bluuebunny/crossref_metadata_2025 huggingface dataset:
Wind Energy Mapping in Al Batinah Region Using Data Mining Techniques
Authors: Natarajan Prabhu , Savarimuthu Charles , Al-Zadjali Najiba Said Hamed , Rances Emanuel O. , Selvam Kulasekar Panneer , Ahamed Z.A. Feroze
Published: July 2023

Renewable energy sources are cheap to produce and have no upfront costs. It can take many different forms, including solar, wind, geothermal, hydroelectric, oceanic, and biological. There are numerous renewable energy resources in Oman, especially wind and solar. The kinetic energy of moving air is transformed into electrical energy to create wind power. This electrical energy has been used to pump water from the sea to tiny artificial ponds close to the wind farms, where the water is desalinated, used for agriculture, and then stored. The research attempts to identify the best locations for windmills that transfer seawater to small ponds. The various parameters are considered to select a suitable site for wind energy mapping, such as wind speed, elevation, distance to the main road, distance to an urban area, and land cover or land use. In order to choose appropriate locations for windmill mapping, data mining techniques are used. Based on parameters applied to classification and clustering techniques, a few wind mill sites are identified as suitable.
Structural Optimization of RC Columns in a Multi-storeyed Building by Tree-Columns Subjected to Lateral Loads
Authors: Balaji G.C. , Vivek S.S. , Fernando P.A. Edwin , Karthikeyan B. , Jaishankar P. , Rathinakumar V.
Published: July 2023

It has become the agenda to use the bottom storey as the parking area in the multi-storey buildings and it has been quite a disturbance caused by RCC columns occupying more while projecting down to the ground. To get rid of this disturbance and for the aesthetic appearance, the number of columns in the bottom storey has to be reduced so that number of the footing will also get reduced. To achieve this, the five-storey RCC framed structure of plan area 30m X 33m which is assumed to be situated in Chennai with each storey height of 4m is modelled in STAAD Pro software in the way that the loads from the four columns present in the ends of each room will be transferring to the single-column placed in the centre of each room at the bottom storey. Then the necessary loads such as Gravity loads, Seismic loads, Wind loads, and software-generated automatic load combinations were applied to the generated model and the analysis was carried out. Similarly, the conventional model of the same plan was also analyzed by STAAD Pro software with the same set of load cases, and a comparative study of structural parameters such as bending moment, shear force, and deflection was done. Finally, both the models were designed as per IS code and Cost analysis between the two models was carried out.
Solidification and Stabilization of Spent Pine-cone Biochar using Chemically Bonded Phosphate Cement
Authors: Tyagi Shivani , Annachhatre Ajit
Published: July 2023

Spent biochar is produced after adsorption of heavy metal which is hazardous by nature. A suitable disposal technique is required to prevent the leaching of heavy metals from spent biochar into the environment. This study highlights the solidification and stabilization (S/S) of copper loaded spent pine-cone biochar by chemically bonded phosphate cement (CBPC). The response surface methodology (RSM) was used to conduct S/S experiments in order to evaluate the compressive strength of CBPC products. The CBPC samples were prepared by varying biochar content (5-50 wt. %); W:S (0.15-0.3) and curing time(3-28d). Results illustrated that CBPC products containing biochar had higher compressive strength upto 12.8 MPa in comparison to CBPC without biochar i.e., upto 10.8 MPa. XRD and SEM analysis confirmed the presence of K-struvite (MgKPO4.6H2O), copper containing phases (Ca-Cu-Si), copper phosphate precipitates (Cu3(PO4)2) and filling of pore spaces by spent biochar. Highest compressive strength of 12.8 MPa was obtained at an optimized biochar content of 25%, W:S of 0.18 and curing time of 28 d. The evaluation of leaching potential by TCLP illustrated that stabilization of Cu (II) upto 99.9% was achieved in CBPC product. The risk assessment study revealed that there is no significant danger due to leaching of heavy metals from final CBPC product indicating that it can be readily disposed in the hazardous landfill sites.
Performance of analytical footprint models in heterogeneous landscapes under varying atmospheric stability conditions
Authors: Kumari Shweta , Kambhammettu BVN P
Published: July 2023

Analytical footprint models that simulate the source area of scalar fluxes generally include a fundamental assumption that the fluxes originate from a horizontal, homogeneous surface. It is widely understood that this assumption is often violated in flux studies, especially for sites where there are significant variations in topography, leaf area, photosynthetic pathway and underlying soil properties. An accurate interpretation of the measured flux footprint under heterogeneous canopy condition can help alleviate the problem. We evaluated the performance of analytical models (Hsieh, K&M, and Schuepp) under stable and unstable atmosheric conditions for the homoeneous canopy (Cotton- C3, zm = 3m and Sugarcane- C4, zm = 4m) and heterogeneous canopy (mixed fetch) compared to FFP model in a complex sugarcane-cotton (C3-C4) cropping system. Performance of models were evaluated using a set of three eddy covariance (EC) towers (one each capturing homogenous C3 and C4 fluxes, and a third capturing heterogeneous, mixed (C3-C4) fluxes at zm = 8m). High-quality EC fluxes that fulfil stationarity and internal turbulence tests were analyzed on the basis of daytime, unstable condition datasets. K&M model (Corr >0.75 , RMSE <0.06 , SD <0.006) performed the best in comparison to FFP model flux footprint prediction under unstable atmospheric condition in heterogeneous canopy condition with respect to Hsieh (Corr <0.6, RMSE >0.01 , SD >0.005), and Schuepp analytical model (Corr =0.2, RMSE <0.01, SD>0.2 ). Unstable atmospheric condition is further classified into four categories (neutral, near neutral unstable, unstable, and very unstable). Relative performance of the analytical models was further analyzed with experimental flux tower generated flux footprint under neutral, near neutral unstable, unstable, and very unstable atmospheric condition. FFP model performs the best in heterogeneous canopy condition under varying neutral to very unstable atmospheric condition. We make clear recommendations for future analysis of fluxes in heterogeneous crop lands under varying atmospheric stability condition.
Assessment of possible damages of residential buildings in the Fergana Valley of Uzbekistan
Authors: Kondratiev Vladimir , Nishonov Nematilla , Akhmedov Mashrap , Abirov Rustam
Published: July 2023

