bluuebunny/crossref_metadata_2025 huggingface dataset:
Modern vision on the problem of chronic heart failure in the older persons
Authors: Larina V. N.
Published: April 2021

Aim. To analyze the factors associated with the development of chronic heart failure (CHF) in older age and to evaluate possible approaches to managing outpatients.

Material and methods. The search for domestic and foreign publications in Russian and international systems (PubMed, eLibrary, Medscape, etc.) for the last 0.5–15 years has been carried out. The analysis includes articles from the peer-reviewed literature.

Results. During aging, a number of structural changes and changes at the cellular level occur in the cardiovascular system, predisposing to the development of myocardial dysfunction, which explains the variety of manifestations of heart failure and the prevalence of preserved left ventricular ejection fraction (LVEF). Involutional functional and morphological changes in organs and systems form multimorbidity and nonspecificity of clinical symptoms and signs. «Cross symptoms» of frailty and CHF often complicate the timely diagnosis of the heart failure. Medications used for the treatment of CHF in older and younger patients are similar, but when choosing a specific drug, caution should be exercised in the group of the most vulnerable patients: over the age of 85, in the first two weeks after discharge from the hospital and in the presence of frailty.

Conclusion. Based on the available results of studies, it is necessary to be alert of primary care physicians regarding the presence of CHF with preserved LVEF in  older persons with multimorbidity and geriatric syndromes. The therapeutic strategy for CHF older patients is complex and involves an individualized approach, depending on the clinical situation.
Kidney aging.Geriatric view
Authors: Merkusheva L. I. , Runikhina N. K. , Tkacheva O. N.
Published: April 2021

Individuals age >65 years old are the fastest expanding population demographic throughout the developed world. Consequently, more aged patients than before are receiving diagnoses of impaired renal function and nephrosclerosis. In this review, we examine these features of the aged kidney and explore the various validated and putative pathways contributing to the changes observed with aging. Senescence or normal physiologic aging portrays the expected age-related changes in the kidney as compared to chronic kidney disease (CKD) in some individuals. The microanatomical structural changes of the kidney with older age include a decreased number of functional glomeruli from an increased prevalence of nephrosclerosis (arteriosclerosis, glomerulosclerosis, and tubular atrophy with interstitialﬁbrosis), and to some extent, compensatory hypertrophy of remaining nephrons. Among the macroanatomical structural changes, older age associates with smaller cortical volume. There is reason to be concerned that the elderly are being misdiagnosed with CKD. In addition to the structural changes in the kidney associated with aging, physiological changes in renal function are also found in older adults, such as decreased glomerular ﬁltration rate, vascular dysautonomia, altered tubular handling of creatinine, reduction in sodium reabsorption and potassium secretion, and diminished renal reserve. These alterations make aged individuals susceptible to the development of clinical conditions in response to usual stimuli that would otherwise be compensated for in younger individuals, including acute kidney injury, volume depletion and overload, disorders of serum sodium and potassium concentration, and toxic reactions to water -soluble drugs excreted by the kidneys. Additionally, the preservation with aging of a normal urinalysis, normal serum urea and creatinine values, erythropoietin synthesis, and normal phosphorus, calcium and magnesium tubular handling distinguishes decreased GFR due to normal aging from that due to chronic kidney disease.
Joint pain treatment planning in osteoarthritis patients with chronic kidney disease
Authors: Naumov A. V. , Kotovskaya Yu. V. , Moroz V. I. , Khovasova N. O. , Meshkov A. D. , Manevich T. M. , Demenok D. V.
Published: April 2021

Treatment of osteoarthritis, as the most common pathology of the musculoskeletal system, presents certain clinical difﬁculties in comorbid patients. The frequent combination of osteoarthritis (OA) and cardiovascular diseases (CVD), diabetes mellitus type 2 and other cardiometabolic pathologies raises questions about the safety of pain relievers in the presence of chronic kidney disease (CKD). Safe treatment for chronic pain syndrome implies an informed decision about the risks / beneﬁts of using any analgesic intervention. Particular attention should be paid to the decision on the appointment of non-steroidal anti-inﬂammatory drugs (NSAIDs). An alternative strategy for the treatment of joint pain in patients with CKD may be the use of chondroitin sulfate prescription form. Particular attention should be paid to the possibility of using the parenteral form of the drug, which has reliable evidence, faster onset of the clinical effect of analgesia, with a potential protective effect on the structure of joint tissues.
Maggot debridement therapy for the treatment of diabetic foot ulcers: robbing the rich past to give to the sore
Authors: Cutteridge Joseph , Bera Katarzyna
Published: April 2021

