COVID-19 pneumonia: pathophysiology and management

Coronavirus disease 2019 (COVID-19) pneumonia is an evolving disease. We will focus on the development of its pathophysiologic characteristics over time, and how these time-related changes determine modifications in treatment. In the emergency department: the peculiar characteristic is the coexistence, in a significant fraction of patients, of severe hypoxaemia, near-normal lung computed tomography imaging, lung gas volume and respiratory mechanics. Despite high respiratory drive, dyspnoea and respiratory rate are often normal. The underlying mechanism is primarily altered lung perfusion. The anatomical prerequisites for PEEP (positive end-expiratory pressure) to work (lung oedema, atelectasis, and therefore recruitability) are lacking. In the high-dependency unit: the disease starts to worsen either because of its natural evolution or additional patient self-inflicted lung injury (P-SILI). Oedema and atelectasis may develop, increasing recruitability. Noninvasive supports are indicated if they result in a reversal of hypoxaemia and a decreased inspiratory effort. Otherwise, mechanical ventilation should be considered to avert P-SILI. In the intensive care unit: the primary characteristic of the advance of unresolved COVID-19 disease is a progressive shift from oedema or atelectasis to less reversible structural lung alterations to lung fibrosis. These later characteristics are associated with notable impairment of respiratory mechanics, increased arterial carbon dioxide tension (PaCO2), decreased recruitability and lack of response to PEEP and prone positioning.

A retórica do capítulo IX do tratado Da Interpretação

This paper analyses the argumentative strategy of the ninth chapter of the treatise De Interpretatione in the light of Aristotle's Rhetoric. The subject of the ‘future events’ developed in chapter IX brings up themes that are proper not only to philosophical thought, but also to political practice, forensic rhetoric, deliberative rhetoric and even tragic poetry. In this paper, it is argued that Aristotle uses the dialectical method and certain rhetorical techniques to touch the various discussions related to the subject addressed. He erects a hypothetical adversary and a thesis to refute, condensing some positions that were probably scattered in the most diverse textual and oratory sources of his time. Moreover, he builds the thesis of his hypothetical opponent from premises established in previous chapters of his own treatise. With this, he can simulate the defense of his opponent's thesis before demolishing it. Thus, according to the hypothesis defended here, the philosopher does not in fact commit himself to the arguments presented between 18a35 and 18b25, but only simulates the defense of the reasoning which he will soon refute. In addition, it is also concluded that chapter IX is part of the argumentative chain of the treatise, having as a peculiar characteristic, not the theme or nature of the arguments exposed, but the rhetorical method it employs.

Impact of COVID-19 on the economy of micro, small and medium enterprises in Mexico

The objective of this research is to analyze the effects of COVID-19 on the economy and finances of micro, small and medium enterprises (MIPYMES) in Mexico, as well as the economic and financial strategies to survive this perfect storm, where the characteristic The main thing about this type of business is that it survives and is used to these events due to the way in which they are generally created and because they have a peculiar characteristic that the vast majority are family businesses. A mixed methodology is used that starts from grounded theory, is contrasted with findings from other national and international research that show the importance of analyzing the economic and financial effects for MSMEs. For the quantitative analysis, statistics of the companies that closed since the beginning of the pandemic were analyzed according to data collected by the INEGI Statistics Institute in 2020. As a result, it is obtained that the MIPYMES made use of their savings and previous returns, a change in the way of marketing their products, using online and home sales. This as economic and financial survival strategies in the red light months in each of the states of the Mexican Republic, and that affected all companies in the world.

A Cost-Effective Approach for Non-Persistent Gold Nano-Architectures Production

The effective exploitation of the intriguing theranostic features of noble metal nanoparticles for therapeutic applications is far from being a routine practice due to the persistence issue. In this regard, passion fruit-like nano-architectures (NAs), biodegradable and excretable all-in-one, nature-inspired platforms which jointly combine these characteristics with the appealing optical behaviors of noble metal nanoparticles, can offer a new alternative for theranostic applications. Besides the need for efficacious and innovative systems, the reliable and cost-effective production of nanomaterials is a pivotal subject for their translation to the clinical setting. Here, we demonstrate the production of a new cheaper class of degradable, ultrasmall-in-nano-architectures (dragon fruit NAs, dNAs) using polyethyleneimine (PEI) as a cationic polymer without affecting either their compositions or their physiological behaviors, compared to the previous NAs. In particular, the standardized protocol characterized in this work ensures the preparation of high gold-loading capacity nanoparticles, a peculiar characteristic that, synergically with the interesting properties of PEI, may unlock new possible applications previously precluded to the first version of NAs while reducing the hand-made production cost by three orders of magnitude.

