Background In elderly patients, especially those older than 80 years, atrial fibrillation （AF） is associated with an almost 25% in- creased risk of stroke. Stroke prophylaxis with anticoagulants is therefore highly ...Background In elderly patients, especially those older than 80 years, atrial fibrillation （AF） is associated with an almost 25% in- creased risk of stroke. Stroke prophylaxis with anticoagulants is therefore highly recommended. The prevalence of factors that have been associated with a lower rate of prescription and adherence to anticoagulant therapy in these patients is little known. The objective of this study was to explore the clinical characteristics of elderly subjects, with and without AF, consecutively admitted to an acute geriatric unit, discussing factors that may decrease the persistence on stroke prophylaxis therapy. We also highlight possible strategies to overcome the barriers conditioning the current underuse of oral anticoagulants in this segment of the population. Methods A retrospective observational study was performed on a cohort of elderly patients with and without AF admitted to the Acute Geriatric Unit of San Gerardo Hospital （Monza, Italy）. Results Compared to patients without AF （n = 1216）, those with AF （n = 403） had a higher Charlson Comorbidity Index （3 vs. 2, P 〈 0.001）, number of administered drugs （4 vs. 3, P 〈 0.001）, rate of heart failure （36.5% vs. 12%, P 〈 0.001） and chronic kidney disease （20.6 vs. 13.2, P 〈 0.001）. Many patients with AF were frail （54%） or pre-frail （29%）. Conclusions Elderly patients with AF have higher rates of conditions that affect adherence to traditional anticoagulant therapy （vitamin K antagonists, VKA）. New direct oral anticoagulants （DOAs） can help overcome this problem. In order to prescribe the most appropriate VKA or DOAs, with the best efficacy/safety profile and the highest compliance, a comprehensive geriatric assessment should always accompany the scores for thrombotic and hemorrhagic risk stratification.展开更多
This paper will attempt to clarify the clear tendency, in our contemporary world, to look at ethics as something that ＂cures＂ all wrongs, all unbalance, and all evils from the political, environmental, to the busine...This paper will attempt to clarify the clear tendency, in our contemporary world, to look at ethics as something that ＂cures＂ all wrongs, all unbalance, and all evils from the political, environmental, to the business ones. For this reason, there is nothing better than to turn to ethics in order to ＂moralise＂ the system and the world, when the numerous news of fraud, injustice, and scandals are a part of everyday life in the business world and in our society. But, is this the role of ethics？ Can we reduce the aim of ethics to a mere technique？ In this paper, it is argued that ethics needs to be replaced in the epistemological scale of knowledge, where until now it has occupied a place at the top. Ethics needs to be repositioned in a different level of knowledge where we may find the roots of its foundation. It is also discussed that it is at the core of being that the experience of the action takes place and develops and in it, ethics takes root. Furthermore, it is suggested that understanding ethics from this point of view presupposes a new ethos around a relational poietics which privileges inter-subjectivity, self-creation, and an active and dynamic construction of the human and of the world.展开更多
In the science fiction novel titled The Planet of the Apes （1963）, Pierre Boulle tells a story about a completely reversed world where the apes dominate the humans. Coming from the normal world that is ours, a small...In the science fiction novel titled The Planet of the Apes （1963）, Pierre Boulle tells a story about a completely reversed world where the apes dominate the humans. Coming from the normal world that is ours, a small group of people is totally embarrassed and confused by observing this strange world. On the planet of the apes that they have discovered, it is the apes that are more intelligent than the humans. On the earth, it was the other way around. That observation results in their perplexity. The two communities, human and simian, bear with one another the relationship that corresponds to what Lotman calls ＂enantiomorphic pairings＂. In this context, a series of questions deserves to be raised： Is a ＂common language＂ possible between the two communities in the enantiomorphic pairings？ If the answer is yes, under what conditions could they succeed in opening up a space where they can have something in common？ In rereading The Planet of the Apes with reference to Lotman＇s semiotics of culture, we would like to formulate a response to those questions. Our claim is that the experience of finitude of one＇s own language can make possible an access to the new form of universality requisite for the cross-cultural communication： commonality without common points.展开更多