A diabetic foot ulcer (DFU) is a serious complication of diabetes mellitus that results in significant morbidity and mortality. The lifetime risk of a patient with diabetes developing a DFU is 15-25%1. Furthermore, the incidence of DFUs is increasing in line with the growing burden of diabetes worldwide. The number of lower limb amputations secondary to diabetes has reached an all-time high in England, with 26,378 recorded from 2014-2017, an increase of 19.4% from 2010-20132. Maggot debridement therapy (MDT) involves the application of sterile larvae, usually of the species Lucilla sericata (common green bottle fly), which remove devitalised tissue to promote wound healing. This historical therapy re-emerged in the 1990s to combat the increasing incidence of recalcitrant wounds, such as DFUs. Since its reintroduction, there has been ongoing debate in the medical literature regarding the efficacy of MDT in the treatment of DFUs and other chronic wounds. We present the case of a 57-year-old male admitted with diabetic foot sepsis and multiorgan failure and discuss how MDT was used to complement initial surgical and antibiotic management. A 14-day course of MDT improved wound debridement and decreased necrotic tissue burden, after which no further surgical interventions were needed. This case provides further evidence that MDT is effective in the selective debridement of necrotic tissue and can aid the preservation of limb length in DFU patients, thereby highlighting the importance of MDT in multispecialist diabetic foot care.
Analysis of Affecting Factors of the Medical Record Service Waiting Time of Outpatient Ambulatory in Sundari Medan Hospital
Authors: Lunanda Lilya , Nyorong Mappeaty , Rifai Achmad
Published: April 2021

Administering outpatient medical records is required to provide excellent service to create patient satisfaction, especially with short waiting times. The purpose of this study was to determine how the factors that influence the waiting time for outpatient medical record services at Sundari Hospital, Medan.This type of research is descriptive analytic with a qualitative approach. The informants in this study consisted of 7 people, namely 4 registration officers and 3 patients who made outpatient visits. The data analysis used descriptive qualitative and the validity of the data used was data triangulation. The results show that the waiting time for outpatient medical record services for patients who register manually is longer than 60 minutes, the SOP for outpatient registration services has been implemented, it's just not done perfectly, Human resources in outpatient medical record services Sundari Hospital does not match educational qualifications, the facilities available in the outpatient medical record service at Sundari Hospital are incomplete, the technology has not been running well because the bridging system and administrative requirements for outpatients are not in accordance with Permenkes No. 28 of 2014.It is recommended that Sundari General Hospital be able to implement the requirements for outpatient administration in accordance with Permenkes No. 28/2014 and be able to implement a bridging system in outpatient services so that services can be carried out effectively and efficiently.
PANDEMIC-INDUCED LOCKDOWN'S SHOCK TO HOUSEHOLD LEVEL FOOD SECURITY
Authors:   Assistant Professor,  Centre for Distance & Online Education,  Rabindra Bharati University, Rabindra Bhavan,  EE-9 & 10, Bidhannagar, Kolkata , West Bengal, INDIA, Pal Tanmoy Kumar , Santra Subhrangsu ,   Assistant Professor, Department of Lifelong Learning & Extension, Visva-Bharati, Sriniketan, P.O- Sriniketan,  District – Birbhum, West Bengal, INDIA
Published: April 2021

The impact of the lockdown induced by the COVID-19 pandemic was devastating for the farm as well as the non-farm sectors of the Indian economy. Even though many authors expressed the apprehensions of hunger, and journalistic accounts of hunger appeared in newspapers, very few studies were undertaken to investigate the nature and extent of lockdown-induced food insecurity experienced by the households and understand the household management strategies adopted by those households. This study was undertaken in a village located in the Birbhum district of West Bengal during the unlock-I phase to fill the above-stated gap. Data for this study were collected from 40 households using a standardized tool known as the Household Food Insecurity Access Scale (HFIAS), and a semi-structured questionnaire. Results showed that inaccessibility of food was experienced by the households in three domains- anxiety and uncertainty (82.5% households), unsatisfactory quality (100% households), and insufficient quantity (77.5% households). However, quantitative scale scores of food insecurity showed that none of the households experienced the highest possible degree of food insecurity. The public distribution system and mid-day-meal programs were most effective in reducing the food insecurity of many families, but the level of support extended was not enough. More than half of the households reported a reduction in animal protein consumption, higher expenditure on vegetables and fruits, and an increase in taking loans. Based on the findings of the study, two specific suggestions were provided for facilitating the management of disruptions caused by lockdown-like emergency conditions.
PENGGUNAAN METODE COMMUNICATIVE LANGUAGE TEACHING PADA PELATIHAN KETERAMPILAN BERBICARA GURU SMA SINT LOUIS SEMARANG
Authors: Sarwendo Djoko Sri Bimo , Dartani Maria Yustina Rensi , Muflikah Binti
Published: April 2021

Pengabdian ini diadakan dengan tujuan untuk mengajarkan bahasa Inggris speaking kepada guru-guru SMA Sint Louis Semarang. Pengabdian ini berbentuk pelatihan yang bertujuan untuk membekali para guru di SMA Sint Louis Semarang agar dapat memiliki keterampilan berbicara, berkomunikasi dalam bahasa Inggris dengan baik dan benar, dan pelatihan ini diperuntukkan bagi seluruh guru, baik guru bahasa Inggris maupun guru bidang studi lain. Metode pembelajaran yang digunakan dalam pelatihan ini adalah Communicative Language Teaching (CLT). Metode tersebut mendorong para peserta pelatihan untuk lebih mengembangkan kemampuan dirinya, memahami tentang bahasa Inggris dan cara berkomunikasi, sehingga pada individu terjadi perubahan sikap dan memiliki kecakapan dalam berbicara bahasa Inggris. Teknik yang digunakan dalam pelatihan ini yaitu teknik deskriptif dengan pendekatan kuantitatif. Sampel berjumlah 25 orang peserta, berasal dari latar belakang bidang ilmu yang berbeda. Pelatihan dilakukan selama 10 kali dengan durasi waktu selama 90 menit setiap sesinya. Hasil menunjukkan bahwa ada peningkatan kemampuan peserta dalam berkomunikasi menggunakan Bahasa Inggris. Peserta mampu menuangkan idenya dan mengungkapkannya dalam percakapan. Berdasarkan hasil analisis secara deskriptif juga diperoleh adanya peningkatan minat dan motivasi peserta. Peserta sudah mulai memiliki rasa percaya diri saat melakukan percakapan (conversation) dengan teman ataupun dengan tim abdimas.
PEMPERDAYAAN PETANI PADI UNTUK MENINGKATKAN EKONOMI PERTANIAN MELALUI IMPLEMENTASI MESIN THRESHER DI DESA OPO-OPO SELAMA MASA PANDEMI COVID 19
Authors: Imaduddin Ilmi Rizki Imaduddin , Jannah Raudhatul , Dani Irfan , Putra Hendriano Andika , Imaduddin Muhammad , Umam Moch Chotibul , Rifqi Muhammad Wildan , Andhika Leo , Muniri Misbahul
Published: April 2021

