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"en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Clinical pathway for perioperative anemia management.</p> <p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">The surgical team which proposes the surgery must initiate the process (1) and assess the procedure’s bleeding/transfusion risk (2). If there is no bleeding/transfusion risk, the standard preoperative evaluation for the procedure is ordered (3). If anemia is detected during the evaluation, it must be investigated and treated without postponing the surgery. In case of a procedure with bleeding/transfusion risk, laboratory tests are ordered in order to screen for and classify anemia and hematinic deficiencies (iron, folic acid, vitamin B12) (4). This must also be done for patients with known anemia, whether or not it was caused by the disease which requires surgery (chronic bleeding), and in patients with additional risk factors that may increase the likelihood of bleeding (e.g., treatment with anticoagulants or antiplatelet agents), even if the surgery does not entail bleeding/transfusion risk. Blood collection should be done at that same visit (coordination with the blood collection room). In case of non-deferrable elective surgery (e.g., colon cancer), the presence of anemia may be determined in venous blood using a point-of-care device. This would allow for starting empirical treatment (e.g., IV iron administration) immediately in a day hospital or anemia clinic. The laboratory test results must be available to the professionals involved (surgery/family medicine/internal medicine/anesthesia/hematology) as soon as possible. If Hb is ≥13 g/dL (5), possible hematinic deficiency should be checked (6) in order to administer the pertinent supplements, if necessary, and proceed with the surgery (7). If Hb is <13 g/dL (8), the patient’s management will depend on the severity of the anemia and the time remaining until surgery: Deferrable elective surgery (9): classify anemia and initiate treatment, verify the treatment’s efficacy at least two weeks before surgery (10), consider postponing surgery until the anemia is corrected (11); Non-deferrable elective surgery (12): classify anemia and initiate treatment (10), proceed with surgery on the scheduled date (7); Urgent surgery deferrable by 24–48 h (13): classify anemia and initiate treatment during hospitalization (10), according to etiology or empirically (surgeon, anesthesiologist, internist, hematologist), and proceed with surgery (7); Urgent or emergent surgery (14): collect blood samples on admission for anemia classification (15) and initiate treatment in the postoperative period. In all cases, assess the need for postoperative treatment (see <a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>).</p>"
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"textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">A brief history of the Nobel Prize</span><p id="par0005" class="elsevierStylePara elsevierViewall">Alfred Nobel, born on October 21, 1833, in Stockholm, Sweden, belonged to a family of engineers.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> With over 355 patents for various industrial inventions,<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> his most renowned creation was dynamite, serving both peaceful and military destructive purposes. Concerned about the potential harm his inventions could cause, Nobel aimed to leave a positive legacy.</p><p id="par0010" class="elsevierStylePara elsevierViewall">On November 27, 1895, he penned a will and testament expressing his desire to establish a fund for annual prizes to be awarded to those who had made significant contributions to humanity in the preceding year.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> In 1900, the Nobel Foundation was established to manage the financial assets and oversee the awarding of the prizes.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Fields of Nobel Prizes</span><p id="par0015" class="elsevierStylePara elsevierViewall">Alfred Nobel's interests in literature, science, and peace prompted him to express his will to establish prizes in Physics, Chemistry, Medicine, Literature, and Peace. Later, in 1968, the Swedish National Bank introduced the Sveriges Riksbank Prize in Economic Sciences in Memory of Alfred Nobel, commonly known as the Nobel Prize in Economic Sciences. Additionally, the Nobel Peace Prize is granted to individuals, organizations, or movements that have made noteworthy contributions to peace and conflict resolution.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Nomination and selection process</span><p id="par0020" class="elsevierStylePara elsevierViewall">Nominations for Nobel Prizes typically come from a diverse pool, including scientists, past Nobel laureates, institutions, and members of parliamentary assemblies. Each Nobel Prize has its dedicated committee within its respective field. The selection process is exclusive to Swedish institutions: the Royal Swedish Academy of Sciences for Physics, Chemistry, and Economics; the Karolinska Institute for Physiology or Medicine; the Swedish Academy for Literature; and a committee elected by the Norwegian Parliament (Storting) for the Nobel Peace Prize.