Social media has become an inevitable part of our lives in the age of network society. People establish multiple identities for themselves, with or without references to the real world, and behave according to those i...Social media has become an inevitable part of our lives in the age of network society. People establish multiple identities for themselves, with or without references to the real world, and behave according to those identities. Self-made components of virtual presence are not limited to identities only; many users also create hyper-personalities for themselves with the help of new technologies. Then, the fundamental question becomes： Why do people create self-made identities and hyper-personalities to portray or hide themselves in social media environments？ The answer to this question has certain connections and implications for behaviors of social media users. Therefore, researchers have investigated why some people find social media attractive and attend whenever possible, while others are afraid of social media and hesitate to attend. Positive and negative behaviors of social media users can be classified as braggadocian and preventative. Braggadocian behaviors are related to courageously taking advantage of social media, whereas preventative behaviors are concerned with avoidance of social media. The dominant behavioral pattern of a user depends on what one can achieve through attending or preventing social media. This paper first discusses basic elements of human behavior that drive social media such as altruism, hedonism, connectionism, homophily, multiple identities, memetics, narcissism, and tribalism. Then, it focuses on precautionary elements of human behavior such as avoidance, escape, blocking, fear, hiding, removal, and protectionism. Whether they are attentive or not, one thing is clear： People refrain or enrich their own lives in social media rather than being abused or watching others in industrial media.展开更多
The paper addresses the failure of renewing the same millennium development goals （MDGs） format in measuring achievement in a region like the Middle East and North Africa （MENA） region which is drastically being t...The paper addresses the failure of renewing the same millennium development goals （MDGs） format in measuring achievement in a region like the Middle East and North Africa （MENA） region which is drastically being transformed. A new approach focusing on ＂human security＂ principles based on freedom, dignity, justice, equality, solidarity, tolerance, and respect articulated in the millennium declaration is needed. Achieving this requires a more integrated, inclusive, and comprehensive development framework that is able to analyze and understand the context with its progress and setbacks. The paper realizes that measuring MDGs achievement does not only need a comprehensive integrated approach, but also a defmition of risks and challenges that the region faces. Issues like poverty, inequality, unemployment of graduates, personal and collective insecurity due to conflict, migration, and brain drain, food insecurity, and gender inequality are all issues that need to be redefined when analyzing the region to suit the context. The paper concludes that in order to understand the context, re-definition of concepts like poverty reduction, participation, and empowerment is needed to make concepts more relevant to the context. Lastly, the paper reflects the new call from youth for a new development model that is not based on market economy, ends political economy of the rentier states, and emphasizes a productive oriented economy that is able to generate employment and decent work. It also emphasizes democratic governance as an only path for a sustainable participatory development that can realize ambitions and aspirations of the majority of population.展开更多
With the development of economy, a large number of surplus labor force in rural areas has been transferred to cities, resulting in the increasing number of left-behind children in rural areas. Left-behind children are...With the development of economy, a large number of surplus labor force in rural areas has been transferred to cities, resulting in the increasing number of left-behind children in rural areas. Left-behind children are in a critical period of ideological enlightenment, accepting obligation education, outlook on life and world outlook, and the absence of parental care and education has a negative impact on their growth. It is an important problem to solve this problem in every aspect of society.展开更多