The Fergana Valley is the most densely populated cross-border region of Central Asia; it is located in three states - Uzbekistan, Tajikistan, and Kyrgyzstan. The seismicity of this region suggests possible earthquakes up to 9-intensity degrees by the MSK macroseismic intensity scale (further “Scale”). About 10 million people live in the Uzbek part of the valley. A significant part of the population lives in residential dwellings built in the traditional style. Legislative measures nowadays do not include an obligation of individual developers to comply with the aseismic norms. It has an advisory character only. So, assessment of possible damages after different intensity seismic events is vital for measures developed by local authority and other responsible institutions. Based on data on the design features of individually built housing, predictive estimates of damage in the event of strong earthquakes are provided in this issue.
A Study on the Determination of Damage Levels in Reinforced Concrete Structures during the Kahramanmaraş Earthquake on February 06, 2023
Authors: Işık Ercan , Shendkar Mangeshkumar R. , Avcil Fatih , Büyüksaraç Aydın , Deshpande Sandip S.
Published: July 2023

Planning for settlement and urban redevelopment following disastrous earthquakes depends on the early detection and control of structural damage. The first damage assessment to be made immediately after the earthquake should be done as practically and quickly as possible. Within the scope of the study, the general causes of damage to the reinforced-concrete buildings in the region affected by the Kahramanmaraş earthquake couple dated 06 February 2023, which can be called the disaster of the century for Türkiye, and the first damage assessments were made using the European Macroseismic Scale (EMS-98) for 30 different reinforced concrete structures. This method gives six different building examples for each of the five different damage levels. Considering the buildings used in damage level, information is given about the causes and consequences of the damage. In general, it is the main cause of insufficient reinforced concrete frame damage as well as the effects of structural negativities such as soft storey, short columns, etc.
A Study on Durability Parameters of Ferrocement
Authors: Nivate Siddhesh , Makwana Mahesh , Kulkarni Mrudula
Published: July 2023

Ferrocement is formed of a thin layer of cement mortar that has been strengthened with multiple layers of wire mesh with a diameter of between 0.5 mm to 1 mm. To evaluate the durability criteria for the specimen, a series of cubes and cylinders were cast in this experiment using a mortar mix at a ratio of 1:3 and a water-cement ratio of 0.40 was selected. In this study, the ability of the ferrocement to endure water penetration, sorptivity, and resistance to sulphates were examined. The curing period was chosen to be 28, 56, and 90 days, respectively, in order to track changes in the outcome and investigate the effects of the various curing times on the ferrocement. In order to measure the rate of water absorption by capillarity rise, Sorptivity test was conducted in accordance with ASTM C1585-04. The average absorption rate at day 9 was found to be 84.87 x 10-7 mm/s1/2, 93.78 x10-7mm/s1/2, and 96.34x10-7 mm/s1/2 for 28, 56, and 90 days of curing respectively. The Sulphate attack test was conducted as per ASTM C 1012-2010. The mass loss was observed to be 0.28%, 0.32%, and 0.33% of the original mass, while the strength loss was 6.96%, 6.44%, and 6.33% for the curing periods of 28, 56, and 90 days respectively. According to DIN-1048, part 5, Water permeability test was conducted. Water was pressured with 500 KPa on the specimen to determine its water penetration. The average water penetration of the specimen was found to be 22.33 mm, 18.67 mm, and 14.33 mm for the corresponding curing periods of 28, 56, and 90 days. The results were within the range twaswere specified in the respective code, and they were judged acceptable in terms of the ferrocement's durability guidelines.
Study of Redevelopment Procedure of Old and Dilapidated Buildings as Per Section 79-A of Maharashtra Cooperative Societies Act ,1960 and its Comparison with section 41 – A of Gujarat Ownership Flats (GOF) (Amendment) Act 2018
Authors: Sonavane Omkar , Shinde Vaishnavi , Dadhich Shishir
Published: July 2023

In various urban agglomerations throughout India and especially in Mumbai, there is a serious problem with old and dilapidated buildings in the city core. These buildings, mostly small in land and built-up area, are single isolated buildings which are in dilapidated state and are more than 30 years old. Yet the tenants/owners are living in them. These buildings form a major part of Thane, suburban Mumbai and Mumbai respectively. If these buildings are redeveloped, it will lead to better housing for tenants, increase the facade of buildings, bring in more open spaces and amenities, increase the value of real estate, and so on. Redevelopment is basically demolishing the old building and erecting a new, more structurally sound building on the same site with the same or more built-up area. The redevelopment process itself is ridden with various barriers and difficulties and is in no way a cakewalk for any of the stakeholder. One of the key problems is the implementation of 79 - A Process which is applicable to whole of Maharashtra is not done properly. As the redevelopment process done in Maharashtra is as per Section 79 - A of the MCS Act, which is compulsory to be followed, its study is important to make the process of redevelopment more user-friendly by proposing some changes. The research will help to identify general technical shortcomings in the 79 - A process of redevelopment of old buildings as per the Maharashtra Co-operative Societies Act 1960, respectively. The main aim of the study in this paper is to study in depth the existing Section 79 - A process of the Maharashtra Cooperative Societies Act, and compare it with Section 41- A of the Gujarat ownership flats Act, and suggest a few plausible and sound improvements in Section 79-A process backed by the, collected data from study area, its analysis other similar literature survey respectively.
Circulating and Urinary miR-210 and miR-16 Increase during Cardiac Surgery Using Cardiopulmonary Bypass – A Pilot Study
Authors: Mazzone Annette L. , Baker Robert A. , McNicholas Kym , Woodman Richard J. , Michael Michael Z. , Gleadle Jonathan M.
Published: July 2023

