bluuebunny/crossref_metadata_2025 huggingface dataset:
Angiotensin 1–7 in an experimental septic shock model
Authors: Garcia Bruno , Su Fuhong , Manicone Francesca , Dewachter Laurence , Favory Raphaël , Khaldi Amina , Moiroux-Sahroui Alexander , Moreau Anthony , Herpain Antoine , Vincent Jean-Louis , Creteur Jacques , Taccone Fabio Silvio , Annoni Filippo
Published: March 2023

Background

Alterations in the renin–angiotensin system have been implicated in the pathophysiology of septic shock. In particular, angiotensin 1–7 (Ang-(1–7)), an anti-inflammatory heptapeptide, has been hypothesized to have beneficial effects. The aim of the present study was to test the effects of Ang-(1–7) infusion on the development and severity of septic shock.

Methods

This randomized, open-label, controlled study was performed in 14 anesthetized and mechanically ventilated sheep. Immediately after sepsis induction by bacterial peritonitis, animals received either Ang-(1–7) (n = 7) or placebo (n = 7) intravenously. Fluid resuscitation, antimicrobial therapy, and peritoneal lavage were initiated 4 h after sepsis induction. Norepinephrine administration was titrated to maintain mean arterial pressure (MAP) between 65 and 75 mmHg.

Results

There were no differences in baseline characteristics between groups. Septic shock was prevented in 6 of the 7 animals in the Ang-(1–7) group at the end of the 24-h period. Fluid balance and MAP were similar in the two groups; however, MAP was achieved with a mean norepinephrine dose of 0.4 μg/kg/min in the Ang-(1–7) group compared to 4.3 μg/kg/min in the control group. Heart rate and cardiac output index were lower in the Ang (1–7) than in the control group, as were plasma interleukin-6 levels, and creatinine levels. