1,460 research outputs found

    Grounding Operators: Transitivity and Trees, Logicality and Balance

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    We formally investigate immediate and mediate grounding operators from an inferential perspective. We discuss the differences in behaviour displayed by several grounding operators and consider a general distinction between grounding and logical operators. Without fixing a particular notion of grounding or grounding relation, we present inferential rules that define, once a base grounding calculus has been fixed, three grounding operators: an operator for immediate grounding, one for mediate grounding (corresponding to the transitive closure of the immediate grounding one) and a grounding tree operator, which enables us to internalise chains of immediate grounding claims without loosing any information about them. We then present an in-depth proof-theoretical study of the introduced rules by focusing, in particular, on the question whether grounding operators can be considered as logical operators and whether balanced rules for grounding operators can be defined

    Indagine su Henosepilachna elaterii (Rossi) (=Epilachna chrysomelina (F.)) e Raphidopalpa foveicollis (Lucas) in meloneti biologici della Sicilia occidentale.

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    Investigations on Henosepilachna elaterii (Rossi) and Raphidopalpa foveicollis (Lucas) in an organic cultivation of winter melon in western Sicily. A study on H. elaterii and R. Foveicollis, serious pests of winter melon, was conducted in two organic melon fields of the western Sicily. Dynamics of population and infestation levels were investigated. In addition, the possible influence of mulching on R. Foveicollis infestation has been taken into account. Our results showed that H. elaterii occurred only in one field from the beginning of June and it infested 60% of the plants in the mid-July, then the pest population density dropped to about 10%. R. foveicollis occurred in both locations from the beginning of June and reached high levels of population density around the mid-June; then the pest density rapidly decreased in the two following weeks. Adults were found in the traps and the peak catches occurred in mid-June. A greater number of catches was found in the traps placed between the rows and the greater number of individuals has been detected on plants of the not mulched plots. The percentage of plants with damaged leaves ranged from 68.7% to 100% on mulched plots and 93.3% to 100% on not mulched plots. In conclusion, the damages inflicted by R. foveicollis are counterbalanced by the rapid growing rate of the plant occurring during June. Hence, this pest may cause serious injuries only in case of heavy infestation on winter melon seedlings. Similarly, the damage caused by H. elaterii is usually not heavy even if presence of high levels of infestation

    Which is the best algorithm for evaluating a patient’s candidate to sleeve with suspected reflux or hiatal hernia: is manometry or reflux assessment always necessary

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    Laparoscopic sleeve gastrectomy (SG) has reached wide popularity during the last 15 years, owing to limited morbidity and mortality rates, very successful weight loss results, and impact on comorbidities. However, the postoperative development or worsening of gastroesophageal reflux disease (GERD) is one of the most important drawbacks of this surgical procedure. To date, there is great heterogeneity concerning the definition of GERD, the indication for SG in patients with GERD, and the standardization of pre and postoperative diagnostic pathways. In patients with severe obesity, a strictly symptom-based diagnosis of GERD is unreliable. In fact, a high rate of silent GERD (s-GERD, asymptomatic patients despite objective evidence of GERD) has been reported. Moreover, patients with preoperative s-GERD have a significantly higher risk of experiencing GERD symptoms after SG. For these reasons, the reflux burden and the competence of the anti-reflux barrier should be carefully assessed during the preoperative work-up of patients undergoing SG. Ambulatory pH monitoring (APM) and high-resolution manometry (HRM) are useful diagnostic tools that could provide valuable evidence in the guidance of surgical strategy. In this review, we evaluate the current literature concerning the use of APM and HRM in the diagnostic pathway before SG, as well as their predictive value for the evolution of GERD in the postoperative course. Moreover, we propose a diagnostic algorithm for preoperative GERD assessment, which includes validated symptom questionnaires, upper gastrointestinal endoscopy, APM, and HRM

    Enfermedad de Creutzfeld Jakob, desafío diagnóstico : reporte de dos casos en la ciudad de Mendoza