A novel approach was presented to solve the navigation problem of autonomous mobile robots in unknown environments with dense obstacles based on a univector field method. In an obstacle-free environment, a robot is en...A novel approach was presented to solve the navigation problem of autonomous mobile robots in unknown environments with dense obstacles based on a univector field method. In an obstacle-free environment, a robot is ensured to reach the goal position with the desired posture by following the univector field. Contrariwise, the univector field cannot guarantee that the robot will avoid obstacles in environments. In order to create an intelligent mobile robot being able to perform the obstacle avoidance task while following the univector field, Dyna-Q algorithm is developed to train the robot in learning moving directions to attain a collision-free path for its navigation. Simulations on the computer as well as experiments on the real world prove that the proposed algorithm is efficient for training the robot in reaching the goal position with the desired final orientation.展开更多
Heart failure （HF） is a major public health problem worldwide entailing high morbidity and mortality as well as high costs. This chronic syndrome associates with a low functional status and quality of life. Most pa...Heart failure （HF） is a major public health problem worldwide entailing high morbidity and mortality as well as high costs. This chronic syndrome associates with a low functional status and quality of life. Most patients with HF are elderly, constituting up to 80% of patients suffering from this disease with both incidence and prevalence of the condition increasing with age. This is due to the progressive aging of the population as well as improved and better survival after cardiac insults, such as myocardial infarction,展开更多
Helicobacter pylori(H pylori) infection is a leading world-wide infectious disease as it affects more than half of the world population and causes chronic gastritis,peptic ulcer disease and gastric malignancies.The in...Helicobacter pylori(H pylori) infection is a leading world-wide infectious disease as it affects more than half of the world population and causes chronic gastritis,peptic ulcer disease and gastric malignancies.The infection elicits a chronic cellular inflammatory response in the gastric mucosa.However,the effects of this local inflammation may not be confi ned solely to the digestive tract but may spread to involve extraintestinal tissues and/or organs.Indeed,H pylori infection has been epidemiologically linked to extra-digestive conditions and diseases.In this context,it has been speculated that H pylori infection may be responsible for various endocrine disorders,such as autoimmune thyroid diseases,diabetes mellitus,dyslipidemia,obesity,osteoporosis and primary hyperparathyroidism.This is a review of the relationship between H pylori infection and these endocrine disorders.展开更多
Gastric cancer is the third leading cause of cancer-related death worldwide. Surgery is currently the only curative treatment strategy. Chemotherapy has shown limited efficacy in advanced gastric cancer patients with ...Gastric cancer is the third leading cause of cancer-related death worldwide. Surgery is currently the only curative treatment strategy. Chemotherapy has shown limited efficacy in advanced gastric cancer patients with a median overall survival of less than one year. Thus, new treatments are urgently needed. Trastuzumab and Ramucirumab are the only targeted therapies approved currently. Most Phase Ⅲ clinical trials evaluating targeted drugs in gastric cancer have failed. This review will evaluate relevant clinical trials with targeted therapies performed in gastric cancer patients, discuss the possible reasons for the failure, and indicate new possibilities to enhance gastric cancer treatment.展开更多
Chaviano＇s Fables of an Extraterrestrial Grandmother is a pioneering Cuban science fiction novel with four interconnected plots that manifest their separate worlds--the Havana of Ana, the protagonist writer, the Neol...Chaviano＇s Fables of an Extraterrestrial Grandmother is a pioneering Cuban science fiction novel with four interconnected plots that manifest their separate worlds--the Havana of Ana, the protagonist writer, the Neolithic Celtic world of Merlin and Stonehenge, Faidir, the planet of Ijj e and the winged psyches with three eyes, and Rybel, the world of Ana＇s character Arlena, the ＂jumen＂ on the run in an alien planet after being wrecked in a space ship---through Ana＇s writing. Ana uses mental exercises and automatic writing to temporarily regress to a pre-rational state of consciousness where these parallel universes interpenetrate and cross in the locus of her subconscious. Writing for her is a form of possession that withdraws her fi＇om her immediate reality into a visionary state resembling that of a shaman. She is a writer being invented and written by her own characters. Her stories are not fictions, but already existing realities, and she is a channel by which they are able to manifest their existence through her writing. This science fiction vision of worlds within worlds suggests another origin of science fiction in the ancient literary genre of Menippean satire, a type of fiction that appeals to highly cosmopolitan, alienated readers who seek to renew contact with the sources of consciousness from which technological and social change have alienated them.展开更多