Dampak terpuruknya perekonomian masyarakat akibat pandemi COVID-19 terjadi pula pada para petani padi dalam melakukan hasil panennya. Banyak petani tidak mematuhi protokol kesehatan COVID-19, dan di samping itu juga banyaknya pekerja dalam melakukan panen membutuhkan biaya yang cukup banyak, dan alat yang digunakan untuk panen padi tersebut masih menggunakan alat yang manual, sehingga membutuhkan waktu yang cukup lama. Oleh karna itu itu metode yang digunakan pada PKM ini meliputi, (i) Penelitian awal, (ii) Perumusan masalah  dan tujuan penelitian, (iii) Pengumpulan data, (iv) Perancangan mesin theser padi otomatis, (v) Implementasi hasil rancangan mesin thresher padi otomatis, (vi) Pengujian mesin thresherpadi otomatis, (vii) Kesimpulan, untuk peningkatan ekonomi pertanian yang dapa membuat petani lebih cepat proses panennya dari pada sebelumnya. Hasil dari perontokkan padi 1000-1800 per jam, dengan luas lahan antara 150 m3 – 220 m3, dengan putaran motor 106.2 S – 35.7 S. Program kemitraan masyarakat (PKM) ini juga sebagai sarana peningkatan ekonomi pertanian di Desa Opo-opo Kecamatan Krejengan Kabupaten Probolinggo di masa pandemi COVID-19.
New economic policy for Russia
Authors:   Primakov National Research Institute of World Economy and International Relations, Mirkin Yakov M.
Published: April 2021

Collective behavior model, deregulation, developmental state, economic liberalization, financial policy, life expectancy, new economic policy, super-fast growth.
What possibilities exist to back up the mechanisms which support economy in Russia
Authors:   Institute for Energy and Finance, Professor of the Financial University under the Government of the Russian Federation, Ershov Mikhail V.
Published: April 2021

The growth of state spending should rely on appropriate mechanisms of financing. In the crisis environment the large scale emission of state bonds in domestic market may cause worsening of finance conditions for private sector. The article outlines the reasons why domestic central bank should play more active role, purchasing state bonds as is the case in other countries.
Recovery from the current crisis and development paths of the Russian economy
Authors:   The Russian Presidential Academy of National Economy and Public Administration, Aganbegyan Abel G. , Porfiryev Boris N. ,   Institute of Economic Forecasting of the Russian Academy of Sciences, Shirov Alexander A. ,   Institute of Economic Forecasting of the Russian Academy of Sciences
Published: April 2021

The report contains proposals of VEO of Russia experts on the restoration of Russian economy and the transition to a dynamic and sustainable socioeconomic development. According to experts it is necessary to double the government’s anti-crisis measures in 2021 and maintain them at this level in the period 2022–2023. An increase of the anti-crisis program could be based on increased borrowing, and partly on the use of funds from the National welfare fund. The report contains measures for restoration of incomes of Russians, first to the level of 2019, and then to the level of 2012–2013 — that is 17% more than in 2020. The necessary structural reforms are listed. The implementation should be started in 2022, when a steady rise in the country’s economy is expected.
Prospects for the development in Russia of non-industrial (extensive) farming by the example of poultry
Authors:   CIS SERVICES (International consulting), Shibaev Stepan S.
Published: April 2021

The article considers prospects and potential for the development in Russia of non-industrial (extensive) poultry farming. The experience of France in this sector is analyzed, the ways of development in Russia are suggested.
Development of housing insurance in the national project «housing and urban environment»
Authors:   Financial University under the Government of the Russian Federation, Tsyganov Alexander A.
Published: April 2021

National projects adopted at the end of 2018 have an important impact on the development of Russian society and the economy, forming goals and targets, quantitative indicators of development. This should be taken into account when adopting new laws, but national projects should also be expanded and adjusted to take into account changes in the world and Russia, modern legislative initiatives.
Human resourses management strategies in Russian corporations on the way to noonomy
Authors:   Chelyabinsk State University, Pletnev Dmitri A. , Kazadayev Maxim S. ,   Chelyabinsk State University
Published: April 2021