A pilot study to measure and compare blood and urine microRNAs miR-210 and miR-16 in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) and off-pump coronary artery bypass grafting surgery. Frequent serial blood and urine samples were taken from patients undergoing cardiac surgery with CPB (n = 10) and undergoing off-pump cardiac surgery (n = 5) before, during, and after surgery. Circulating miR-210 and miR-16 levels were determined by relative quantification real-time polymerase chain reaction. Levels of plasma-free haemoglobin (fHb), troponin-T, creatine kinase, and creatinine were measured. Perioperative serum miR-210 and miR-16 were elevated significantly compared to preoperative levels in patients undergoing cardiac surgery with CPB (CPB vs. Pre Op and Rewarm vs. Pre Op; p < .05 for both). There were increases of greater than 200% in miR-210 levels during rewarming and immediately postoperatively and a 3,000% increase in miR-16 levels immediately postoperatively in urine normalized to urinary creatinine concentration. Serum levels of miR-16 were relatively constant during off-pump surgery. miR-210 levels increased significantly in off-pump patients perioperatively (p < .05 Octopus on vs. Pre Op); however, the release was less marked when compared to cardiac surgery with CPB. A significant association was observed between both miR-16 and miR-210 and plasma fHb when CPB was used (r = −.549, p < .0001 and r = −.463, p < .0001 respectively). Serum and urine concentrations of hypoxically regulated miR-210 and hemolysis-associated miR-16 increased in cardiac surgery using CPB compared to off-pump surgery. These molecules may have utility in indicating severity of cardiac, red cell, and renal injury during cardiac surgery.
Successful Use of Extracorporeal Life Support in a Hematopoietic Stem Cell Transplant Patient with Neuroblastoma
Authors: Williams Feifei Z. , Vats Atul , Cash Thomas , Fortenberry James D.
Published: July 2023

Respiratory failure associated with hematopoietic stem cell transplantation (HSCT) has been considered a contraindication for use of extracorporeal membrane oxygenation (ECMO) at many centers. We describe a child with neuroblastoma and hypoxemic respiratory failure following HSCT who was successfully managed with veno-venous (VV) ECMO. The patient was an 18-month-old female with high-risk neuroblastoma status post tumor resection, chemotherapy, autologous HSCT, and primary site radiation. On day 113 posttransplant while receiving maintenance immunotherapy, she had an acute respiratory decompensation because of rhinovirus, aspiration pneumonia, and capillary leak syndrome. The patient was intubated and transitioned to a high frequency oscillatory ventilation and inhaled nitric oxide. Because of refractory hypoxemia, she was cannulated for VV ECMO. She was weaned and decannulated after 7.5 days on ECMO, then subsequently transferred for inpatient rehabilitation. The most recent Extracorporeal Life Support Organization registry analysis showed low survival (3/29) in patients requiring ECMO after HSCT, and 2 of 3 survivors had nononcological diagnoses. However, our patient’s outcome suggests that HSCT status should not be an absolute contraindication. The presence of a reversible single organ failure and the absence of significant bleeding risk in an engrafted, neurologically intact, and non-neutropenic HSCT patient with a favorable prognosis can support the potential benefit of ECMO.
Sickle Cell Hemoglobin C Disease Patient Undergoing Coronary Artery Bypass Grafting with Complete Exchange Blood Transfusion during Cardiopulmonary Bypass
Authors: Mullins Francesca , Ott Shawn , Mister Nakia , Travis Jeffrey
Published: July 2023

Sickle cell disorders are associated with increased risk of sickling and vaso-occlusive complications when undergoing cardiopulmonary bypass (CPB) surgery. Monitoring of certain parameters such as venous and arterial oxygen content, hematocrit, acid base homeostasis, and body temperature are required for a superior outcome. Furthermore, perioperative exchange transfusion has a positive effect on the outcome of surgery and on the survival of patients undergoing heart surgery. Avoiding intraoperative hypoxia and hypothermia, and minimizing hemoglobin S (HbS) and hemoglobin C (HbC) levels with exchange transfusion make bypass surgery relatively safe with enhanced outcomes in these cases. The exact HbS level for conducting cardiac surgery with CPB is not known, however, a HbS level <30% is considered safe for conducting CPB. By using a “discard” cardiotomy reservoir and priming the oxygenator reservoir with donor blood, we were able to reduce the intraoperative circulating HbS and HbC levels to less than 15% and sequester the plasma and clotting factors from the discarded blood using intraoperative plasmapheresis.
Cardiopulmonary Bypass in the Setting of Waldenström’s Macroglobulinemia
Authors: D’Aloiso Brandon D. , Rupchak Sarah S. , Gettle Kaitlin J. , Lima Claudio , Rush Robert D.
Published: July 2023

