bluuebunny/crossref_metadata_2025 huggingface dataset:
Quels enjeux des éducations environnementales et de développement durable entre transition écologique, urgence climatique et Anthropocène ?
Authors: Barthes Angela
Published: February 2023

Les éducations environnementales et de développement suivent les grands enjeux de l’actualité. Aujourd’hui devant l’incertitude, entre transitions écologiques, économies vertes ou circulaires, Anthropocène ou urgences climatiques, plusieurs voies éducatives de nature différente se profilent. On assiste à une remise en cause du modèle cumulatif des savoirs et à une politisation de l’éducation. Divers modèles d’approches par enjeux se développent, qui tendent à s’organiser en deux temps : (1) penser les changements et (2) mener des actions. Cela incite à poser la question : quelle éducation voulons-nous ? Pour quelles finalités et quelles actions ? Qu’est-ce qui relie ou différencie les courants éducatifs actuels concernant les questions environnementales et de développement ?
Mesotrophy is not enough: Re-assessing phosphorus objectives for the restoration of a deep Alpine lake (Lake Lugano, Switzerland and Italy)
Authors: Lepori Fabio , Lucchini Bianca , Capelli Camilla , Rotta Federica
Published: February 2023

The restoration of eutrophic lakes requires the identification of phosphorus objectives, i.e., the phosphorus reductions needed to achieve desired water quality goals. Due to inherent uncertainty, phosphorus objectives need periodic revision as the restoration progresses. We used monitoring data from a deep southern Alpine lake (Lake Lugano, Switzerland and Italy) to assess restoration progress and revise the current phosphorus objective of 30 mg m–3. Because one basin of the lake is meromictic (North basin) and the other is holomictic (South basin), restoration focussed on the mixolimnion for the North basin and the entire water column for the South basin. Time series analyses indicated that, thanks to restoration, phosphorus concentrations in the lake declined to values compliant with the objective (~20-30 mg m–3). In contrast, little progress was observed towards achieving the main water quality goals (chlorophyll a ≤4 mg m–3, primary production ≤150 g C m–2 year–1 and oxygen concentrations ≥4 mg L–1). Using predictive models, we estimated that achieving these goals requires a phosphorus objective of <10 mg m–3, which would bring the lake back to the original oligotrophic state. The concentration of <10 mg m–3 is lower than the objectives predicted for other (mainly northern) deep Alpine lakes. The apparent sensitivity of Lake Lugano, which we attribute to unfavorable hydrodynamic conditions common in lakes south of the Alps (weak mixing and long stratification), calls for particularly attentive phosphorus management.
Mobile health applications in kidney stone disease management: A reliable support for patients?
Authors: Cirillo Luigi , Manfredi Celeste , Barone Biagio , Morgera Vincenzo , Cacace Gianluigi , Mastrangelo Francesco , Di Bello Francesco , Abate Marco , Arcaniolo Davide , Spirito Lorenzo , Crocetto Felice , La Rocca Roberto , Creta Massimiliano , Calace Francesco Paolo , Fusco Giovanni Maria , Napolitano Luigi
Published: February 2023

Introduction: Mobile health applications (MHAs) represent an interesting issue to assist and improve the quality of life of patients affected by Kidney Stone Disease (KSD). Despite this, their scientiﬁc quality and adherence to guidelines are not yet addressed.Material and methods: On 2 November 2022, we conducted an observational cross-sectional descriptive study of all MHAs on KSD. A search in the Apple App Store and Google Play Store was performed. We reviewed all mobile apps from Apple App Store and Google Play Store for KSD and evaluated their usage in screening, prevention, management, and adherence to EAU guidelines.Results: In total 13 MHA were included in the ﬁnal analysis. All MHAs, 4 (30.8%) from the Apple App Store and 9 (69.2%) from the Google Play Store are geared towards the patient. Engagement ranged from 1.73 to 4.06; Functionality ranged from 3.17 to 4.75; Aesthetics ranged from 1.9 to 4.12; Information ranged from 2.25 to 4.27, and Subjective quality ranged from 1.58 to 3.23. MHAs reported low and medium adherence to EAU guidelines.Conclusions: MHAs provide a very useful assistance in several medical ﬁelds, including KSD. Despite MHAs development is constantly increasing, the scientiﬁc validation, content, and quality are not yet solved. Future research is necessary to improve the quality of the apps and promote new user designed, and high-quality apps.
Disposal of spectacles and contact lenses: Optometrist and lens wearer perspectives
Authors: Pillay Rayishnee , Hansraj Rekha , Rampersad Nishanee
Published: February 2023

Background: The increase in global waste generation has adverse impacts on the environment. Significant volumes of waste are generated in the lifecycle of spectacles, contact lenses (CLs) and associated products, and there is a lack of published data on their disposal practices.Aim: To determine optometrists’ recommendations to their patients, and lens wearers’ practices regarding the disposal of ophthalmic lenses and associated lens products.Setting: Optometrists and lens wearers in South Africa.Methods: Surveys were distributed via online platforms to optometrists and lens wearers and paper copies of the surveys were also available. Data from both surveys were analysed using IBM SPSS version 24.Results: Responses from 353 optometrists and 603 lens wearers were analysed. Optometrists were highly likely to recommend that patients should discard their old spectacle lenses (24%), and used CLs into wastewater systems (10%), or make no recommendations on either, respectively, (16%, 12%). Lens wearers were highly likely to retain their old spectacles upon new purchase (57%) and dispose used CLs into wastewater systems (37%). Less than 20% of optometrists and lens wearers were highly likely to recommend and engage in recycling of associated ophthalmic products.Conclusion: The disposal of CLs into wastewater systems, which contributes to microplastic pollution, must be highlighted and avoided. Optometrists should incorporate disposal instructions with all products sold to patients and promote recycling. Lens wearers should also be mindful of the environmental impact of their disposal practices.Contribution: This study provides previously unknown data on ophthalmic lens disposal practices in South Africa, and emphasises the need for environmental awareness.
By Scripture and Plain Reason: A historical retrieval of the relationship between faith and reason to better engage with present-day secularism
Authors: Maritz Daniël J.
Published: February 2023