The future economy is the economy of knowledge, and therefore those companies that will be able to build an effective human resource man agement system and be able to make a breakthrough become leaders in their industries in Russia and the world. The article presents the analysis of the fundamental documents of the strategic development of the largest Russian corporations for the inclusion in them of sections or mention of various aspects of human resources and human capital. The analysis of the use of these concepts in the strategies of Russian corporations related to the sectors of electric power, chemistry, petrochemistry, oil and gas, metals and mining. The classification of types of use in strategies of human resources and human capital has been carried out. For corporations of various types, the assessment of generalized indicators of the efficiency of corporations was carried out, based on which conclusions were drawn about the influence of human resources and human capital in the strategy on the efficiency of the work of Russian corporations.
Integrated logistics systems building with blockchain technology
Authors:   Ural State University of Economics, Khmel’nitskaya Zinaida B. , Bogdanova Elena S. ,   Ural State University of Railway Transport, Ivich Maria L. ,   State University of Economics
Published: April 2021

This article is devoted to research of the problem of “using blockchain technology” relevant for theory and practice for building integrated logistics systems. It is done by the authors critical analysis of the existing Russian and the world’s approach to building integrated logistics systems using progressive informatization technologies. The advantages and disadvantages of blockchain technology, as well as barriers that inhibit widespread use in practice, are noted. The algorithm (logical scheme) of this technology and its application in the development of computerization projects integrated logistics are given. The article provides examples of the use of blockchain technologies in various sectors of the economy, shows a detailed description of the information flow of a foreign trade transaction that involves a significant number of participants, and information on its implementation is concentrated in contracts and sales agreements.
Güvenlik Kültürü için Öğrenme Kuramlarının Değerlendirilmesi
Authors: KARAMAN Esra , BOZ ERAVCI Deniz
Published: April 2021

Güven, insanın temel ihtiyaçlarından biri olmakla birlikte sürdürülebilir güvenliğin sağlanması çeşitli bilgi beceri ve tutum gibi yetkinliklerin edinimini gerektirir. Çalışma, genel anlamda güven kavramını bir kültür unsuru olarak ele alarak ve her yaş için güvenlik farkındalığının ve yetkinliğinin kazanılmasının öğrenme yolu ile mümkün olduğunu açıklamıştır. Güvenlik kültürünün geliştirilmesi için bilimsel öğrenme kuramlarından faydalanılması gerektiğini savunan çalışmada, temel öğrenme kuramları açıklanmış ve güvenlik kültürü bu kuramlar çerçevesinde değerlendirilmiştir. Güvenlik kültürünün multidispliner ve hayat boyu devam eden bir ilgi alanı olması itibari ile zamanla gelişen kuramlarla desteklenerek sürekli geliştirilebileceği sonucuna varılmıştır
Médias ethniques chinois en France : des espaces de communication intra-diaspora en marge de la société ?
Authors: Li Zhipeng
Published: April 2021

Cet article décrit le développement récent des médias en langue chinoise en France, et plus spécifiquement des « médias ethniques », à savoir des médias créés par et pour les migrants chinois. Il met en évidence le lien étroit entre ces médias ethniques et la formation de l’entrepreneuriat diasporique dans le pays d’installation, qui repose sur des stratégies et des objectifs (aussi bien économiques que politiques) internes au groupe diasporique et peu visibles par le reste de la société française. Par ailleurs, cet article souhaite aussi aborder une évolution récente, quoique marginale : le développement de médias ethniques en langue française ciblant en priorité les descendants d’immigrés chinois. Si elle se confirmait, cette tendance pourrait contribuer à élargir la visibilité de ces médias. Le présent article repose sur des données collectées au cours de plusieurs enquêtes qualitatives auprès des organes de presse de la diaspora chinoise en France.
Perquisitionner les nuages - CLOUD Act, souveraineté européenne et accès à la preuve dans l'espace pénal numérique
Authors: Davis Frederick T. , Gunka Charlotte
Published: April 2021

À l'heure où la crise du Covid-19 a fait prendre conscience de la nécessité pressante pour les États européens de renforcer leur souveraineté nationale à travers celle de l'Union européenne, un retour aux possibilités offertes par le CLOUD Act américain en matière de souveraineté pénale et numérique s'impose. Le CLOUD Act propose en effet de réformer les mécanismes d'entraide judiciaire en consacrant le critère de l'accès à la preuve numérique autorisant des perquisitions informatiques hors des frontières étatiques, quelle que soit la localisation des données. Bien que ce critère permette une application extraterritoriale plus étendue des procédures pénales américaines, l'analyse des règlements européens et des législations en vigueur en France et au Royaume-Uni confirme que l'approche européenne n'est pas si différente de celle introduite par les États-Unis. L'émergence du monde informatique et l'accélération des nouvelles technologies ont créé un « espace pénal numérique », immatériel et sans frontière, qui nécessite une réforme profonde des procédures pénales permettant une coopération internationale plus rapide et efficace contre la criminalité transnationale. Cette réforme doit permettre à l'Europe, notamment par le biais de son nouveau Parquet européen, d'affirmer sa souveraineté numérique grâce aux droits fondamentaux individuels qu'elle contribue à véhiculer sans troquer la sécurité et les intérêts stratégiques de ses États membres.
La soumission de l'arbitrage international à un régime protecteur du consommateur
Authors: Loquin Éric
Published: April 2021