Waldenström’s Macroglobulinemia (WM) is a rare lymphoma caused by the overproduction of immunoglobulin M (IgM). The elevated level of IgM causes serum hyperviscosity, cold agglutinins, and cryoglobulinemia. Anemia is also present because of impaired production of erythrocytes. For these reasons, placing a patient with WM on cardiopulmonary bypass (CPB) requires careful preparation. In this case, the patient was a 73-year-old male with known Waldenström’s disease who required coronary artery bypass graft surgery. This report details the perioperative considerations used for successful CPB on a Waldenström’s patient. Critical to this case was the use of plasmapheresis before surgery. Temperature management and acid/base status were carefully controlled. A successful coronary revascularization surgery was performed. Many of the Wadenstrom’s disease complications expected on CPB failed to materialize.
Joeann Guthrey Taylor Fraser: Trailblazing Nurse in a New Profession
Authors: Rowland Charles A. , Formicola Joanne P.
Published: July 2023

This historical vignette describes the career of Joeann Guthrey Taylor Fraser. Her story begins as she cleans animal cages and sweeps floors in the research labs at Jefferson Medical College. As a nursing student at Jefferson she is fascinated by cardiac surgery and accepts the opportunity to learn to operate the heart-lung machine. Esteemed cardiac surgeons, Dr. John H. Gibbon, Jr. and Dr. John Y. Templeton III guide her to become one of the first perfusionists in the United States.
Association of Primary Hemodilution and Retrograde Autologous Priming with Transfusion in Cardiac Surgery: Analysis of the Perfusion Case Database of the Japanese Society of Extra-Corporeal Technology in Medicine
Authors: Saito Chihiro , Kamei Tetsuya , Kubota Shoji , Yoshida Kiyoshi , Hibiya Makoto , Hashimoto Shuji
Published: July 2023

It is important to avoid unnecessary blood cell transfusion. However, the associations of hemodilution and retrograde autologous priming with red blood cell transfusion during and after cardiopulmonary bypass (CPB) in cardiac surgery in Japan are currently unclear. We analyzed these associations using data for 3,090 adults from the Perfusion Case Database of the Japanese Society of Extra-Corporeal Technology in Medicine. Percent hemodilution was calculated by total priming volume and weight. Logistic regression models were used to adjust for covariates including type of surgery, gender, age, hemoglobin concentration before CPB, CPB time, urine volume during CPB, and institution. The percentages of red blood cell transfusions during CPB for patients with <15, 15 to <20, 20 to <25, 25 to <30, and ≥30% hemodilution were 43.0, 51.5, 68.9, 77.3, and 87.7%, respectively. This increase in line with increasing dilution was significant after adjusting for covariates. The percentage of red blood cell transfusion after CPB also increased slightly between 39.0 and 49.4% with percent hemodilution, but the trend after adjusting for covariates was not significant. Use of retrograde autologous priming was significantly associated with blood cell transfusion during CPB after adjusting for covariates, but was not significantly related to blood cell transfusion after CPB. These results suggest that optimizing the percent hemodilution and use of retrograde autologous priming might reduce the use of red blood cell transfusion during CPB in clinical practice in Japan.
Unplanned Autotransplantation for Complex Multi-Valve Replacement in a Super Morbid Obese Female: The Challenge of Intraoperative Decision Making
Authors: McDonald Charles , Dallimore Daniel , Oates Mathew , Shekar Kiran , Thomson Bruce
Published: July 2023

Cardiac autotransplantation is a rare technique typically reserved for the treatment of malignant tumors of the left atrium and left ventricle. Even when well planned, it conveys a high risk to the patient. This report discusses the intraoperative progression to an unplanned autotransplant for mitral valve repair while considering some decision making processes that cardiac surgeons make.
The Association between Cytokines and 365-Day Readmission or Mortality in Adult Cardiac Surgery
Authors: Everett Allen D. , Alam Shama S. , Owens Sherry L. , Parker Devin M. , Goodrich Christine , Likosky Donald S. , Thiessen-Philbrook Heather , Wyler von Ballmoos Moritz , Lobdell Kevin , MacKenzie Todd A. , Jacobs Jeffrey , Parikh Chirag R. , DiScipio Anthony W. , Malenka David J. , Brown Jeremiah R.
Published: July 2023

Cardiac surgery results in a multifactorial systemic inflammatory response with inflammatory cytokines, such as interleukin-10 and 6 (IL-10 and IL-6), shown to have potential in the prediction of adverse outcomes including readmission or mortality. This study sought to measure the association between IL-6 and IL-10 levels and 1-year hospital readmission or mortality following cardiac surgery. Plasma biomarkers IL-6 and IL-10 were measured in 1,047 patients discharged alive after isolated coronary artery bypass graft surgery from eight medical centers participating in the Northern New England Cardiovascular Disease Study Group between 2004 and 2007. Readmission status and mortality were ascertained using Medicare, state all-payer claims, and the National Death Index. We evaluated the association between preoperative and postoperative cytokines and 1-year readmission or mortality using Kaplan–Meier estimates and Cox’s proportional hazards modeling, adjusting for covariates used in the Society of Thoracic Surgeons 30-day readmission model. The median follow-up time was 1 year. After adjustment, patients in the highest tertile of postoperative IL-6 values had a significantly increased risk of readmission or death within 1 year (HR: 1.38; 95% CI: 1.03–1.85), and an increased risk of death within 1 year of discharge (HR: 4.88; 95% CI: 1.26–18.85) compared with patients in the lowest tertile. However, postoperative IL-10 levels, although increasing through tertiles, were not found to be significantly associated independently with 1-year readmission or mortality (HR: 1.25; 95% CI: .93–1.69). Pro-inflammatory cytokine IL-6 and anti-inflammatory cytokine IL-10 may be postoperative markers of cardiac injury, and IL-6, specifically, shows promise in predicting readmission and mortality following cardiac surgery.
The Effect of Standardizing Autologous Prime Techniques in Patients Undergoing Cardiac Surgery with Cardiopulmonary Bypass
Authors: Stammers Alfred H. , Francis Stephen , Tesdahl Eric A. , Miller Randi , Nostro Anthony , Mongero Linda B.
Published: July 2023