The formal principle of the Reformation, sola Scriptura, has sometimes been thought to imply that the Reformed minister and church member need not concern themselves with the use of reason and philosophy in matters of faith and theology. This misconstrued understanding of sola Scriptura led to a low regard for reason in matters of faith among Reformed folk. A low regard for reason, in turn, gave anti-intellectualism and fideism a foothold in local Reformed churches and left secularism and its progressive ideas unchallenged as it infiltrated the minds of Reformed church members, especially at churches in bigger cities and close to universities. This phenomenon can be addressed by establishing apologetics training platforms at local Reformed churches where church members can be trained to better defend the truth against secularism. To establish apologetics on a local church level, however, one must first retrieve the correct role of reason in matters of faith. This article accordingly embarked on an historical retrieval within the broad Reformed tradition. Different Reformers and subsequent Reformed theologians were examined to retrieve the proper relationship between faith and reason. This was accompanied by a focus on other relevant themes such as the concept of common notions and the three acts of the intellect. Through an historical retrieval, this article consulted the primary sources of figures in the Reformed tradition spanning from the early 1500s to the early 1700s. Additionally, modern interpreters of these figures have also been introduced for their insights. It became evident that reason plays a ministerial role in matters of faith. Moreover, the concept of common notions establishes a grounding for the undeniable role of reason in dialogues with secularism. By introducing the three acts of the intellect, the discussion also moved on to function as a critique of mainstream secularism, as it pertains to its disordered approach to reality in the form of expressive individualism. Although this article is the first of two in a series, it nevertheless accomplished its own end to emphasise the need for apologetics on a local church level and to retrieve the role of reason in matters of faith.Contribution: As a historical retrieval within the Reformed tradition, this article fits perfectly within the scope of In the Skriflig. It reminds the Reformed minister of the rich heritage within the Reformed tradition regarding the relationship between faith and reason, and brings it to bear on the challenge of secularism.
Using Community of Inquire to explore teachers’ responses to a reading-for-meaning course
Authors: Condy Janet L.
Published: February 2023

Background: Although one of the most significant educational goals is to teach learners to comprehend written texts, the Global Education Monitoring Report (UNESCO 2021) identified that many children and adolescents have not acquired the minimum proficiency in reading even at the end of their secondary school career. South African literacy rates have remained with approximately 78% of Grade 4 learners unable to answer basic literal questions.Objectives: To explore teachers’ responses to an 18 h online course on reading for meaning for Grade 4–7 teachers, using the Community of Inquire (CoI) framework.Method: An interpretive paradigm, using a qualitative approach and a case study design, was used for this 18 h online study which was conducted between February and March 2022. Ten teachers were purposively selected for this research article.Results: After inductively and deductively analysing the data collected from the post questionnaire survey and the online Telegram application comments, the teachers’ responses to the three CoI presences are presented.Conclusion: When reflecting on the conceptualisation of using the CoI framework, the social presence dominated. The teaching presence became important when the teachers reflected on their teaching experiences. The cognitive presence then interacted with both the teaching and social presences as the teachers began to be more aware of their own changes in how they taught.Contribution: The study found that using the CoI framework was appropriate for understanding the teachers responses to an online course for reading-for-meaning.
The Study of Postoperative Recall in Patients under Total Intravenous Anesthesia
Authors: Parate Leena Harshad , Kaur Navdeep , Iyer Sadasivan S , Geetha C. R.
Published: February 2023

Background:

The incidence of postoperative recall under total intravenous anesthesia (TIVA) is not yet fully established. Avoidance of inhalational agent is a known risk factor for awareness. In addition, lack of reliable technique to monitor drug concentration needed for adequate depth of anesthesia makes TIVA challenging. Hence, we intend to evaluate our standard anesthesia practice for postoperative recall.

Methodology:

This questionnaire-based observational study was done over the period of 2 years. We enrolled 1080 adult (American Society of Anesthesiologists physical status Class I or II) patients undergoing TIVA for Endoscopic retrograde cholangiopancreatography (ERCP). All patients received fentanyl, midazolam and propofol-based anesthesia. Manual boluses of propofol were given to achieve adequate sedation. (Ramsay sedation scale of 5) in accordance with clinical signs as judged by the primary anesthesiologist. Postoperatively within 12–24 h, patients were assessed for recall using Brice questionnaire. Primary outcome was number of patients reporting postoperative recall in the Brice interview. Secondary outcome was the incidence of dreaming.

Results:

On postoperative interview, none of the patients reported awareness. 12.5% of patients had dreams which were pleasant. None of the dreams was unpleasant. The worst thing about surgery was pain.