Au nombre des moyens adéquats et efficaces devant garantir aux consommateurs un droit à un recours effectif doit figurer la possibilité d'introduire un recours ou de former opposition dans de conditions procédurales raisonnables, de sorte que l'exercice de leurs droits ne soit pas soumis à des conditions, notamment de délais ou de frais, qui amenuisent l'exercice des droits garantis par la directive 93/13. Selon la Cour de justice, en l'absence de réglementation communautaire en la matière, les modalités procédurales visant à assurer la sauvegarde des droits que les justiciables tirent du droit communautaire relèvent de l'ordre public interne de chaque État membre en vertu du principe de l'autonomie procédurale des États membres, à condition toutefois qu'elles ne soient pas moins favorables que celles régissant des situations similaires de nature interne (principe d'équivalence) et qu'elles ne rendent pas impossible en pratique ou excessivement difficile l'exercice des droits conférés par l'ordre juridique communautaire (principe d'effectivité). Il résulte de l'article 1448 du code de procédure civile, applicable à l'arbitrage international en vertu de l'article 1506 du même code, sauf si les parties n'en sont autrement convenues, que lorsqu'un litige relevant d'une convention d'arbitrage est porté devant une juridiction de l'État, celle-ci se déclare incompétente sauf si le tribunal arbitral n'est pas encore saisi et si la convention d'arbitrage est manifestement nulle ou manifestement inapplicable. La règle procédurale de priorité édictée par ce texte ne peut avoir pour effet de rendre impossible, ou excessivement difficile l'exercice des droits conférés au consommateur par le droit communautaire que les juridictions nationales ont l'obligation de sauvegarder. Dès lors, la cour d'appel qui, après en avoir examiné l'applicabilité, en tenant compte de tous les éléments de droit et de fait nécessaires dont elle disposait, a écarté la clause compromissoire en raison de son caractère abusif, a, sans méconnaitre les dispositions de l'article 1448 du code de procédure civile, accompli son office de juge étatique auquel il incombe d'assurer la pleine efficacité du droit communautaire de protection du consommateur.
La propriété cédée à titre de garantie sans publicité en Allemagne reste valable après le déplacement du bien en Autriche
Authors: Faber Wolfgang , Costa Martine
Published: April 2021

Renversant une jurisprudence constante depuis des décennies, la Cour suprême d'Autriche décide qu'une propriété valablement cédée en Allemagne à titre de garantie au moyen d'un constitut possessoire - c'est-à-dire sans publicité - reste valable après le transfert du bien grevé en Autriche.
Repenser l’identité de l’aviateur en raison des considérations technologiques et prospectives
Authors: Mestre Thierry
Published: April 2021

Pendant longtemps, l’aviateur s’est identifié au pilote, le héros de l’air. Aujourd’hui, les conditions d’emploi ont évolué avec des perspectives et des emplois différents, bien éloignés des « As » des premiers temps. Pour autant, l’Armée de l’air et de l’espace pourra toujours s’appuyer sur des aviateurs fiers d’eux et de leurs missions.
L’équipage de la Marine
Authors: Liot de Nortbécourt Vincent
Published: April 2021

La Marine, ce sont des marins pour former l’équipage. D’où l’importance de la dimension humaine pour le recrutement, la formation, l’entraînement et l’engagement opérationnel. Un marin compétent et aguerri doit pouvoir exercer son métier dans la sérénité, en particulier dans son environnement personnel et familial.
La gestion des militaires de la Gendarmerie nationale par l’intelligence artificielle ?
Authors: Vaquette William
Published: April 2021

L’intelligence artificielle (IA) peut apporter des outils pertinents pour une meilleure gestion des ressources humaines de la Gendarmerie. Déjà, l’IA contribue à améliorer les processus RH, à condition d’en conserver la maîtrise au profit de la sécurité de nos concitoyens.
Il y a vingt ans, l’opération Héraclès : un succès à revisiter
Authors: Lavernhe Thibault
Published: April 2021

Le groupe aéronaval autour du porte-avions Charles-de-Gaulle , alors juste entré en service, a été engagé pour Héraclès . Le saut qualitatif fut important avec cette opération et a fait progresser nos forces. Ses leçons restent pertinentes avec l’arrivée de nouveaux systèmes comme les Fremm et les SNA de la classe « Suffren ».
Donzoko à Tokyo : la Défense nationale neuve
Authors: Esmein Jean
Published: April 2021

Au mitan des années 1950, le Japon – dans le contexte de la guerre froide – doit reconstruire ses forces de sécurité en faisant appel aux anciens cadres de l’armée impériale dissoute en 1945. D’où l’intérêt de ce témoignage historique évoquant cette période mal connue du Japon sortant de la guerre et imprégné de pacifisme.
Coup de projecteur sur le recul silencieux de l'infraction continue en droit pénal
Authors: Bouchet Marthe
Published: April 2021

Résumé L'infraction continue, celle dont l'exécution se prolonge dans le temps, est une catégorie d'infraction bien ancrée dans la théorie générale du droit pénal. Cependant, cette notion semble être en net recul, le débat sur le caractère continu de l'infraction devenant de plus en plus souvent secondaire. Le recul de l'infraction continue s'explique de deux façons. D'une part, le législateur a consacré d'autres notions, qui restreignent la place de l'infraction continue. D'autre part, la jurisprudence semble se détourner de l'infraction continue, pour ne pas risquer de heurter le principe ne bis in idem , en plein essor aujourd'hui.
Effects of the substitution of fishmeal with mealworm meal on enzymes, haemolymph and intestinal microbiota of the Pacific white shrimp
Authors: Rios C. , Panini R.L. , Menezes L.A. Acordi , Vieira F.N. , Fracalossi D.M. , Samuels R.I. , De Dea Lindner J. , Silva C.P.
Published: April 2021