Autologous priming (AP) of the extracorporeal circuit has been used as a technique to reduce iatrogenic anemia in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). The purpose of this study was to review the results of standardizing AP techniques to reduce variation among clinicians and its effect on clinical outcomes. Standardized goal-directed protocols for AP were established by the cardiac team and applied to all adult cardiac surgical patients where CPB was used. Following Institutional Review Board approval, data were analyzed for two sequential groups of patients: Non-standardized AP (NST-AP) and standardized AP (ST-AP). Exclusion criteria included pre-CPB hemodynamic instability and preoperative hematocrit (Hct) values less than 30%. The primary end point was the transfusion of red blood cells (RBCs), whereas secondary end points included Hct change and other perioperative allogeneic blood product transfusions. Data are presented as mean and SD. Of the 192 patients evaluated, 82 were in the NST-AP group and 110 in the ST-AP group. There were no preoperative demographic differences across groups. Total AP volume was lower in the NST-AP group than in the ST-AP patients (486.8 ± 259.6 mL vs. 1,048.2 ± 218.7 mL,p< .001). Whereas pre-CPB Hct values were identical between the groups, the first on-CPB (25.7% ± 4.5% vs. 27.9% ± 4.2%,p< .001), high CPB (27.7% ± 3.5% vs. 29.1% ± 3.6%,p< .008), and first postoperative (32.5% ± 4.0% vs. 34.3% ± 3.9%,p< .003) were all significantly higher in ST-AP patients. Perioperative transfusion rate was higher in NST-AP patients (63.6%) vs. ST-AP (44.6%),p< .01. There was no difference in intraoperative RBC transfusion, but postoperatively, more patients in the NST-AP group received RBCs than those in the ST-AP group (51.2% vs. 28.2%,p< .01). The application of an ST-AP protocol was effective in reducing hemodilution, which was associated within higher Hcts and lower postoperative transfusion rates.
Paving a Road Home: Developing Education for a Pediatric Home-Going VAD Program
Authors: Duffy Vicky , Nandi Deipanjan , Hodge Ashley , Deitemyer Matt , Simsic Janet
Published: July 2023

The objective was to create a multidisciplinary education plan for discharge home following implantation of a ventricular assist device (VAD) in pediatrics. Educational program was developed for the local community: emergency department, emergency medical services, medical transport team, as well as, the pediatric patient and their caregivers. Education geared to the individual learner included both lecture and hands-on training. A direct line for family and local providers to speak directly with a VAD-trained physician 24/7 was also created. Patient and caregivers required to 1) perform 10 supervised power exchanges; 2) qualify written quizzes on the controller, battery charger, alarms, and troubleshooting; 3) perform 10 supervised dressing changes; 4) pass simulation session responding correctly to alarm scenarios; and 5) take both an on-campus and off-campus field trip unaccompanied by support staff. Once the education plan is complete and the patient is medically stable, they are considered ready for discharge. From a mechanical support perspective, discharge home of a medically complex pediatric patient on a durable VAD can be accomplished safely, even in a low volume center, with attention to detail, creation of a robust education plan, and close partnership between the VAD team, the family, and the community.
Plant height determines phenological variation in Quercus suber L.
Authors: Pinto Clara de Assunção , Correia Alexandra C. , Caldeira Maria da Conceição , David Teresa Soares , Costa e Silva Filipe
Published: July 2023

Phenological traits of vegetative apical buds were monitored in a Quercus suber L. (cork oak) montado near Lisbon during 2015. Natural regeneration plants, growing at a fenced plot, and mature trees (MT) from the surrounding montado were selected and divided in six groups (n=8) according to height (H): Sd1 (small seedlings, H<0.1 m); Sd2 (seedlings, 0.1<H<0.5 m); Sp (saplings, 1<H<2 m); Jv1 (small juveniles, 3<H<6 m); Jv2 (juveniles, H>6 m); MT (mature trees). Observations included budburst date, apical shoot elongation and leaf production.

Vegetative phenology patterns of Q. suber changed according to height/age group. Average budburst dates occurred between early-April (day 99, Sd1) and mid-May (after day 120, mature and juvenile trees), at day lengths between 12.8 (Sd1) and 13.7 hours (Jv2). Height was positively related with average budburst dates, degree day sums and daylength at budburst. Shoot elongation followed different patterns according to size/age group. In seedlings, cumulative growth was smaller and restricted to the weeks immediately after budburst, whilst taller/older trees phenological patterns were more variable, with vegetative growth often maintained until mid-summer. The differences in budburst timing and vegetative growth patterns may be reflecting the different strategies to cope with resource limitation and maximize the length of the growing season among groups.
Destilação de Misturas Multicomponentes: O Procesamento de Gema de Pinheiro em Pez e Aguarrás
Authors: Soares Andreia , Pestana Miguel
Published: July 2023

O trabalho apresentado, assenta no processamento da gema de pinheiro, envolvendo a sua integração na Fileira da Resina, desde o Pinhal aos Outputs da destilação - Pez e Aguarrás.

No introito esclarece-se o que se entende por destilação e aborda-se a sua evolução no tempo até à atualidade, sendo detalhado os diferentes métodos de destilação e realçado os pontos fundamentais da mesma. É ainda apresentado os processos de destilação, dando destaque à destilação por arrastamento de vapor.