Conclusion:

Our study suggests that if adequate doses of propofol are adhered to and necessary action is taken against responses indicating wakefulness, postoperative recall under TIVA is an uncommon occurrence.
Comparison between Dexmedetomidine and Clonidine as an Adjuvant to Ropivacaine in Ultrasound-Guided Adductor Canal Block for Postoperative Analgesia in Total Knee Replacement
Authors: Krishnamurthy Bharath Kumar , Aparna Bathalapalli , Chikkegowda Sangeetha , Kumar K. S. Lokesh
Published: February 2023

Background:

Total knee replacement (TKR) surgeries are associated with significant postoperative pain. Ultrasound-guided adductor canal block is associated with better pain scores. The addition of Clonidine and Dexmedetomidine as additives to local anesthetics was the recent focus of interest. However, there are minimal studies comparing the duration of analgesia as additives to Ropivacaine in ultrasound-guided adductor canal block for TKRs.

Materials and Methods:

Prospective, randomized, double-blind design was followed. One hundred and two American Society of Anesthesiologists I to III patients undergoing unilateral TKR surgeries were included in the study and randomized into two groups. Group C received Clonidine 150 mcg and Group D received Dexmedetomidine 100 mcg as an add on to 30 mL of 0.2% ropivacaine for adductor canal block. Postoperatively, duration of analgesia, sedation score, rescue analgesic requirement, hemodynamics, and any other adverse effects were monitored.

Results:

The total duration of analgesia in Group D (16.01 h [standard deviation [S. D]-0.5]) was significantly higher as compared to Group C (13.02 h [S. D-0.5]) (P < 0.0001). The numerical rating score (NRS) was significantly lower in Group D compared to Group C (P < 0.05) at multiple postoperative timelines. Group D (2.25(S. D-0.44)) had better sedation scores as compared to Group C (2 [S. D-0]) (P = 0.001).

Conclusion:

Dexmedetomidine has longer duration, lower pain, and better sedation scores as compared to clonidine in adductor canal blocks for postoperative pain relief in TKR surgeries.
Knockdown of FKBP3 Suppresses Nasopharyngeal Carcinoma Cell Growth, Invasion and Migration, Deactivated NF-κB/IL-6 Signaling Pathway Through Inhibiting Histone Deacetylase 2 Expression
Authors: Dong Jiadi , Chen Jingjing , Li Qun , Qiu Shijie
Published: February 2023

Nasopharyngeal carcinoma (NPC) is a prevalent malignant tumor worldwide. FKBP3 has been reported to participate in tumorigenesis. Nevertheless, the role and mechanism of FKBP3 in NPC remains unclear. In this study, FKBP3 expression was observed to upregulate in NPC patients and cells. Moreover, knockdown of FKBP3 suppressed cell growth, invasion, and migration in HK1 and C666-1 cells. Mechanically, FKBP3 could enhance the p-p65 expression and activated p65 signaling pathway and increased interleukin-6 (IL-6) expression through enhancing histone deacetylase 2 (HDAC2) expression. In rescued experiment, the overexpression of HDAC2 restored diminished cell growth, invasion, and migration caused by FKBP3 depletion. In summary, the knockdown of FKBP3 suppressed NPC cell growth, invasion and migration, deactivated nuclear factor-κB/IL-6 signaling pathway through inhibiting HDAC2 expression, providing a potential therapeutic strategy for NPC treatment.
The Outcome of Ultrathin-Strut Biodegradable Polymer-Coated Sirolimus-Eluting Stents in Coronary Artery Disease Patients – A Feasibility Study
Authors: Panduranga Prashanth , Mohammed Azzam
Published: February 2023

Background:

Drug-eluting coronary stents with ultrathin struts and biodegradable polymers have been shown to reduce inflammation, neointimal proliferation, and thrombus formation, leading to less early and late complications in patients with coronary artery disease as compared to thinner strut and durable polymer second-generation stents. In Oman, currently, second-generation stents are used for all patients.

Objective:

The purpose of this feasibility study was to evaluate the clinical safety and performance of ultrathin-strut (60 μm) biodegradable polymer-coated sirolimus-eluting stents in an all-comers patient population.

Methods:

This was a prospective, observational, single-center, and single-arm investigator-initiated study from August 2018 to August 2019. Inclusion criteria: 18 years of age, patients with symptomatic coronary artery disease indicated for percutaneous coronary intervention, and stenting of at least one coronary lesion. All patients were followed clinically or telephonically at 12 months after the index procedure.

Results:

A total of 88 patients were recruited in the study, but 10 patients were lost to follow-up and hence excluded from the analysis. The overall mean age was 63 ± 13 years and 78% were males. The main comorbid conditions were hypertension (58%), diabetes mellitus (49%), and hyperlipidemia (26%). Fifty-three percent presented with unstable angina or non-ST elevation myocardial infarction (MI), 10% with ST elevation MI, recent MI 16%, 18% with stable angina, and 1.3% in cardiogenic shock. The mean left ventricular ejection fraction of the cohort was 46 ± 14%. Angiographically, Type A lesions were seen in 25%, Type B in 32%, and Type C in 42%. Left anterior descending stenting was done in 44%, right coronary artery in 32%, left circumflex artery in 14%, left main in 5%, and graft stenting in 4%. Device success was 96%. Procedural success was seen in 97% of patients. At 1-year follow-up, 93% were asymptomatic; overall device-oriented clinical events were 6.8% including cardiac death in 2.7%, target-vessel MI in 2.7%, and target-lesion revascularization in 1.3% which all occurred in uncontrolled diabetic patients.