Shrimp farming is one profitable sector of aquaculture and the Pacific white shrimp (Litopenaeus vannamei) is the most cultivated species worldwide. Nutrition is considered as one of the greatest challenges in shrimp farming due to its dependence on fishmeal (FM) as an ingredient in the feed. The main goal of the present work was to analyse if the substitution of FM by yellow mealworm (Tenebrio molitor) meal (TM) influences digestive enzyme expression, haemolymph parameters or the intestinal microbiota of shrimp juveniles. Shrimps (average initial weight 4.42±0.02 g) were fed five experimental diets where FM protein was gradually substituted by TM protein (0, 25, 50, 75, and 100%). The shrimps were fed four times per day with an amount equivalent to approximately 6% of their biomass for 42 days. The total haemocyte count, protein concentration and prophenoloxidase activity in the haemolymph were not significantly altered (P>0.05) when FM was substituted by TM. However, the agglutinating activity of shrimp serum determined against dog erythrocytes was higher in the shrimp group fed 25% TM. The absolute and specific activities of trypsin, chymotrypsin, lipase, α-amylase and the patterns of proteolytic activities were not affected by the dietary treatments. The shrimp gut bacterial microbiota profile was similar with the generaPseudoalteromonas, Rubritalea, Ruegeria, Tenacibaculum, andVibrio detected. These results show that TM is viable alternative for the replacement of FM, without any deleterious effects on expression of key digestive enzymes, gut microbiota or the immune system of the Pacific white shrimp.
TEACHING NURSING DIAGNOSES TO SCHOOL NURSES: A Standardized Measure of the Cognitive Effect
Authors: Crosby Frances Stevralia , Dunn Joan Dolce
Published: April 2021

ABSTRACT

A continuing education program on nursing diagnosis was conducted for school health nurses. A formal evaluation procedure was performed to measure the programs effectiveness in cognitive and behavioral terms. This article describes the process to measure the cognitive impact. Twenty-one school nurses volunteered to participate and were randomly assigned to the experimental group (N = 10) or the control group (N = 11). Five school health or nursing diagnosis experts created and reviewed two case studies in a two-round review for consensus and to validate a rating standard. Nurses in the experimental group read and assigned nursing diagnoses to a case study, before and after participating in the five-week program. Accurate nursing diagnoses reported for the case study increased with statistical significance from pre to post test. While behavior, or use of nursing diagnoses in clinical practice, was the ultimate goal, assurance of the ability to accurately assign nursing diagnoses was an essential intermediate step. The simulated case study, with an expert panel to formulate an objective rating standard, provided a feasible and effective method to measure accurate identification of nursing diagnoses, the cognitive domain.
OPERATIVE MANAGEMENT OF ACUTE PCL INJURIES WITH ASSOCIATED PATHOLOGY: LONG-TERM RESULTS
Authors: Barrett Gene R , Savoie Felix H
Published: April 2021

ABSTRACT

Eighteen consecutive patients with posterior cruciate ligament injury and associated pathology were reviewed. All were re-examined with an average follow up of 5.4 years (range: 3.5 to 7.5). Six posterior cruciate ligaments were repaired to the femur with multiple #2 nonabsorbable suture, and one "mop end" mid-substance tear was repaired with sutures in each stump. Seven mid-substance tears were repaired and augmented with the semitendinosus tendon, while four additional mid-substance tears were repaired and augmented with the semitendinosus tendon and a Dacron stent (Meadox). One medial meniscus was repaired and one was partially excised, and one lateral meniscus tear was partially excised. The anterior cruciate ligament was repaired to the tibia in two knees, left alone (interstitial tear) in two, and excised with extraarticular iliotibial band tenodesis augmentation in five.

At follow up, arthrometer readings (Stryker) correlated well with clinical examination. The four knees with Dacron stent had a 0 to 1 mm difference at 90°, while the failures had greater than 5 to 6 mm. Six of these were in the repair alone group and two were in the repair with semitendinosus augmentation group. Eight knees (44.5%) had radiographic changes primarily in the medial compartment Using Hughston's perimeters to evaluate the results, objective 55.5% (10) were rated good, 27.8% (5) were rated fain, and 16.7% <3) were rated poor or failures. Using Clancy's criteria, 22.2% (4) were excellent, 22.2% (4) were good, 44.5% (8) were fair, and 11.1% (2) were rated failures.