Quality and Efficacy of the Provided Medial Services as Key Factors for Improving Competitiveness of the Healthcare Institutions

Many researchers mix up the ratios of medical services quality and efficacy. There is no unified methodology for the medical services quality assessment. The quality and efficacy of the medical services provided are the key indicators of their compatibility in the market. These indicators may not absolutely correlate with real indicators of the quality and efficacy of the medical services. They may not depend on the high value of the medical services for direct and indirect consumers of the medical services. The medical services quality and efficacy are usually considered as some single and inseparably peculiar characteristic. At the same time, there may appear a situation when the service is effective but not qualitative, or vice versa.

History of Hospitality Laws - Do Islamic and South Asian Legal History Have the same Approach? (A Comparative Approach of Sharīʿah & Law)

Respect for guests and visitors, indeed, always remain a common notion of civilized nations; existing on this earth since its inception. This peculiar characteristic, of course, differentiates human beings from animal where the previous are rightly called social animals. The South Asian countries i.e. Pakistan, India, Bangladesh and Nepal are not different in this regard. Their history is always remained a solid evidence of their generosity towards the guests and visitors. Being remained under the rule of the Great Britain, these countries have the same legal history and legal spectrum for dealing tourists and visitors. However, this similarity in terms of hospitality laws is also owing to the similar teaching of their corresponding religions. Findings show that Islam, Buddhism and Hinduism have some common teaching regarding the respect of guests. While having deep sentiments for religious teaching, the residents of such states want the inculcation of religious guidelines in their legal system. Islamic law offers a comprehensive guideline for hospitality comparatively to other religions. Being an Islamic country, it is supposed that such guidelines should be followed while framing legislation for hospitality and tourism. However, study shows that much work is not done yet in this regard. Content analysis technique of qualitative research has been followed in the present work for the investigation of the issue.

Jansky VLA observations of synchrotron emitting optical hotspots of 3C 227 and 3C 445 radio galaxies

ABSTRACT We report results on deep Jansky Very Large Array (VLA) A-configuration observations at 22 GHz of the hotspots of the radio galaxies 3C 227 and 3C 445. Synchrotron emission in the optical on scales up to a few kpc was reported for the four hotspots. Our VLA observations point out the presence of unresolved regions with upper limit to their linear size of about 100 pc. This is the first time that such compact components in hotspots have been detected in a mini-sample, indicating that they are not a peculiar characteristic of a few individual hotspots. The polarization may reach values up to 70 per cent in compact (about 0.1 kpc scale) regions within the hotspot, indicating a highly ordered magnetic field with size up to a hundred parsecs. On larger scales, the average polarization of the hotspot component is about 30–45 per cent, suggesting the presence of a significant random field component, rather than an ordered magnetic field. This is further supported by the displacement between the peaks in polarized intensity and in total intensity images that is observed in all the four hotspots. The electric vector position angle is not constant, but changes arbitrarily in the central part of the hotspot regions, whereas it is usually perpendicular to the total intensity contours of the outermost edge of the hotspot structure, likely marking the large-scale shock front. The misalignment between X-ray and radio-to-optical emission suggests that the former is tracing the current particle acceleration, whereas the latter marks older shock fronts.

Foreignization in English-Kurdish Translations Produced by the Voice of America

This paper explores English-Kurdish translations produced by the Kurdish section of the Voice of America (VOA). It is hypothesized that such translations are marked by unnaturalness and foreignness both in terms of linguistic and cultural aspects. This feature seems to be a peculiar characteristic that sets the VOA Kurdish apart from other media outlets producing Kurdish translations. Applying Venuti’s (1995/2008) theory of foreignization and domestication and taking a translation-oriented textual analysis approach, the paper sets out to qualitatively examine a set of 15 English journalistic texts translated into Kurdish by the VOA Kurdish. The study encompasses both linguistic and cultural matrices to identify unnatural or foreignized translation occurrences, which are expected to be otherwise rendered naturally in other media outlets. The results of the study show that Kurdish translations produced by the VOA are peculiarly outlandish and orientated towards foreignization. For journalistic translations to be comprehensible by the target audience, media players ought to present their outputs, translation or otherwise, as naturally as possible. Therefore, the paper recommends that the VOA Kurdish change its tendency from foreignization to domestication.

Maternal Mortality in 19th- and Early 20th-century Italy

Summary Although dramatically reduced in Western and developed countries, maternal mortality is still today one of the most relevant social and health scourges in developing countries. This is the reason why high levels of maternal mortality are always interpreted as a sign of low living standards, ignorance, poverty and woman discrimination. Maternal mortality represents, therefore, a very peculiar characteristic of demographic systems of ancien regime. Despite this important role in demographic systems, no systematic study has been addressed to investigate the impact of maternal mortality in historical Italy. The aim of this article is to shed some light on such a phenomenon by investigating its trend over time and the determinants in some Italian populations between the 18th and the early 20th centuries. The analysis will make use of civil and parish registers linked together by means of nominative techniques, and it will be, therefore, carried out at the micro level.