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The Neurologist in the Emergency Room: Prospective study of the Neurological Emergency Group in Lombardia

Journal of Health science 2019年第4期7卷 254-261页

作者： MariaLuisa Delodovici Marco Mauri Megi Meneri Marco Gallazzi elena Ballabio Giuseppina Borutti Maria Vittoria Calloni Elisa Candeloro Bruno Censori Claudio De Piazza Laura Fusi Franca Mazzucchelli Ignazio santilli Elisabetta Forapani Chiara scaccabarozzi Maria sessa Lucia Tancredi Massimiliano Braga Dept. of Neurology and stroke Unit Ospedale di Circolo e Fondazione MacchiUniversità dell’InsubriaASST-Settelaghile Luigi Borri 57 21100 VareseItaly Dept. of Neurology Ospedale di Desio (MB) Director G. Mazzini 1 20832 Desio (MB)Italy Dept. of Neurology AssT Lecco-Ospedale A. Manzonidell’Eremo 9/11 23900 LeccoItaly Dept. of Neurology Ospedale di Cremona ASST Cremona Directorle Concordia 1 26100 CremonaItaly Dept. of Neurology Ospedale sant’Anna ComoRavona 20 22042 SFermo della BattagliaComoItaly Dept. of Neurology Ospedale di Vimercate (MB) Santi Cosma e Damiano 10 20871 Vimercate (MB)Italy Dept. of Neurology Ospedale S. Carlo BorromeoA. Mosca 12 20152 MilanoItaly Dept. of Neurology Director Ospedale Civile di VogheraVolturno 14 Voghera 27058 (PV)Italy Dept. of Neurology Ospedale di Legnano ASST Ovest MilanesePapa Giovanni Paolo II20025 Legnano (MI)Italy Dept. of Neurology Fondazione IRCCs C. Mondino Mondino 2Pavia 27100Italy Dept. of Neurology AssT Papa Giovanni XXIII Piazza OMS 1 24127 BergamoItaly Dept. of Neurology Ospedale valduce ComoDante Alighieri 11 22100 ComoItaly Dept. of Neurology Ospedale di saronno ASST Valle olonaPiazzale Borella 1 Saronno 21047 (VA)Italy Dept. of Neurology Ospedale s. Antonio Abate Gallarate. Pastori 4 21013 Gallarate VareseItaly

Purpose of the work was to quantify the workloads and the neurologist’s commitment in ER, to verify the management of urgencies and appropriateness of neurological counseling requests. Neurologic emergencies are frequent in elderly patients and are associated with high morbidity and mortality. Due to the aging population, neurologic pathologies in emergency room (ER) are widely expected to increase. The role of the neurologist in this context is controversial. Methods: in 14 operative units of neurology a prospective collection of neurological evaluations in ER was carried out using boards of detection of the most frequent neurological clinical pictures seen in the course of a week. Data were collected from 738 cases. Attention was focused on cerebrovascular diseases (CVD), impairment of consciousness, epilepsy, headache, dizziness, head trauma and disorders of the peripheral nervous system (PNs). Achievements: neurological consultations were on average 5% of total accesses to ER. The most common pathology seen was ischemic stroke. After counseling most patients were discharged home. The CVD required the greatest commitment to the specialist. The usefulness of the specialized neurological “filter” has been confirmed in a non-simple operative context, aimed at optimizing the appropriateness of the hospitalization and the economy of the diagnostic path.

关键词： Emergency room neurological diseases neurology workload

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Bright spots for inland fish and fisheries to guide future hydropower development

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Water Biology and security 2022年第1期1卷 81-99页

作者： William M.Twardek Ian G.Cowx Nicolas W.R.Lapointe Craig Paukert T.Douglas Beard elena M.Bennett David Browne Andrew K.Carlson Keith D.Clarke Zeb Hogan Kai Lorenzen Abigail J.Lynch Peter B.McIntyre Paulo Pompeu Mark Rogers Alexis sakas William W.Taylor Taylor D.Ward Zeenatul Basher steven J.Cooke Fish Ecology and Conservation Physiology Laboratory Department of Biology and Institute for Environmental StudiesCarleton University1125 Colonel By DrOttawaON K1S 5B6Canada Fisheries Institute at the University of Hull Cottingham RdHullHU67RXUnited Kingdom Canadian Wildlife Federation 350 Michael Cowpland DrKanataONK2M 2W1Canada U.s.Geological survey Missouri Cooperative Fish and Wildlife Research UnitUniversity of MissouriColumbiaMO65211United States U.s.Geological survey National Climate Adaptation Science Center12201 Sunrise Valley DriveMS-516RestonVA20192United States McGill school of Environment McGill University845 Sherbrooke St WMontrealQuebec H3A 0G4Canada Princeton Environmental Institute and Department of Ecology and Evolutionary Biology Princeton UniversityM30 Guyot HallPrincetonNJ08544United States Ecological sciences section science Branch Fisheries and Oceans CanadaCanadaPO Box/CP 5667St.John'sNewfoundland and LabradorA1C 5X1Canada University of Nevada Reno.4505 S Maryland PkwyLas VegasNV89154United States Fisheries and Aquatic sciences School of Forest Resources and ConservationUniversity of Florida7922 NW 71st StreetGainesvilleFL32653United States Department of Natural Resources Cornell UniversityIthacaNY14853United States Departamento de Biologia Universidade Federal de LavrasAquenta SolLavrasState of Minas Gerais37200-900Brazil U.s.Geological survey Tennessee Cooperative Fishery Research UnitTennessee tech UniversityCookevilleTN38505United States The Nature Conservancy 6375 Riverside DriveSuite 100DublinOH43017United States Michigan state University Department of Fisheries and WildlifeEast LansingMI48823United States

Hydropower production is one of the greatest threats to fluvial ecosystems and freshwater *** that we have entered the Anthropocene,there is an opportunity to reflect on what might constitute a‘sustainable’Anthropocene in the context of hydropower and riverine fish *** elements of existing practices that promote favorable social-ecological outcomes(i.e.,‘bright spots’)is timely given that there are plans to expand hydropower capacity in previously undammed rivers,intensify dam development in some of the world's largest river systems,and re-license existing *** approach this from a pragmatic perspective:for the foreseeable future,hydropower will likely remain an important source of renewable *** offer support for moving toward a more‘sustainable’Anthropocene,we provide syntheses of best practices during the siting,design,construction,operation,and compensation phases of hydropower development to minimize impacts on inland *** each phase,we offer positive examples(or what might be considered‘bright spots’)pertaining to some of the approaches described within our syntheses,acknowledging that these projects may not be viewed as without ecological and(or)societal detriment by all *** findings underscore the importance of protecting critical habitat and free-flowing river reaches through careful site selection and basinscale planning,infrastructure designs that minimize reservoir effects and facilitate safe passage of fish,construction of hydropower plants using best practices that minimize long-term damage,operating guidelines that mimic natural flow conditions,and compensation that is lasting,effective,inclusive,and locally *** from these‘bright spots’may require engagement of diverse stakeholders,professionals,and governments at scales that extend well beyond a given site,river,or even ***,environmental planning that integrates hydropower development into broader discussions

关键词： Migration Dams salmon Hydroelectric Flow socioecological Fish passage Barriers Ecosystems

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