Conclusions:

At index admission and 1 year, ultrathin-strut biodegradable polymer-coated sirolimus-eluting stent study showed low device-related adverse clinical events which are comparable to published data for the second-generation stents. This feasibility study shows that these stents can be used in all types of stent-indicated patients with added advantages of biodegradable polymer and ultrathin struts. In addition, measures to prevent, diagnose, and control diabetes need to be taken in Oman as this cohort of patients develop ST after stenting.
MitraClip to the Rescue in Cardiogenic Shock
Authors: Ahmed Ashraf Omer Elamin , Mohammed Nazar , Alzaeem Hakam Abdallah , Jalil Syed Muhammad Saad , Maaly Cheikh Abdoul , Al-Hijji Mohammed
Published: February 2023

Cardiogenic shock (CS) in the setting of acute coronary syndrome carries detrimental consequences and high levels of mortality and morbidity if not managed promptly. Acute mitral regurgitation (MR) as a complication of the myocardial infarction might superimpose refractory CS that warrants mitral valve repair. There has been growing use of Transcatheter edge-to-edge mitral valve repair (TEER) as a therapy for CS secondary to acute MR. In this cohort, we describe two cases of CS secondary to acute ischemic MR managed with a Mitraclip.
Giant Carotid Aneurysm in Takayasu Arteritis
Authors: Acharya Debasis , Das Debasish , Singh Jogendra , Pramanik Subhas
Published: February 2023

Takayasu arteritis is an arteritis of unknown etiology, resulting in stenosis or dilatation of the aorta and its major branches. We report a rare case of a giant right common carotid artery aneurysm on the one side in a 29-year-old young male with refractory hypertension with severely stenotic, diffusely diseased, corkscrew appearance of the contralateral carotid artery, which has not been described in the literature so far. Our case is a unique demonstration of nature's paradox in vascular behavior in Takayasu arteritis in the right and left carotid arteries in an index patient; one having a giant aneurysm and the other one being severely stenotic, diffusely diseased with corkscrew appearance.
Post-Covid-19 Sequela
Authors: Kumar G. Anand , Parajiya Lakhan , Avinash Pandi S. P. , Patel Vishalkumar Amrutbhai
Published: February 2023

Long-term sequelae following COVID-19 infection are not well established. Hence, COVID-19 sequelae are been studied extensively as cases are being followed up to reduce avoidable prolonged morbidity and mortality in the country. COVID-19 and currently available drugs for treatment are both reasons for a change in immune status of patients leading to reactivation or increase the chance of infection of common diseases like tuberculosis (TB), particularly in India. A case of post-COVID-19 disease (2 months back) presented with breathlessness and chest pain. On history, workup, and evaluation, the case was diagnosed with massive tubercular pericardial effusion suggesting reactivation of latent TB in a post-COVID-19 disease. Due to COVID-19 disease itself and possible immunomodulatory drugs used for treatment, reactivation of latent TB has to be considered in post-COIVD-19 disease with nonspecific presentation and unexplained prolonged clinical course of the disease. This case highlights the need of further follow-up of COVID-19 patients to understand the effects of disease on the immune system and the possibilities of opportunistic infections, especially after this second wave of COVID-19.
Rheumatic Heart Disease
Authors: Narayanan Kumar
Published: February 2023

Rheumatic heart disease (RHD) continues to be responsible for the loss of millions of young productive lives worldwide, with a disproportionate burden being borne by the underdeveloped and economically disadvantaged strata of society. There is an urgent need to develop approaches to identify RHD in its early stages and reverse it before it can cause significant valvular damage. This is especially relevant for the developing world where advanced cardiac surgery is inaccessible to many. Research over the last decade has made it possible to diagnose subclinical or latent RHD through systematic echocardiographic screening using standardized criteria, which can pick up early disease better compared to clinical screening alone. Furthermore, initial studies show promise that timely institution of penicillin prophylaxis can lead to regression of such latent disease. This brief review summarizes the current state of the field in this regard and outlines some of the challenges in translating this concept from benchside to public health policy.
A Study on Clinical Profile and In-Hospital Outcome of Elderly Patients Receiving Thrombolytic Therapy for St Elevation Myocardial Infarction
Authors: Thakkar Darshan P. , Ramalingam Rangaraj , Palakshachar Anand , Patil Shivanand S. , Subramanyam K. , Moorthy Nagaraja , Thacker Meet M. , Arun B. S. , Manjunath C. N.
Published: February 2023

Objective:

Ischemic heart disease is the leading cause of mortality in population above the age of 70 years. ST-elevation myocardial infarction (STEMI) constitutes important treatable cause of death in elderly population. However, many large, randomized trials have excluded this age group. The present study was planned to find out the benefits and complications related to thrombolytic therapy in elderly patients.

Materials and Methods:

The study was done between January 1, 2019, and December 31, 2019, in the Department of Cardiology, Sri Jayadeva Institute Of Cardiovascular Sciences and Research, Bengaluru, India, which included the study group comprising 106 elderly patients (age >70 years) with acute STEMI and underwent thrombolytic therapy. All patients were followed up till the index hospitalization and evaluated for in-hospital outcome.