The burgeoning geriatric population worldwide has resulted in an unprecedented challenge to the cardiology community. Cardiovascular disease is the major cause of morbidity and mortality in the elderly population, but...The burgeoning geriatric population worldwide has resulted in an unprecedented challenge to the cardiology community. Cardiovascular disease is the major cause of morbidity and mortality in the elderly population, but its recognition and management are characteristically confounded by substantial comorbidities, polypharmacy, and other complexities of care, not encountered in younger cardiac patients.展开更多
The last ten years have seen remarkable progress in cancer research. However, despite significant breakthroughs in the understanding, prevention, and treatment of cancer, the disease continues to affect millions of pe...The last ten years have seen remarkable progress in cancer research. However, despite significant breakthroughs in the understanding, prevention, and treatment of cancer, the disease continues to affect millions of people worldwide. Cancer＇s complexity compounded with financial, policy and regulatory roadblocks has slowed the rate of progress being made against cancer. In this paper, we review a few of the most recent breakthroughs that are fueling medical advances and bringing new hope for patients affected by this devastating disease. We also address the challenges facing us and the opportunities to accelerate future progress against cancer. The efforts of the American Association for Cancer Research （AACK） to address the cancer burden already extend beyond the borders of the United States of America. The AACR is committed to increasing its efforts to stem the tide of cancer worldwide by promoting innovative programs, strategies, and initiatives for cancer researchers and all those engaged in cancer-related biomedical sciences around the world.展开更多
文摘Background In elderly patients, especially those older than 80 years, atrial fibrillation （AF） is associated with an almost 25% in- creased risk of stroke. Stroke prophylaxis with anticoagulants is therefore highly recommended. The prevalence of factors that have been associated with a lower rate of prescription and adherence to anticoagulant therapy in these patients is little known. The objective of this study was to explore the clinical characteristics of elderly subjects, with and without AF, consecutively admitted to an acute geriatric unit, discussing factors that may decrease the persistence on stroke prophylaxis therapy. We also highlight possible strategies to overcome the barriers conditioning the current underuse of oral anticoagulants in this segment of the population. Methods A retrospective observational study was performed on a cohort of elderly patients with and without AF admitted to the Acute Geriatric Unit of San Gerardo Hospital （Monza, Italy）. Results Compared to patients without AF （n = 1216）, those with AF （n = 403） had a higher Charlson Comorbidity Index （3 vs. 2, P 〈 0.001）, number of administered drugs （4 vs. 3, P 〈 0.001）, rate of heart failure （36.5% vs. 12%, P 〈 0.001） and chronic kidney disease （20.6 vs. 13.2, P 〈 0.001）. Many patients with AF were frail （54%） or pre-frail （29%）. Conclusions Elderly patients with AF have higher rates of conditions that affect adherence to traditional anticoagulant therapy （vitamin K antagonists, VKA）. New direct oral anticoagulants （DOAs） can help overcome this problem. In order to prescribe the most appropriate VKA or DOAs, with the best efficacy/safety profile and the highest compliance, a comprehensive geriatric assessment should always accompany the scores for thrombotic and hemorrhagic risk stratification.
文摘This paper will attempt to clarify the clear tendency, in our contemporary world, to look at ethics as something that ＂cures＂ all wrongs, all unbalance, and all evils from the political, environmental, to the business ones. For this reason, there is nothing better than to turn to ethics in order to ＂moralise＂ the system and the world, when the numerous news of fraud, injustice, and scandals are a part of everyday life in the business world and in our society. But, is this the role of ethics？ Can we reduce the aim of ethics to a mere technique？ In this paper, it is argued that ethics needs to be replaced in the epistemological scale of knowledge, where until now it has occupied a place at the top. Ethics needs to be repositioned in a different level of knowledge where we may find the roots of its foundation. It is also discussed that it is at the core of being that the experience of the action takes place and develops and in it, ethics takes root. Furthermore, it is suggested that understanding ethics from this point of view presupposes a new ethos around a relational poietics which privileges inter-subjectivity, self-creation, and an active and dynamic construction of the human and of the world.