Neither repair of the posterior cruciate ligament alone or semitendinosus augmentation of the proximal one third or mid third substance tears gave adequate stabilization in this series. A synthetic stent does seem to keep the tibia in a reduced position and improve results. This eliminates problems with pins and braces in an attempt to maintain the tibia in a reduced position. Although the patella tendon was not utilized in this retrospective study, we do not know what effect this would have on the frequently affected patellofemoral joint during the rehabilitation phase of this type of injury.
An Innovative Method Using the Leeds-Keio Artificial Ligament in the Unstable Spine
Authors: Mochida Joji , Toh Eiren , Suzuki Kanae , Chiba Masahiro , Arima Toni
Published: April 2021

ABSTRACT

We have designed two innovative surgical procedures using the Leeds-Keio artificial ligament to solve the difficult problems caused by the difference in physical properties between bone structure and spinal implants, such as pedicle screw systems, used for treating the unstable lumbar spine. The procedures aim at intervertebral immobilization or reinforcement of a posterior lumbar interbody fusion. Twenty-one patients with over 2 years of follow up were evaluated. The clinical results showed these procedures to be advantageous compared with various pedicle screw systems. We conclude that these combined procedures may be applicable to patients with various types of unstable lumbar spine problems who, until now, were treated with instrumentation surgery. The best indications for these two procedures are degenerative spondylolisthesis or degenerative disk lesion with various instabilities, degenerative canal stenosis for which wide laminectomy is essential, and herniated disk with instability during flexion.
A Simple Method to Measure Compartment Pressures Using an Intravenous Catheter
Authors: Wilson Scott C , Vrahas Mark S , Berson Lawrence , Paul Emmanuel M
Published: April 2021

ABSTRACT

A simple method was investigated to measure compartment pressures using 16-ga intravenous catheters with or without side ports attached by arterial line tubing to a pressure transducer. Pressure measurements from the experimental catheters were within 4 mm Hg of the slit catheter for 99% of all readings, and pressure measurements from the Stryker device were within 5 mm Hg of the slit catheter for 95% of all readings. The addition of one or two side ports to the experimental catheters did not alter the pressure readings. This method is comparable in accuracy to the slit catheter and in simplicity to the Stryker device.
Lateral Extracavitary Approach to the Thoracic and Thoracolumbar Spine
Authors: Graham Angus W , Millan Michael Mac , Fessler Richard G
Published: April 2021

ABSTRACT

Twenty-nine patients with anterior spinal cord compression underwent decompression and fusion through a laterally based approach to the thoracic and thoracolumbar spine. The lateral extracavitary approach allows access to the vertebral bodies as well as the posterior elements through a single incision. This approach was chosen for patients who had complicating medical conditions that made staged procedures less desirable. Ten men and 19 women with an average age of 53 years were studied. Diagnoses included post-traumatic deformity, metastatic disease, osteomyelitis, and primary neoplasms. Twenty-three patients had frank neurologic loss preoperatively, and 28 patients had significant medical comorbidities as evidenced by American Society of Anesthesiology classes II, III, and IV. One patient died postoperatively from pneumonia, which developed in a lung with metastatic disease, and two patients developed seromas that subsequently became infected. The average intensive care unit stay was less than 2 days. Patients remained intubated for an average of 1 3 hours after surgery.

In this population of medically compromised patients with difficult spinal disease, the lateral extracavitary approach provided an effective means of one-stage treatment. Patients tolerated the procedure, and cardiopulmonary complications were minimal. This approach is most appropriate in patients who require posterior stabilization in conjunction with anterior stabilization.
Femoral Fixation in Primary Total Hip Arthroplasty
Authors: Engh Charles A , Culpepper William J
Published: April 2021

Femoral Fixation Options in the 1990s
Dissociated Horizontal Deviation
Authors: Wilson M Edward , McClatchey Scott K
Published: April 2021

ABSTRACT

Despite the emphasis placed on the vertical aspect of the deviation by its currently accepted clinical label, dissociated vertical deviation is well known to include movements in both the torsional and horizontal planes. When the horizontal component is very prominent, dissociated horizontal deviation is suggested as an appropriate label. We report the clinical characteristics and surgical treatment of six patients with a dissociated horizontal deviation that was marked enough to be the reason for seeking medical attention. All patients underwent lateral rectus recession unilaterally or bilaterally, alone or in combination with superior rectus recession. In addition, we report the use of the darkening wedge test to demonstrate the Bielschowsky phenomenon in the horizontal plane. This phenomenon, a dissociated exotropia spontaneously moving toward and crossing the midline to become an esotropia under cover when a progressively darkening filter is placed over the fixing eye, has not to our knowledge been previously reported.
Radiation Regression Patterns in Treated Retinoblastoma: 7 to 21 Years Later
Authors: Abramson David H , Gerardi Cynthia M , Ellsworth Robert M , McCormic Beryl , Sussman David , Turner Liebert
Published: April 2021

ABSTRACT

A retrospective review of cases on file at the Ophthalmic Oncology Center of The New York Hospital-Cornell Medical Center, New York was performed in order to examine the appearance of radiation regression patterns 7 or more years after successful treatment of retinoblastoma with external beam radiotherapy.