Results:

Out of the 106 patients in the study group, 64 (60.38%) were male and 42 (39.62%) were female. Out of which, 88 (83%) patients were between 70 and 80 years whereas 18 (17%) patients were >80 years. Mortality was happened in 32 patients (30.2%). Coronary angiogram post thrombolysis was performed as pharmacoinvasive or rescue percutaneous coronary intervention (PCI) in 25 patients (23.6%), and cardiac arrhythmias were noted in 22 (20.6%) patients, acute kidney injury in 7 (6.6%) patients, ventricular septal rupture in 5.7%, ischemic stroke in 4.7%, free-wall rupture in 2.8%, and intracranial hemorrhage in 0.9% of patients.

Conclusions:

Primary PCI may offer clinical advantage over fibrinolytic therapy as manifested by the trends toward improvements in the combined endpoint of death, reinfarction, and stroke in the oldest patients. Despite the higher prevalence of comorbidities and high-risk features in elderly patients of acute STEMI, timely thrombolysis is also beneficial particularly who present early after symptom onset, absence of comorbid condition, and lower NYHA class on admission (NYHA I/II). In developing countries like India where primary PCI may not be feasible, timely thrombolysis should be given to the elderly patients also.
Elevated Thyroid-Stimulating Hormone is a Risk Factor in Coronary Artery Bypass Grafting
Authors: Thukral Ankit , Kotwal Ankush Singh , Gupta Rajan Prasad , Rastogi Amit , Pande Shantanu , Agarwal Surendra Kumar , Tewari Satyendra
Published: February 2023

Introduction:

Asymptomatic hypothyroidism is endemic in most regions of our country. We planned a study to observe the effect of thyroid-stimulating hormone (TSH) in otherwise asymptomatic for hypothyroidism patients, on outcome after coronary artery bypass grafting (CABG).

Materials and Methods:

This is a retrospective cohort study conducted between January 2017 and December 2019. A total of 449 patients undergoing CABG were included in the study. Patients with redo operations, combined procedures, and emergency operations were excluded from the study. The groups were formed on the level of TSH (normal, subclinical elevation, and clinical elevation) as follows: TSH normal (Group 1, n = 309), TSH subclinical elevation (Group 2, n = 122), and TSH clinical elevation (Group 3, n = 12). One-way ANOVA was used to analyze the groups.

Results:

There was an increase in the use of inotrope, appearance of atrial fibrillation, and use of intra-aortic balloon pump in Group 3 when compared to that in Groups 1 and 2, P = 0.0001. Higher mortality was observed in group 3 (25%) when compared to group 1 (2.91%) and group 2 (2.45%). There was no difference in the level of free T4, between groups. T3 was similar in TSH normal, TSH subclinical elevation, and clinical elevation group. TSH level of >10 mIU/l predicted mortality with a sensitivity of 91.7% and a specificity of 99.8% in predicting mortality.

Conclusion:

About 2.67% of the patients undergoing CABG had asymptomatic but clinical elevation of TSH, and it is associated with higher mortality.
Left Ventricular Global Longitudinal Strain in Patients with Chronic Kidney Disease with and Without Renal Replacement Therapy
Authors: Sankaran Ramesh , Ramalakshmi S , Uppupetai Ganeshbabbu Manish Babbu , Jayakumar Matcha , Ramamurthy Muralidharan Thoddi , Balakrishnan Vinod Kumar , Senguttuvan Nagendra Boopathy
Published: February 2023

Background:

Cardiovascular disease is the leading cause of mortality among patients with chronic kidney disease (CKD). Hemodialysis treatment is associated with an increased risk of developing left ventricular (LV) dysfunction. LV global longitudinal strain (GLS) has emerged as a sensitive parameter in evaluating LV function in patients with CKD. We aimed to assess cardiac function using two-dimensional (2D) echocardiogram, 2D speckle-tracking echocardiogram (2DSTE), and traditional ejection fraction (EF) in patients undergoing hemodialysis.

Methods:

A cross-sectional study was conducted for 3 months in patients with CKD at a tertiary care center in Southern India. Patients were subjected to conventional 2DSTE and evaluated for LV ejection fraction (LVEF), GLS, pulmonary systolic blood pressure, and the degree of tricuspid regurgitation.

Results:

Among 100 patients with CKD, 54.3% underwent hemodialysis, and 26.7% on drug therapy had impaired LV GLS. The LVEF was normal in 61.4% of patients undergoing hemodialysis and 86.7% of patients on drug therapy. Proportion of patients undergoing hemodialysis were significantly high with moderate-to-severe pulmonary hypertension (21.4%), moderate-to-severe tricuspid regurgitation (21.4%), and mild-to-moderate EF (37.1%) compared to respective patients on drug therapy. Pulmonary hypertension and abnormal EF are significantly associated with lesser GLS in patients undergoing hemodialysis.