Foi feito uma breve descrição sobre a resinagem, como evoluiu e como é feita hoje em dia, desde a abertura e condução das feridas, até à recolha e transporte da gema para a unidade fabril. Foi ainda apresentado os diferentes tipos de coletor atualmente em uso.

No processamento abordamos a terebintinagem e a destilação. Na primeira, processo preparatório da gema a destilar, esta é limpa e liquefeita. Na destilação são apresentados os diferentes aparelhos, descrevendo-se a evolução e o aparecimento dos mesmos, indicando-se as vantagens e as desvantagens de cada um, os parâmetros a controlar. Por fim, é referido as operações a efetuar ao Pez e à Aguarrás até ao seu armazenamento.

Encerramos este trabalho de pesquisa com a indicação de vias para a melhoria do processamento da gema de pinheiro.
Nouveaux formats de course, nouveaux engagements ? L’exemple des courses de type « Backyard »
Authors: Lancelevé Simon , Knobé Sandrine
Published: July 2023

Depuis 20 ans, de nouvelles épreuves de course pédestre ont vu le jour, à partir des pays occidentaux (Bridel, W., Markula, P., & Denison, J. (Éds.). (2016). Endurance running: A socio-cultural examination. London, New York: Routledge). Ces dernières ont pour point commun de vouloir insuffler un caractère festif au sein du monde de l’endurance, sans se départir des notions d’« extrême » ou de « convivialité » (Bessy, O. (2002). Le grand raid de La Réunion : À chacun son extrême et un emblème pour tous. Saint-André : Océan Édition). Depuis 2019, nous nous sommes intéressés à un format d’épreuves poussant les athlètes à courir le plus longtemps possible sur une boucle de 7 km, en moins d’une heure, sous peine d’élimination. Ces épreuves sont nommées « Backyard » ou « Dernier homme debout ». À partir d’un travail d’observation et de questionnaires en ligne, nous avons essayé de comprendre les motifs d’inscription et de pratique des athlètes y participant (n = 389). Nous avons comparé ces résultats à ceux d’athlètes de courses plus « classiques », afin d’en relever les éventuelles spécificités (n = 1407). Nous avons alors noté des caractéristiques sociales et sportives différentes au sein des deux groupes.
Körperkontakt in der physiotherapeutischen Ausbildung – Wissenschaft nachgefragt
Authors: Veit Katrin
Published: July 2023

Victoria Britz untersuchte in ihrer Bachelorarbeit das Thema Körperkontakt im Rahmen der physiotherapeutischen Ausbildung. Dass Lernende es akzeptieren, sich ständig von anderen berühren zu lassen und selbst in eine enge körperliche Nähe mit den anderen zu gehen, wird meist einfach vorausgesetzt. Für viele ist es jedoch eine Herausforderung.
Training unter Strom – Reizstromtherapie gegen Rückenschmerz und Sarkopenie
Authors: Müller Stephan , Vatter Jens , Sutor Volker
Published: July 2023

EMS liegt im Trend. Das Trainieren in feuchter Weste soll schnell, gezielt und gelenkschonend die Kraft und Funktionalität der Muskulatur verbessern. Profitieren können nicht nur Untrainierte, Breitensportler*innen oder Spitzenathlet*innen. Bei Patient*innen mit unspezifischen chronischen Rückenbeschwerden wirkt richtig dosiertes EMS-Training so gut wie intensives Krafttraining. Bei Senioren und Seniorinnen kann das Trainieren unter Strom den im Alter einsetzenden Muskelschwund ausbremsen.
Die Rebellion des kleinen Mannes – Maier-Kolumne
Authors: Maier Ulrike
Published: July 2023

Hausbesuche im Seniorenstift sind immer für Überraschungen gut. Besonders dann, wenn ein Faschingsmuffel die Rosenmontagsfeier sprengt.
Vollstationäre Behandlung in den eigenen vier Wänden
Authors: Wenzel William
Published: July 2023

Es gibt unterschiedliche Gründe, warum psychiatrische Behandlungen nicht in einem stationären Setting stattfinden können. Um Menschen mit einer psychiatrischen Erkrankung dennoch zu erreichen, eignet sich die stationsäquivalente Behandlung. Wie diese Maßnahme im häuslichen Umfeld umgesetzt werden kann, verdeutlicht unser Fallbeispiel.
Braucht es einen psychologischen Masterplan 70plus?
Authors: Gürtler Klaus
Published: July 2023

Um die Achtsamkeit derjenigen zu schärfen, die ältere Menschen geriatrisch und/oder psychiatrisch pflegen, erstellt unser Autor einen Masterplan 70plus, der Herausforderungen in dieser Lebensphase benennt und aufzeigt, wie Lebensqualität gesichert werden kann.
Interview: Tätigkeit als psychosomatische Liaison Nurse
Authors: Jansen Heike
Published: July 2023

Vor 12 Jahren wurde das psychosomatische Liaisonteam der Universitätsklinik Freiburg um einen Fachgesundheits- und Krankenpfleger für Psychiatrie erweitert. Das Team, bisher aus Ärzt*innen und Psycholog*innen bestehend, musste gemeinsam entwickeln, welchen Beitrag psychiatrisch Pflegende zur Unterstützung von Patient*innen, Pflegenden und Angehörigen in der Somatik beitragen können. Im Interview berichtet Johannes Eichenlaub wie er die Stelle als psychosomatische Liaison Nurse seit 2011 aufgebaut und entwickelt hat.
Körperliche Aktivität und Ernährung in der Prävention und Therapie des Kolorektalen Karzinoms
Authors: Adamek Michaela Ute , Bergmann Laura , Adamek Henning Ernst
Published: July 2023

Hintergrund Kolorektale Karzinome sind eine der häufigsten Krebserkrankungen in Europa. Moderne Therapieformen verbessern die Überlebenschancen; trotzdem sind die Erkrankung und ihre Behandlung mit einer hohen Morbidität verbunden. Körperliche Aktivität (KA) hat offensichtlich einen positiven Einfluss auf das Erkrankungsrisiko, die perioperative Komplikationsrate und die adjuvante Therapie.