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> Furthermore, the workings of the committees are shrouded in high confidentiality, with nomination details, deliberations, and discussions kept a closely guarded confidential for a minimum of 50 years. The committees meticulously review nominations and conduct thorough evaluations to select Nobel Prize laureates. The question of “who gets nominated and who doesn't” plays a pivotal role in shaping the narrative and impact of these awards.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Nobel Prize ceremony</span><p id="par0025" class="elsevierStylePara elsevierViewall">The Nobel Prizes are traditionally awarded on December 10th, marking the anniversary of Alfred Nobel's death. The ceremony takes place in Stockholm, Sweden, with the exception of the Nobel Peace Prize, which is presented in Oslo, Norway. Each prize comprises a financial reward (approximately $1 million), a personal diploma, and a medal. The inaugural Nobel Prizes were awarded in 1901 in Chemistry, Literature, Peace, Physics, and Physiology/Medicine.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Impact of Nobel Prizes</span><p id="par0030" class="elsevierStylePara elsevierViewall">The significance of the Nobel Prize extends far beyond the individual laureates, reaching into the realms of public discourse, inspiring future generations, and potentially shaping societal values and priorities. Nobel Prizes have a significant influence on various medical specialties, influencing the areas of knowledge and advancements within these fields.<a class="elsevierStyleCrossRef" href="#fn0005"><span class="elsevierStyleSup">1</span></a> Acknowledging and engaging with these aspects enriches the conversation surrounding the Nobel Prize, urging to reflect not only on the achievements of laureates but also on the broader implications and responsibilities tied to such awards.</p><p id="par0035" class="elsevierStylePara elsevierViewall">Alfred Nobel's intent in creating the Nobel Prize was to recognize and promote the achievements of those who contribute to the betterment of humanity across various domains. Today, the Nobel Prizes stand as international symbols of “excellence and prestige”. Nobel laureates are frequently celebrated for their outstanding contributions and portrayed as luminaries in their respective fields. They receive the lion's share of recognition in scientific and societal endeavors, often accompanied by additional advantages, whether rightfully earned or not. These may include securing funding for projects, obtaining other prizes, and acquiring further honors. Nevertheless, the reality behind these achievements is often more intricate and nuanced than the success stories of the prize winners.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Controversy around Nobel prizes</span><p id="par0040" class="elsevierStylePara elsevierViewall">The objective of any prize, whether in science, sports, or society at large, is to acknowledge the contributions of laureates in their respective fields, regardless of the associated financial values. In contrast to sports competitions, where the outcome is observable, the selection process for Nobel laureates involves subjective factors such as reputation, country, name, or gender of the nominees. While Nobel committees' members are expected to be impartial and nonpartisan,<a class="elsevierStyleCrossRef" href="#fn0010"><span class="elsevierStyleSup">2</span></a> they are ultimately humans susceptible to the idiosyncrasies of their species. The attribution of the prize can be entwined by discrepancies across nationalities, races, and gender.<a class="elsevierStyleCrossRef" href="#fn0015"><span class="elsevierStyleSup">3</span></a> The nomination process, restricted to institutions or previous laureates, may introduce conscious or subconscious influences on the selection members. Scientific knowledge and achievements are often cumulative, yet current prize categories like medicine, physics, chemistry, and economics restrict recognition to a few individuals only. This prompts the question of whether multiple prizes shared by a larger group would better acknowledge the collective efforts leading to culminating achievements, rather than awarding a prize to a select few who built upon previous works to claim the award alone.</p><p id="par0045" class="elsevierStylePara elsevierViewall">The Nobel Prizes, notably the Peace Prize, have not been immune to controversies. In 1973, the Peace Prize was awarded to Henry Kissinger and Le Duc Tho for their roles in the Vietnam War. However, the controversy deepened when Le Duc Tho declined the prize,<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> citing the ongoing violence in Vietnam. This decision cast a shadow over the award and sparked enduring debates about the appropriateness of recognizing individuals involved in negotiations amid an active conflict.