Conclusions:

This study indicated that patients undergoing hemodialysis are at higher risk for impaired LV GLS. The GLS by 2DSTE can act as an early diagnostic tool for this high-risk patient group. Thus, regular cardiac screening is required for early detection, and treatment in patients undergoing hemodialysis with risk of LV dysfunction.
Current Concepts in the Management of Acute St-Elevation Myocardial Infarction with Ventricular Septal Rupture – Early Versus Late Approach
Authors: Kasturi Sridhar , Pantula Narsingarao
Published: February 2023

Ventricular septal rupture (VSR) is an uncommon complication of Acute ST-Elevation myocardial infarction (STEMI) with poor prognosis. Mortality of patients with cardiogenic shock due to VSR is as high as 67% within 48 hrs and 100% within 30 days. Surgical closure of VSR a challenging procedure with mortality between 20% to 87% depending upon operator's experience and surgical facilities with backup system. In view of the poor prognosis of VSR patients and the ben¬efits from VSR closure, transcatheter closure or surgical repair of the VSR in the acute phase is usually the only option in order to stabilise haemodynamics and restore cardiac function for those with unstable hemodynamic status, despite high risk and mortal¬ity in both therapeutic operations.
Sports nutritionists adopt the nutrition care process road map to develop individualized meal planning for athletes
Authors: Mustafa Norashikin , Safii Nik Shanita , Mohamad Mohd Izham , Jamil Sameeha Mohd , Abdul Rahman Abdul Hadi , Sani Nor Samsiah , Ahmad Azimah , Yatiman Noor Hafizah , Zakaria Ahmad Zawawi , Talib Ruzita Abd , Koon Poh Bee
Published: February 2023

Background:

It is considered that the implementation of nutrition care process (NCP) leads to more efficient and effective care, as well as enhancing the roles of dietetics and nutrition professionals in the clinical setting. However, little is known about the NCP being implemented in the sports nutrition setting to deliver nutrition care, especially in meal planning. Therefore, this study aims to identify the process that sports nutritionists (SNs) practice in meal planning to plan meals for athletes and identify the application of NCP.

Methods:

In-depth interviews, using semi-structured interview questions, were conducted with SNs employed at the National Sports Institute of Malaysia. Five SNs who managed different types of sports were recruited. The interviews were audio-recorded and transcribed verbatim. Data were entered into ATLAS.ti 8 and analysed using thematic analysis.

Results:

The following processes were identified: (i) collecting pertinent data, (ii) analysing the collected data, (iii) determining nutrition prescriptions, (iv) formulating goals and determining actions, (v) implementing actions and recommendations and (vi) monitoring.

Conclusions:

This study identified six general processes practiced by SNs in meal planning that comprised the NCP's interrelated steps, except nutrition diagnosis statement from the nutrition diagnosis step of the NCP. A comprehensive process and workflow can help sports dietitians or nutritionists to develop individualised meal plans that can improve athletes' nutritional status, adherence, health and sports performance.
A Unique Methodology to Evaluate the Structural Robustness of a Dual-Mass Flywheel under Real-World Usage Conditions
Authors: Vellandi Vikraman , AP Baaheedharan , Vijayarangan Deepak
Published: February 2023

Dual mass flywheel (DMF) is an excellent solution to improve the noise, vibration and harshness (NVH) characteristic of any vehicle by isolating the driveline from the engine torsional vibrations. For the same reason, DMFs are widely used in high power-density diesel and gasoline engines. However, the real-world usage conditions pose a lot of challenges to the structural robustness of the DMF. In the present work, a new methodology is developed to evaluate the robustness of a DMF fitted in a compact sports utility vehicle (SUV) with rear-wheel drive architecture.

The abuse conditions (mis-gear, sudden braking, etc) in the real-world usage could lead to a sudden engine stall leading to an abnormally high angular deceleration of the driveline components. The higher rate of deceleration coupled with the higher rotational moment of inertia of the systems might end up in introducing a significantly high impact torque on the DMF. Hence, prolonged usage of the vehicle in abuse conditions could lead to a structural failure of the DMF which needs to be assessed during the development stage of a vehicle. In the present work, the authors propose a unique methodology to assess the structural robustness of any DMF. The methodology is a combination of multiple mis-gear shifts and abuse maneuvers creating a high impact torque. The impact torque throughout the testing was measured to establish a correlation with real-world failures. The effectiveness of the methodology is confirmed by comparing the results of the tested DMFs with the long duration high mileage durability DMFs. Moreover, the duration of the methodology is designed to be extremely short that any DMF could be validated within 2 days.

In the present work, based on the results of this proposed methodology, the robustness of the DMF could be improved by modifying the internal child parts of the DMF. The paper explains the typical robustness measures needed inside the DMF to avoid real-world structural failures.
Structural Analysis of Belleville Spring Used in Automatic Shift Transmission Multi-Plate Wet Clutch for Off-Highway Application
Authors: Chidambarathanu Ganesh Kuttalam , Nair Venugopal , Stanis Starvin Michael
Published: February 2023

In the present article, structural spring characteristics of two different Belleville springs are analyzed to overcome a failure issue in an automatic shift transmission clutch system. The spring design is evaluated through explicit dynamics analysis by finite element modelling and validated by DIN 2093 standard. Automatic shift transmissions that are used in off-highway vehicles are employed with multi-plate wet clutch system to actuate the planetary gears. These clutches are actuated through automatic transmission fluid that are supplied through flow channels. The clutch piston is moved axially by fluid pressure against the clutch pack and Belleville spring thereby transfers torque. Meanwhile, the clutch piston is retracted by the spring force once the fluid pressure is cut off. The spring is designed in such a way that during the energizing mechanism, positive spring stiffness is maintained. It is noticed that the clutch function is obstructed as the spring is inverted to other side due to unstable negative stiffness characteristic. It stalls the function of clutch system and automatic shift transmission thereby vehicle becomes inoperable. The present study compares two different spring characteristics required to suit the clutch design for proper function of transmission system.
CFD Simulation of a Lithium-Ion Battery Cooling System for Electricvehicles Using a Phase-Change Material and Heat Pipes
Authors: Ellappan Sivakumar , Teja poddu.arun bhargav , K Vetrivelkumar , Rajendran Silambarasan
Published: February 2023