文摘In the science fiction novel titled The Planet of the Apes （1963）, Pierre Boulle tells a story about a completely reversed world where the apes dominate the humans. Coming from the normal world that is ours, a small group of people is totally embarrassed and confused by observing this strange world. On the planet of the apes that they have discovered, it is the apes that are more intelligent than the humans. On the earth, it was the other way around. That observation results in their perplexity. The two communities, human and simian, bear with one another the relationship that corresponds to what Lotman calls ＂enantiomorphic pairings＂. In this context, a series of questions deserves to be raised： Is a ＂common language＂ possible between the two communities in the enantiomorphic pairings？ If the answer is yes, under what conditions could they succeed in opening up a space where they can have something in common？ In rereading The Planet of the Apes with reference to Lotman＇s semiotics of culture, we would like to formulate a response to those questions. Our claim is that the experience of finitude of one＇s own language can make possible an access to the new form of universality requisite for the cross-cultural communication： commonality without common points.
文摘Social media has become an inevitable part of our lives in the age of network society. People establish multiple identities for themselves, with or without references to the real world, and behave according to those identities. Self-made components of virtual presence are not limited to identities only; many users also create hyper-personalities for themselves with the help of new technologies. Then, the fundamental question becomes： Why do people create self-made identities and hyper-personalities to portray or hide themselves in social media environments？ The answer to this question has certain connections and implications for behaviors of social media users. Therefore, researchers have investigated why some people find social media attractive and attend whenever possible, while others are afraid of social media and hesitate to attend. Positive and negative behaviors of social media users can be classified as braggadocian and preventative. Braggadocian behaviors are related to courageously taking advantage of social media, whereas preventative behaviors are concerned with avoidance of social media. The dominant behavioral pattern of a user depends on what one can achieve through attending or preventing social media. This paper first discusses basic elements of human behavior that drive social media such as altruism, hedonism, connectionism, homophily, multiple identities, memetics, narcissism, and tribalism. Then, it focuses on precautionary elements of human behavior such as avoidance, escape, blocking, fear, hiding, removal, and protectionism. Whether they are attentive or not, one thing is clear： People refrain or enrich their own lives in social media rather than being abused or watching others in industrial media.
文摘The paper addresses the failure of renewing the same millennium development goals （MDGs） format in measuring achievement in a region like the Middle East and North Africa （MENA） region which is drastically being transformed. A new approach focusing on ＂human security＂ principles based on freedom, dignity, justice, equality, solidarity, tolerance, and respect articulated in the millennium declaration is needed. Achieving this requires a more integrated, inclusive, and comprehensive development framework that is able to analyze and understand the context with its progress and setbacks. The paper realizes that measuring MDGs achievement does not only need a comprehensive integrated approach, but also a defmition of risks and challenges that the region faces. Issues like poverty, inequality, unemployment of graduates, personal and collective insecurity due to conflict, migration, and brain drain, food insecurity, and gender inequality are all issues that need to be redefined when analyzing the region to suit the context. The paper concludes that in order to understand the context, re-definition of concepts like poverty reduction, participation, and empowerment is needed to make concepts more relevant to the context. Lastly, the paper reflects the new call from youth for a new development model that is not based on market economy, ends political economy of the rentier states, and emphasizes a productive oriented economy that is able to generate employment and decent work. It also emphasizes democratic governance as an only path for a sustainable participatory development that can realize ambitions and aspirations of the majority of population.
文摘With the development of economy, a large number of surplus labor force in rural areas has been transferred to cities, resulting in the increasing number of left-behind children in rural areas. Left-behind children are in a critical period of ideological enlightenment, accepting obligation education, outlook on life and world outlook, and the absence of parental care and education has a negative impact on their growth. It is an important problem to solve this problem in every aspect of society.
基金Project(2010-0012609) supported by the Basic Science Research Program,Korea
文摘A novel approach was presented to solve the navigation problem of autonomous mobile robots in unknown environments with dense obstacles based on a univector field method. In an obstacle-free environment, a robot is ensured to reach the goal position with the desired posture by following the univector field. Contrariwise, the univector field cannot guarantee that the robot will avoid obstacles in environments. In order to create an intelligent mobile robot being able to perform the obstacle avoidance task while following the univector field, Dyna-Q algorithm is developed to train the robot in learning moving directions to attain a collision-free path for its navigation. Simulations on the computer as well as experiments on the real world prove that the proposed algorithm is efficient for training the robot in reaching the goal position with the desired final orientation.