<a class="elsevierStyleCrossRef" href="#fn0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">Another noteworthy incident involves Boris Pasternak, the Soviet-Russian author who was awarded the Nobel Prize in Literature in 1958 for his contributions to contemporary poetry and Russian narrative traditions.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> Faced with pressure from the Soviet government, Pasternak declined the prize,<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> sparking debates about freedom and political interference. In more recent years, Nobel Peace Prizes have been granted to individuals not necessarily contributing to peace but involved in war. In 2020, the Nobel Prize in Chemistry<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> was awarded to the CRISPR/Cas9 technology, which can be used for both beneficial and potentially harmful DNA modifications in animals, humans, plants, and microorganisms, creating wide disapproval in the scientific community due to ethical concerns, and calls for a moratorium on inheritable genomic manipulations.<a class="elsevierStyleCrossRef" href="#fn0025"><span class="elsevierStyleSup">5</span></a> Receiving a Nobel Prize does not inherently guarantee the safety or ethical considerations of the achievements for which it is awarded. Simply because a technology like CRISPR has been honored with a Nobel Prize does not ensure its safety.<a class="elsevierStyleCrossRef" href="#fn0030"><span class="elsevierStyleSup">6</span></a> These instances and many others highlight the complex nature of the Nobel Prizes, where geopolitical and cultural factors can influence the decisions and responses of laureates.</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Nobel Prize paradox</span><p id="par0055" class="elsevierStylePara elsevierViewall">One of the ethical paradoxes within the Nobel Prize lies in the circumstances of its establishment by a man who created one of the most destructive materials in human history. This ethical dilemma raises questions about the responsibility of individuals for the consequences of their inventions. Is accepting a prize in the name of a man who invented destructive material a form of endorsement? How can one accept an award while acknowledging the genesis of its creation? Can one champion the expansion of peace through knowledge while bearing the name of a creator of destructive materials? Does the recognition translate into meaningful change, or is it more symbolic? Shouldn’t the prizes perhaps go to the victims who suffered from the use of the destructive inventions created by Nobel?</p><p id="par0060" class="elsevierStylePara elsevierViewall">Answering these questions is not easy, given that the value of a single human life lost due to Nobel's inventions overshadows all wealth in the world. However, philanthropic benefactions may be the only way to rectify errors after death. Perhaps it was the reversal of remorse in creating his fund that could alleviate his sense of guilt and that of those who are awarded in his name.</p><p id="par0065" class="elsevierStylePara elsevierViewall">Another contradiction within Nobel Prizes is that winning the Nobel Prize would be associated with a decrease in productivity for some laureates, as they tend to be less productive after receiving the award than before.<a class="elsevierStyleCrossRef" href="#fn0035"><span class="elsevierStyleSup">7</span></a> The integrity of images in scientific papers co-authored by a Nobel laureate has been called into question, with concerns raised about their accuracy and reliability.<a class="elsevierStyleCrossRef" href="#fn0040"><span class="elsevierStyleSup">8</span></a> The predominance of Nobel laureates from Western countries raises other questions about the fulfillment of the humanitarian dimension articulated in Nobel's testament. The testament stipulates the allocation of funds for individuals who contribute to the well-being of humanity, yet the disproportionate representation from Western nations prompts scrutiny regarding the inclusivity and global reach of the Nobel Prize. Nobel Prizes, like any other awards, are susceptible to biases, subjectivity, and the influence of surrounding circumstances, including biases of committee members and external factors.