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    La enfermedad de Creutzfeldt-Jakob (ECJ) es una afección neurodege-nerativa rápidamente progresiva y mortal producida por priones. Es la más común de las encefalopatías espongiformes. La hipótesis prevalente sugiere que se inicia y propaga por conversión de una proteína priónica normal (PrP) en una isoforma conformacional anormal (PrPreS), que se acumula en el cerebro causando destrucción neuronal. Se reporta el caso de dos pacientes asistido en el Servicio de Neurología del Hospital Lagomaggiore de la ciudad de Mendoza en el período de 2 años: mujer de 49 años con cuadro de deterioro cognitivo rápidamente progresivo asociado a trastorno de la marcha y ataxia de 2 meses de evolución; y varón de 54 años con conductas inapropiadas y desorientación temporo-espacial de 20 días de evolución. Ambos con EEG compatible y proteína 14.3.3 positiva, falleciendo semanas después del diagnóstico. Se discute ambos casos, los cuales representaron un desafío diagnóstico dada la baja frecuencia y escaso reconocimiento de esta entidad en nuestro medio, debiendo debe ser considerado en pacientes que evolucionan a una demencia rápidamente progresiva.Creutzfeldt-Jakob disease (CJD) is a rapidly progressive and fatal neurodegenerative disease caused by prions. It is the most common of spongiform encephalopathies. The most accepted hypothesis suggests that it initiates and propagates through conversion of normal prion protein (PrP) in an abnormal conformational isoform (PrPres), which accumulates in the brain causing neuronal destruction. The cases of two patients assisted in the Department of Neurology of Hospital Lagomaggiore city of Mendoza in 2-year period are reported: A 49-year old female patient with symptoms of rapidly progressing cognitive impairment associated with gait disturbance and ataxia of 2 months of progression; and a 54-year old male with misconduct and temporo-spatial disorientation of 20 days of evolution. In both cases, EEG was compatible with CJD and 14.3.3 protein was positive, dying weeks after diagnosis. Both cases are discussed, which represented a diagnostic challenge given the low frequency and little recognition of this entity in our environment, must be considered in patients who develop a rapidly progressive dementia.Fil: Galiana, Graciana Lourdes. Hospital Luis Lagomaggiore (Mendoza, Argentina)Fil: Farfan Alé, F.. Hospital Luis Lagomaggiore (Mendoza, Argentina)Fil: De Monte, M.. Hospital Luis Lagomaggiore (Mendoza, Argentina)Fil: Sánchez, C.. Hospital Luis Lagomaggiore (Mendoza, Argentina)Fil: Torres, A.. Hospital Luis Lagomaggiore (Mendoza, Argentina)Fil: Ianardi, S.. Hospital Luis Lagomaggiore (Mendoza, Argentina)Fil: Genco, J.. Hospital Luis Lagomaggiore (Mendoza, Argentina)Fil: Genco, D.. Hospital Luis Lagomaggiore (Mendoza, Argentina)Fil: Castellino, G.. Hospital Luis Lagomaggiore (Mendoza, Argentina

    Inverse association of circulating SIRT1 and adiposity. A study on underweight, normal weight, and obese patients

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    Context: Sirtuins (SIRTs) are NAD+-dependent deacetylases, cellular sensors to detect energy availability, and modulate metabolic processes. SIRT1, the most studied family member, influences a number of tissues including adipose tissue. Expression and activity of SIRT1 reduce with weight gain and increase in conditions of starvation. Objective: To focus on SIRT1 plasma concentrations in different conditions of adiposity and to correlate SIRT1 with fat content and distribution, energy homeostasis and inflammation in under-weight, normal-weight, and obese individuals. Materials and Methods: 21 patients with anorexia nervosa, 26 normal-weight and 75 patients with obesity were evaluated. Body fat composition by dual-energy X-ray absorptiometry, ultrasound liver adiposity, echocardiographic epicardial fat thickness (EFT), inflammatory (ESR, CRP, and fibrinogen), and metabolic (FPG, insulin, LDL- and HDL-cholesterol, triglycerides) parameters, calculated basal metabolic rate (BMR) and plasma SIRT1 (ELISA) were measured. Results: SIRT1 was significantly higher in anorexic patients compared to normal-weight and obese patients (3.27 ± 2.98, 2.27 ± 1.13, and 1.36 ± 1.31 ng/ml, respectively). Linear regression models for each predictor variable adjusted for age and sex showed that SIRT1 concentration was inversely and significantly correlated with EFT, fat mass %, liver fat content, BMR, weight, BMI, WC, LDL-cholesterol, insulin, ESR. Stepwise multiple regression analysis revealed that age and EFT were the best independent correlates of SIRT1 (β = -0.026 ± 0.011, p = 0.025, and β = -0.516 ± 0.083, p < 0.001, respectively). Conclusions: Plasma SIRT1 shows a continuous pattern that inversely follows the whole spectrum of adiposity. SIRT1 significantly associates with EFT, a strong index of visceral fat phenotype, better than other indexes of adiposity studied here
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