In order to ensure the safety and improve the performance, the maximum operating temperature and local temperature difference of batteries must be maintained in an appropriate range. The effect of temperature on the capacity fade and aging are simply investigated. Lithium-ion power battery has gotten one of the principle power hotspots for electric vehicles and mixture electric vehicles due to prevalent execution contrasted and other force sources. In this paper, the displaying in CREO parametric programming and examination done in ANSYS. The model planned with various sort of warmth pipe shapes and breaks down the warmth pipe with various mass stream gulfs (30& 50L/min). In this paper CFD examination to decide the weight, speed, heat move coefficient, mass stream rate and warmth move rate for the various structures of warmth pipe and diverse mass stream bays. In this theory the warm investigation to decide the temperature appropriation and warmth transition for two sorts of stage change materials (RT50 and Li Fe PO4). The consequences of the CFD investigation think about the warmth move pace of the three various types of the cooling framework structure Such as straight sort, box type and curve type heat pipes. By watching the CFD investigation results, the mass stream rate, heat move rate, heat move coefficient esteems are expanded by expanding the mass stream bays and warmth move rate more at box type heat pipes. By watching the warm examination results, the warmth transition esteem is more for lithium particle phosphate stage change material than RT50 stage change material at box type heat pipes.
Next-generation Sensors for Automated Road Vehicles
Authors: Beiker Sven
Published: February 2023

This follow-up report to the inaugural SAE EDGE Research Report on “Unsettled
Topics Concerning Sensors for Automated Road Vehicles” reviews the progress made
in automated vehicle (AV) sensors over the past four to five years.
Additionally, it addresses persistent disagreement and confusion regarding
certain terms for describing sensors, the different strengths and shortcomings
of particular sensors, and procedures regarding how to specify and evaluate
them.

Next-gen Automated Road Vehicle Sensors summarizes current trends
and debates (e.g., sensor fusion, embedded AI, simulation) as well as future
directions and needs.

Click
here to access the full SAE EDGETM
Research Report portfolio.
Savoy Ballroom, The
Authors: Crease Robert P.
Published: February 2023

The Savoy Ballroom, Harlem’s largest and most famous ballroom during the Swing Era, was nicknamed ‘The Home of Happy Feet’. After it opened in 1926, it became one of the most cosmopolitan places in the world, artistically speaking, where intersecting popular music genres, and racial and class divides, opened a space for personal creativity. Unlike most other ballrooms in Harlem and throughout the country, it had an open admission policy from the beginning and, as a result, its clientele was integrated—mixing classes, ethnicities, and races. It pioneered the ‘battle of the bands’ format, in which two orchestras would alternate sets, competing for the audience’s favour.
Dance Directors
Authors: Cohen-Stratyner Barbara
Published: February 2023

The term Dance Director was used in the first three decades of the twentieth century for stage and film work. At first, it simply meant the person who set movement, in contrast to the stage director, who was responsible for dialogue. The term became associated with popular dance—musical comedy, tap and stepping, character specialties, and social dance-derived production numbers—in contrast to ballet and modern dance, where the term ‘choreographer’ was favoured. The terminology was maintained in Prologues and early musical film, but is seldom used today.
Dunham, Katherine Mary (1909–2006)
Authors: Das Joanna Dee
Published: February 2023

As a choreographer, anthropologist, educator, and activist, Katherine Dunham transformed the field of dance in the twentieth century. In the mid-1930s she conducted anthropological research on dance and incorporated her findings into her choreography, blending the rhythms and movements of the Caribbean with ballet and modern dance. Through her dance troupe, which she formed in 1936, Dunham brought Africanist aesthetics to the concert dance stage and popularized the genre of African-American modern dance. For the next 28 years, Dunham and her company of dancers, singers, and musicians toured the USA, Europe, Latin America, and Asia, exposing international audiences to a creative, modern interpretation of African diasporic culture. Through her school in New York, Dunham also established the Dunham Technique, which synthesized what she called primitive rhythms with ballet and modern dance. This technique became one of the foundations of modern and jazz dance in the postwar period. As an anthropologist, Dunham paid attention not only to how people danced, but why they did so. She disseminated her ideas on the social importance of dance through performance, publications, and education. Throughout her career Dunham used her public stature to fight for progressive social change, challenging segregation in the USA, discrimination in Brazil, and American foreign policy in Haiti.
Miranda, Carmen (1909–1955)
Authors: Lior Mika
Published: February 2023

Portuguese-born Brazilian singer, dancer and actress Carmen Miranda defied twentieth-century social and theatrical conventions to become a modern pop icon, an emblem of Hollywood’s Latina stereotype, and an ambassador of American intercontinental diplomacy. Inspired by the new sounds and bohemian aesthetics of Rio’s entertainment district where she was raised, Miranda embodied modern fashion and Latin femininity. After achieving musical success in Brazil, Miranda and her band brought samba rhythms to American and international audiences in the 1940s through Broadway, expanding recording technologies, and cinema. Miranda’s appearances in Fox musicals including That Night in Rio and Weekend in Havana incited criticism from Latin American audiences for homogenizing ethnic distinctions and identities. Nevertheless, Miranda rose to fame as Hollywood’s ‘Brazilian bombshell,’ becoming 1945’s highest paid woman in the USA, as well as a de facto ambassador of Roosevelt-era cultural policy between the Americas.
Regen (Rain) (1929)
Authors: Hielscher Eva
Published: February 2023