Methode Grundlage für diese narrative Übersicht ist eine selektive Literatursuche in der Datenbank PubMed, ergänzt durch eine Suche in GoogleScholar bis 30.09.2022. Eingeschlossen wurden Originalarbeiten, Metaanalysen und systematische Reviews. Studien, die Bewegung und Ernährung analysierten, wurden ebenso berücksichtigt wie Leitlinien und Positionspapiere der deutschen, europäischen und amerikanischen Fachgesellschaften.

Ergebnisse Ein körperlich aktiver Lebensstil trägt über epigenetische Mechanismen zur Reduktion des Kolonkrebsrisikos bei. Je nach Studienprotokoll und Dosis der körperlichen Aktivität sind Risikoreduktionen zwischen 12 und 27 Prozent dokumentiert. Eine Prehabilitation aus Ernährung, Bewegung und psychologischer Unterstützung kann die peri- und postoperativen Ergebnisse beim kolorektalen Karzinom verbessern. Ausdauer- und Krafttraining können das rezidivfreie Überleben und die Tumorsterblichkeit verbessern. Keine Studie konnte eindeutige Verbesserungen bei Symptomabfragen (z.B. Fatigue) oder Biomarkern durch eine Ernährungsumstellung zeigen.

Schlussfolgerung Trotz einer Vielzahl an wissenschaftlichen Untersuchungen sind viele Fragen zum Einfluss von kA auf die verschiedenen Phasen einer Kolonkarzinomerkrankung nicht hinreichend geklärt. Empfehlungen zur Prehabilitation und zur Tertiärprophylaxe können aktuell nur auf Basis heterogener Studiendaten gegeben werden.
Bridging the gap: A quality improvement project to implement
psychosocial care standards into clinical practice in pediatric
oncology
Authors: Weiler-Wichtl Liesa J. , Fohn-Erhold Verena , Schneider Carina , Schwarzinger Agathe , Krottendorfer Kerstin , Pletschko Thomas , Rosenmayr Verena , Gojo Johannes , Peyrl Andreas , Dieckmann Karin , Kollmann Alina Stefanie , Hansl Rita , Slavc Irene , Fries Jonathan , Hopfgartner Maximilian , Leiss Ulrike
Published: July 2023

Background Psychosocial guidelines and standards systematically describe
stressors and resources in particularly challenging situations and hence serve
as a basis for interventions to achieve defined psychosocial goals. Despite
fundamental principles and guidelines for psychosocial methods, the quality of
provided care varies considerably depending on setting, provision, and
profession. The purpose of the present protocol is to illustrate the development
and evaluation of the standardized psychological intervention “My
Logbook”, a practical guide accompanying children through all stages of
treatment by directly translating current quality standards of psychosocial care
into practice.

Methods In an evidence-based set-up, using face-to-face discussions and
telephone conferences, a multi-professional team of local experts decide on
critical disease-related issues, structure, content (information and
intervention elements) and design of the quality improvement tool. Via delphi
surveys an extended expert team is asked to rate the content, method, and design
of all booklets which is concluded by a final agreement by the specialist group
for quality assurance of the psychosocial working group in the Society for
Pediatric Oncology (PSAPOH). The developed tools are piloted in an international
multicenter study to evaluate the patient-reported outcome and feasibility and
to integrate practical views of patients, as well as psychosocial and
interdisciplinary professionals into the further development of the “My
Logbook”.

Discussion The iterative development of the “My Logbook”
including local and international experts as well as the patient and practical
perspective allow for the design of a process-oriented, consensus – and
evidence-based tool directly translating the S3-Guideline into clinical
practice. Feasibility and applicability are fostered through an iterative
process of constant evaluation and adaptation of the tool by international
experts and through the clinical experience gathered in the multi-centered pilot
study. Furthermore, the systematic evaluation of the tool by patients,
psychosocial, and interdisciplinary professionals enables the identification of
persisting gaps between evidence-based standards and clinical practice,
discrepancies between the various stakeholders’ perspectives as well as
regional differences in feasibility, thereby directly linking practice and
research. The preliminary results emphasize that psychological support can be
standardized, enabling an evaluation and optimization of psychosocial care which
future studies need to assess in multicenter clinical randomized controlled
trials.
Palladium-Catalyzed Ring Opening of Cyclobutanones with Carbon- and Heteroatom-Centered Nucleophiles
Authors: Ano Yusuke , Takahashi Daichi , Yo Kazumune , Nagamune Ryosuke , Chatani Naoto
Published: July 2023

The transformation of cyclobutanones into acyclic carbonyl compounds through a Pd-catalyzed C–C bond cleavage is reported. The use of an N-heterocyclic carbene ligand efficiently promoted the ring opening and functionalization of various cyclobutanones, not only with alcohols, but also with N-centered nucleophiles, such as aniline or amide derivatives. Cyclobutanones were also found to react with arylboronic esters, resulting in the production of acyclic aryl ketones.
H3 K27M-Altered Diffuse Midline Gliomas: A Review
Authors: Wiśniewski Karol , Ghaly Andrew , Drummond Kate , Fahlstrӧm Andreas
Published: July 2023