文摘Heart failure （HF） is a major public health problem worldwide entailing high morbidity and mortality as well as high costs. This chronic syndrome associates with a low functional status and quality of life. Most patients with HF are elderly, constituting up to 80% of patients suffering from this disease with both incidence and prevalence of the condition increasing with age. This is due to the progressive aging of the population as well as improved and better survival after cardiac insults, such as myocardial infarction,
文摘Helicobacter pylori(H pylori) infection is a leading world-wide infectious disease as it affects more than half of the world population and causes chronic gastritis,peptic ulcer disease and gastric malignancies.The infection elicits a chronic cellular inflammatory response in the gastric mucosa.However,the effects of this local inflammation may not be confi ned solely to the digestive tract but may spread to involve extraintestinal tissues and/or organs.Indeed,H pylori infection has been epidemiologically linked to extra-digestive conditions and diseases.In this context,it has been speculated that H pylori infection may be responsible for various endocrine disorders,such as autoimmune thyroid diseases,diabetes mellitus,dyslipidemia,obesity,osteoporosis and primary hyperparathyroidism.This is a review of the relationship between H pylori infection and these endocrine disorders.
基金Supported by a grant from the National Natural Science Foundation of China(No.81372664)
文摘Gastric cancer is the third leading cause of cancer-related death worldwide. Surgery is currently the only curative treatment strategy. Chemotherapy has shown limited efficacy in advanced gastric cancer patients with a median overall survival of less than one year. Thus, new treatments are urgently needed. Trastuzumab and Ramucirumab are the only targeted therapies approved currently. Most Phase Ⅲ clinical trials evaluating targeted drugs in gastric cancer have failed. This review will evaluate relevant clinical trials with targeted therapies performed in gastric cancer patients, discuss the possible reasons for the failure, and indicate new possibilities to enhance gastric cancer treatment.
文摘Chaviano＇s Fables of an Extraterrestrial Grandmother is a pioneering Cuban science fiction novel with four interconnected plots that manifest their separate worlds--the Havana of Ana, the protagonist writer, the Neolithic Celtic world of Merlin and Stonehenge, Faidir, the planet of Ijj e and the winged psyches with three eyes, and Rybel, the world of Ana＇s character Arlena, the ＂jumen＂ on the run in an alien planet after being wrecked in a space ship---through Ana＇s writing. Ana uses mental exercises and automatic writing to temporarily regress to a pre-rational state of consciousness where these parallel universes interpenetrate and cross in the locus of her subconscious. Writing for her is a form of possession that withdraws her fi＇om her immediate reality into a visionary state resembling that of a shaman. She is a writer being invented and written by her own characters. Her stories are not fictions, but already existing realities, and she is a channel by which they are able to manifest their existence through her writing. This science fiction vision of worlds within worlds suggests another origin of science fiction in the ancient literary genre of Menippean satire, a type of fiction that appeals to highly cosmopolitan, alienated readers who seek to renew contact with the sources of consciousness from which technological and social change have alienated them.
文摘The burgeoning geriatric population worldwide has resulted in an unprecedented challenge to the cardiology community. Cardiovascular disease is the major cause of morbidity and mortality in the elderly population, but its recognition and management are characteristically confounded by substantial comorbidities, polypharmacy, and other complexities of care, not encountered in younger cardiac patients.
文摘The last ten years have seen remarkable progress in cancer research. However, despite significant breakthroughs in the understanding, prevention, and treatment of cancer, the disease continues to affect millions of people worldwide. Cancer＇s complexity compounded with financial, policy and regulatory roadblocks has slowed the rate of progress being made against cancer. In this paper, we review a few of the most recent breakthroughs that are fueling medical advances and bringing new hope for patients affected by this devastating disease. We also address the challenges facing us and the opportunities to accelerate future progress against cancer. The efforts of the American Association for Cancer Research （AACK） to address the cancer burden already extend beyond the borders of the United States of America. The AACR is committed to increasing its efforts to stem the tide of cancer worldwide by promoting innovative programs, strategies, and initiatives for cancer researchers and all those engaged in cancer-related biomedical sciences around the world.