</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Prestige of Nobel Prizes: Nobel Prizes, not noble prizes</span><p id="par0070" class="elsevierStylePara elsevierViewall">Despite the tragic history of its inception and a monetary value that may not be the highest among other prizes, the Nobel Prize maintains a high level of prestige. The dichotomy between its historical background and continued significance raises intriguing questions about the criteria by which prestige is bestowed upon awards. How and why does a prize established by a man burdened by guilt for inventing destructive materials stand out as the most prestigious award, despite there being numerous prizes and compensations with higher financial values than the Nobel Prize? There are multiple reasons that can explain this paradox:<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">1)</span><p id="par0075" class="elsevierStylePara elsevierViewall">Nobel Prizes are frequently awarded to public figures and politicians who hold influential positions in societies. The regular and intensive media coverage of Nobel Prize attributions distinguishes it from other awards, which are often celebrated silently or with minimal media attention. This popularization and media immersion create a sense of importance and heightened public awareness, contributing to the perceived significance of the Nobel Prize in comparison to other accolades.</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">2)</span><p id="par0080" class="elsevierStylePara elsevierViewall">The value of achievements or realizations is not always tied to monetary worth. Instead, Nobel Prizes aim to honor exceptional scientific and intellectual contributions. However, assessing this value remains subjective and open to debate, as the term "best" is inherently elusive.</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">3)</span><p id="par0085" class="elsevierStylePara elsevierViewall">Newspapers and scholarly journals frequently highlight their connections with Nobel laureates, either implicitly or explicitly, showcasing a sense of pride in featuring contributions from these esteemed individuals. This is especially noticeable in journals where Nobel laureates hold editorial positions, underscoring their influence. Such an emphasis can add an extra layer of an exaggerated prestige to the Nobel Prize.</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">4)</span><p id="par0090" class="elsevierStylePara elsevierViewall">The homonymy between "Nobel" and "noble" may subconsciously lead our minds to associate the Nobel Prize with the notion of "nobility," thus leading to an unconscious perception of the Nobel Prize as a "noble prize." While other prizes may offer comparable or higher financial values, such as the Breakthrough Prize (around $3 million)<a class="elsevierStyleCrossRef" href="#fn0045"><span class="elsevierStyleSup">9</span></a> and the Shaw Prize (approximately $1.3 million),<a class="elsevierStyleCrossRef" href="#fn0050"><span class="elsevierStyleSup">10</span></a> the Nobel Prize's unique touch might arise from this homonymic confusion. Whether etymological connections exist or not between the name “Nobel” and adjective “noble”, the Nobel Prize does not confer nobility or recognition of noble work. Awarding for instance the Nobel Prize to CRISPR technology is particularly striking, as it draws parallels between the potential harm to living species and the controversial legacy of Nobel's dynamite invention. This raises questions about the rationale behind awarding a prize to a technology with potential risks, akin to awarding Nobel himself a prize for his creation of dynamite. Such instances underscore the subjective nature and biases in the attribution of the award.</p></li></ul></p><p id="par0095" class="elsevierStylePara elsevierViewall">Awards bearing names like Brown, Jones, Smith, Shaw, Wilson, and Wood, even if accompanied by a higher monetary value than the Nobel Prize, might be perceived as less prestigious, as illustrated by the Shaw and Breakthrough prizes. It is worthy to note, however, that “Nobel” and “noble” are not necessarily synonymous within the context of the Nobel Prize.</p><p id="par0100" class="elsevierStylePara elsevierViewall">In conclusion, evaluating the Nobel Prize with critical eyes beyond its apparent prestige and monetary value is essential for gaining a more nuanced understanding of its role in the world. This involves examining its influence in shaping narratives, promoting positive contributions, and navigating the complexities of recognizing individuals with both positive and potentially negative impacts on humanity.</p><p id="par0105" class="elsevierStylePara elsevierViewall">Alfred Nobel's commendable decision to allocate funds for rewarding those who contribute to human well-being should serve as inspiration for other affluent individuals. This inspiration can extend beyond the shadow of guilt associated with the invention of destructive materials. Finally, wealthy individuals have the opportunity to encourage and acknowledge the efforts and contributions of others without succumbing to guilt feelings akin to Nobel's own.</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Conflict of interest</span><p id="par0110" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflict of interest.</p></span></span>"
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