Regen (Rain) is a black-and-white short film by Joris Ivens and Mannus Franken about a rain shower in Amsterdam. As a masterpiece of Dutch avant-garde cinema, it is an impressionist and lyrical example of a city symphony, a film form that organizes urban images according to musical guidelines by combining experimental, documentary and narrative techniques. In 1932 Ivens asked Lou Lichtveld to write a score for the originally silent film, and a second sound version was made by Hanns Eisler in 1941. The film shows the effects of a natural phenomenon on the modern city with its motorized traffic and crowds, and reveals the transforming and aesthetic qualities of this everyday event by depicting the city before, during and after the rain. In a poetic play of light and shadow, reflection and refraction, the film studies the urban textures and semi-transparent surfaces such as skylights, tram windows and canals. During the rain shower, the entire city is covered with a second, semi-reflecting surface, generating a new and modern mediated vision not unlike cinematic perception. Reflected images appear on rain-soaked streets, puddles and canals. The city becomes a screen that Ivens’s camera uncovers and doubles.
Bulgakov, Mikhail Afanas’evich (Булгаков, Михаил) (1891–1940)
Authors: Dement Sidney
Published: February 2023

Mikhail Bulgakov was a Russian prose writer and playwright. In the last 25 years of the Soviet Union’s existence Bulgakov was one of its most widely read and performed writers. This reception, which rescued Bulgakov from near obscurity, occurred posthumously with the partial publication of the novel Master i Margarita (Master and Margarita, written 1928–1940, partially published 1966–1967, fully published 1973). Bulgakov experienced severe censorship, especially after the success of his play about a monarchist, Kievan family during the years of the Russian Revolution and Civil War, Dni Turbinykh (The Days of the Turbins, 1926), a play that became the favourite of Joseph Stalin. For the rest of his professional and personal life Bulgakov struggled with the ambivalence of Stalin’s favour: he survived the Stalinist repression that took the lives and productivity of so many of his peers, and yet his works were repeatedly banned. In his writing Bulgakov addressed the moral and personal crises he experienced (war, revolution, censorship, hypocrisy, Soviet ideology, totalitarianism) with a unique mixture of literary fantasy, grotesque, humour, and irony.
Gippius, Zinaida (ГИППИУС, ЗИНАИДА) (1869–1945)
Authors: Osipovich Tatiana
Published: February 2023

Zinaida Nikolaevna Gippius (Hippius) was a poet, prose writer, playwright, literary critic, religious thinker, and editor. Together with her husband Dmitry Merezhkovsky (1865–1941) and fellow poet Valery Briusov (1873–1923), she co-founded the Symbolist Movement in Russia. In fin-de-siècle St Petersburg she hosted an influential literary salon and was one of the major organizers of the famed Religious-Philosophical Meetings (1901–1903). She established and edited the journal The New Path (Novyi put; 1903–1905) in which she and her husband publicized their Neo-Christian beliefs, printed the works of their fellow Symbolists and reported on their Religious-Philosophical Meetings. After 1919, when the couple was forced to leave Bolshevik Russia, Gippius continued her literary and religious activities in the Russian émigré community in Paris, France, where she died in 1945.
Poesía en Voz Alta
Authors: Ward Julie
Published: February 2023

Poesía en Voz Alta (Poetry Out Loud) was an experimental theatre group in existence from 1956 to 1963 whose members included several well-known artists associated with Mexican and international modernism. Rather than emphasising sophisticated costumes and sets, as was popular in Mexican theatre at the time, Poesía en Voz Alta attempted to allow the word to come through, using simple spaces and elemental costumes. The members of Poesía en Voz Alta eschewed the use of everyday language that was typical of realist theatre. The format of performances was based on poetry recitals, and the group was closely tied to the University Theatre of the National Autonomous University of Mexico.
Ross, (James) Sinclair (1908–1996)
Authors: Stouck David
Published: February 2023

Sinclair Ross was a founding figure of Canadian literature. His novel, As For Me and My House, and short stories, including ‘The Lamp at Noon’ and ‘The Painted Door’, have been widely recognised as defining accounts of life in early- to mid-twentieth century Western Canada. Ross’s work both evokes a modernist context through its focus on the ambiguities of first-person narration, and initiates a nationalist discourse through its depiction of small-town Canadian landscapes and communities. As For Me and My House has been described by Margaret Atwood as ‘archetypally’ Canadian, while fellow Western writer Margaret Laurence credits Ross with showing her that ‘novels could be written here’.
Schoeman, Karel (1939–)
Authors: Burger Willie
Published: February 2023

Although Karel Schoeman is not as well-known as his South African contemporaries André Brink, Nadine Gordimer, J. M., Coetzee and Breyten Breytenbach, he is one of the finest South African novelists. He was born on 26 October 1939 in the small town of Trompsburg in the southern Free State—a specific setting to which he often returns in his later fiction. He grew up with his mother, first in Bloemfontein and later in Paarl. After obtaining a BA degree from the University of the Free State in Bloemfontein, Schoeman converted to Catholicism and studied at the St John Vianny Seminary in Pretoria.