Diffuse midline glioma H3 K27M-altered is a recently renamed high-grade glioma in the 2021 World Health Organization (WHO) Classification of Central Nervous System Tumors, previously being labelled diffuse midline glioma H3 K27M-mutant in the 2016 update and diffuse intrinsic pontine glioma prior to 2016. After identification of multiple alterations causing H3 K27 hypomethylation, the definition of this tumor subtype was changed. To further characterize this new entity in both the pediatric and adult population, we conducted a review of the current literature, investigating genetic, epidemiological, clinical, radiological, histopathological, treatment and prognostic characteristics, particularly highlighting the differences between adults and children. This tumor is more common in children, and has a poorer prognosis. Additionally, childhood H3 K27-altered gliomas are more common in the brainstem, but more common in the thalamus in adults. Sadly, limited treatment options exist for these tumors, with radiotherapy the only treatment shown to improve overall survival.
Endoscopic Excision of Third Ventricle Choroid Plexus Papilloma
Authors: Rathore Lavlesh , Sahana Debabrata , Kumar Sanjeev , Sahu Rajiv K.
Published: July 2023

Choroid plexus papilloma is a rare intraventricular tumor in children. Its management poses a challenge. Here we describe such a case of third ventricular choroid plexus papilloma and its endoscopic excision through a single burr hole. A 1-year-old child presented with headache, vomiting, and a large head with sunset sign and tense fontanel. Computed tomography (CT) and magnetic resonance imaging brain plain and contrast revealed dilated ventricles with a frondlike mass in the third ventricle with intense contrast enhancement, suggestive of choroid plexus papilloma of the third ventricle. The lesion was excised completely using an endoscope placed through a single burr hole at the right Kocher's point. Postoperative recovery was uneventful. The child was relieved of his symptoms. CT scan revealed complete removal of the lesion. Histopathology confirmed the diagnosis of choroid plexus papilloma. We document our surgical experience and present an edited video of the surgery. The key steps and nuances are described in the audio timeline. The authors acknowledge the feasibility of performing this complex surgery via a minimally invasive method, which has not been accepted routinely for this pathology.
Oxygenation Instability during Bolus versus Continuous Feeding among Very Low Birth Weight Premature Infants, Supported by Noninvasive Ventilation: A Randomized Prospective Study
Authors: Borenstein-Levin Liron , Haj Ahmad , Riskin Arieh , Dinur Gil , Littner Yoav , Hochwald Ori , Kugelman Amir
Published: July 2023

Objective This study aimed to compare oxygenation instability, as documented by the oxygen saturation (SpO2) histograms, during bolus (over 30 minutes) versus continuous (over 2 hours) feeding among very low birth weight (VLBW) premature infants, supported with noninvasive ventilation (NIV).

Study Design This was a randomized prospective study. VLBW infants supported with NIV received three consecutive feeds in a random order of bolus-continuous-bolus or continuous-bolus-continuous. During each feed, 30 minutes and 2 hours histograms were documented.

Results Twenty-four infants (birth weight [mean ± standard deviation, SD] 820 ± 168 g, gestational age [mean ± SD] 27.0 ± 1.6 weeks) were included in our study (12 infants started with bolus feeding and 12 with continuous feeding) and 72 histograms were obtained (36 during bolus feeding and 36 during continuous feeding). No differences in mean fraction of inspired oxygen (FiO2), and number of apnea events were observed between the two feeding modes. Oxygenation instability as assessed by time spent in different SpO2 ranges and histogram types (stable or unstable) was comparable during bolus and continuous feedings. Changing feeding mode from bolus to continuous or vice versa did not significantly change the oxygenation instability of the group, though individual infants did show a consistence response to feeding length changes.

Conclusion Among VLBW infants supported with NIV, oxygenation instability, as documented by SpO2 histograms, was comparable between bolus and continuous feedings. Individual infants may benefit from specific feeding length, and this can be easily demonstrated by the SpO2 histograms.

Key Points
Intraoperative Squash Cytology and Histopathological Correlation of Glial Tumors at a Tertiary Care Hospital
Authors: Bajaj Diya , Ramchandani Lekha , Ansari Shamim , Yadav Nishtha , Bajaj Jitin , Ratre Shailendra , Parihar Vijay , Swamy M. Narayan , Yadav Yad Ram
Published: July 2023

Introduction Central nervous system (CNS) tumors account for around 1 to 2% of all neoplasms, commonest of them being gliomas. Gliomas constitute a large, heterogenous group of tumors known for a wide variation in clinical presentation, gross and microscopic features, and biologic behavior. Squash cytology can be a great asset in the intraoperative diagnosis of CNS pathology. In this article, we correlate it with the histopathology of gliomas.

Methods A prospective analytical study was conducted at the Department of Neuropathology, Super-Speciality Hospital, NSCB Medical College, Jabalpur, India. A total of 75 samples were collected for intraoperative squash cytology. The biopsy samples were collected subsequently after surgery for histopathological correlation. Statistical analysis was done using SPSS software to calculate the sensitivity, specificity, and diagnostic accuracy of squash cytology.

Results Of the total 75 patients clinically and radiologically suspected of having gliomas, 43 (57.33%) were males to give a male-to-female ratio of 1.34:1. The mean age at presentation was 36.50 ± 16.87 years. Right-sided tumors were more common. The most common location was the frontal lobe (46.66%). Concordance with squash cytology was found in 81.33% of cases. Sensitivity, specificity, and diagnostic accuracy of squash cytology in the diagnosis of gliomas were found to be 98.61, 66.66, and 97.33%, respectively.

Conclusion Squash cytology is a rapid, inexpensive, and accurate diagnostic method for intraoperative diagnosis of gliomas that can guide the surgeon on the extent of tumor resection.