group. CONCLUSIONS: In our study, muscle flap reconstruction guaranteed better early and late-term results as shown by lower rates of mortality, procedure failure and hemisternum stability. Moreover, Group 1 patients had greater postoperative VC, lower NYHA class and better quality of life. These results suggest that, in patients with multiple bone fracture, the rewiring approach does not promote physiological bone consolidation, whereas the muscle flap reconstruction can assure more physiological ventilatory dynamics

3-Tesla MR spectroscopy in patients subjected to bone marrow transplantation: clinical correlations.

PURPOSE: This study evaluated the usefulness of 3-Tesla magnetic resonance (MR) spectroscopy in patients with non-Hodgkin's lymphoma (NHL) undergoing bone marrow transplantation (BMT). MATERIALS AND METHODS: Twelve NHL patients who were candidates for BMT underwent three MR examinations of the lumbosacral spine: before ablative therapy for BMT, 15±4 days and 54±24 days after BMT. The MR study was supplemented by spectroscopic analysis. The lipid content was calculated and expressed as a percentage of lipid signal intensity relative to total signal intensity [fat fraction (FF)]. RESULTS: In the first MR study, the FF was 62.5±7%, in the second it was 70.75±5% and in the third it was 75±1%. We observed a statistically significant difference between FF values calculated at the various MR studies (p=0.02) and between red blood cell count (p=0.017), platelet count (p=0.003) and haematocrit (p<0.001) at the three MR studies. FF had a statistically significant correlation with the number of circulating platelets (p<0.01) CONCLUSIONS: MR spectroscopy of the bone marrow of NHL patients undergoing BMT is noninvasive and highly sensitive for characterising and monitoring bone marrow after BMT