Forty-eight patients were found to have 89 tumors in 57 eyes which were treated solely with external beam radiation; they were followed for a minimum of 7 years and had sufficient information available for analysis. All but five of the patients had bilateral retinoblastoma. Seventy-four of the 89 tumors continued to be ophthalmoscopically visible after 7 or more years. Taking into account those that did change between the time of first evaluation (usually at the completion of treatment) and final evaluation (7 or more years after treatment), the number of Type I regressions increased by 10.1%, Type lis decreased by 19.1%, Type Ills fell by 7.8%, Type IVs rose by 10.1%, and the number of tumors that disappeared increased by 6.8%. Type Il remained the most common regression throughout the follow-up. The regression with the greatest potential for change was the Type Il regression. The pretreatment volume of the tumor correlated with long-term radiation regression patterns. The smallest tumors (mean size 1.1 dd [disc diameter] or less in size) completely disappeared, while the largest (mean 9.9 dd) became Type I regressions.
Stereopsis Testing to Reduce Overreferral in Preschool Vision Screening
Authors: Ruttum Mark S , Nelson David B
Published: April 2021

ABSTRACT

Three- and 4-year-old children who obtain the minimum failing visual acuity result of one-line difference between eyes in preschool vision screening with isolated optotypes have a high rate of overreferral. We evaluated the Random Dot E Stereotest (RDES) to determine if a passing result at a high threshold on this test, as administered by lay screeners, could safely nullify referral for a minimum failing visual acuity test result. Fifty-eight children with a "one-line difference" result also had the RDES administered to them during screening at distances of 40 cm and 1.5 m. Upon subsequent ophthalmologic examination, 45 of these children were found to be normal, and 13 had abnormal findings. Thirty-nine of the children with normal examinations had correctly passed the RDES at 1.5 m. Seven of the 13 children with abnormal findings had correctly failed the RDES. Thus, the specificity of stereotesting was 87% and the sensitivity was 54%. Among the six children who falsely passed the stereopsis test during screening, best-corrected visual acuity was no worse than 20/40 and no child had greater than a one-line difference in acuity. Therefore, no amblyopia was missed. If a passing result on the stereotest at 1.5 m had been allowed to nullify a one-line difference referral, overreferral would have decreased 87% but underreferral would have increased 46%. We cannot yet recommend modifying current visual acuity referral criteria based on stereopsis testing results until the sensitivity of stereopsis screening by lay screeners at a sufficient threshold is improved.
Strabismus Following Endoscopic Intranasal Sinus Surgery
Authors: Eitzen John P , Elsas Frederick J
Published: April 2021

ABSTRACT

Two patients developed exotropia with limited medial rectus function following endoscopic intranasal ethmoid sinus surgery. In both patients, fractures occurred in the medial orbital wall. The first patient required horizontal rectus muscle surgery to regain ocular alignment. The second required no surgery, but was left with limited horizontal motility secondary to scarring at the fracture site. While endoscopic techniques improve the surgeon's view of sinus anatomy, they do not eliminate the risk of entering the orbit and causing ocular complications.
Predictors of Prism Response During Prism Adaptation
Authors: Repka Michael X , Wentworth Deborah
Published: April 2021

ABSTRACT

Results of the Prism Adaptation Study (PAS) indicate that prism adaptation improves the success rate of strabismus surgery for patients with acquired esotropia. Patients who show a fusion response to the prisms benefit most from this preoperative treatment. This study analyzes the characteristics of those patients who were and were not prism responders in the PAS. Significant factors predicting a prism response included: patients who were older at the time of onset of their esodevlation (P = .007), duration of deviation less than 1 year (P = .04), alternating fixation (P = .003), fusion on the Worth four-dot test at near with prism neutralization (P = .008), and equal vision (P = .009). Demographic characteristics were similar for both responders and nonresponders except that non-Hispanic patients were significantly more likely to respond to prisms than Hispanic patients (P < .002). No test or characteristic was found which could reliably predict the prism response. Therefore, all patients with acquired esodeviations should be considered candidates for prism adaptation prior to strabismus surgery.
Ocular Findings in Conjoined (Siamese) Twins
Authors: Mansour Ahmad M , Mansour Nada , Rosenberg Harvey S
Published: April 2021

ABSTRACT

Conjoined twinning is a rare form of congenital anomaly. The ocular findings in six sets of conjoined twins as well as those reported elsewhere include abnormal optic nerve decussation, pseudosynophthalmos, microphthalmia, abnormal eyelids, orbital encephalocele, occipital encephalocele, and eyelid coloboma. These findings are interpreted as due to deformations from appositional fusion-related factors or malformations from developmental factors.
Treatment of Glaucoma in Children With Sturge-Weber Syndrome
Authors: Van Emelen C , Goethals M , Dralands L , Casteels I
Published: April 2021

ABSTRACT

Background: Sturge-Weber syndrome is a rare congenital neuro-oculocutaneous disorder. Ocular involvement can include glaucoma and vascular malformations of the conjunctiva, episclera, choroid, and retina.

Methods: The records of 19 Sturge-Weber syndrome patients (mean age 8.2 years) treated at our institution were reviewed to determine the incidence of ophthalmologic manifestations in Sturge-Weber syndrome.

Results: Glaucoma occurred in 42% of all patients and was more frequent in patients with a port-wine stain involving both upper and lower eyelids. Other ocular manifestations included conjunct! va l/episc lera I hemangioma, choroidal hemangioma, iris heterochromia, retinal detachment, strabismus, and homonymous hemianopia.

In 7 of 8 patients with glaucoma, topical pharmacotherapy (beta-blockers and carbonic anhydrase inhibitors) alone failed to normalize intraocular pressures. In those patients, cryocoagulation of the ciliary body was performed. Mean postoperative intraocular pressure after a mean follow-up of 4-5 years was <22 mm Hg in 6 patients.

Conclusions: Cryocoagulation of the ciliary body combined with topical medication is an effective and safe treatment option in the management of glaucoma in children with Sturge-Weber syndrome.

Journal of Pediatrie Ophthalmology and Strabismus 2000;37:29-34.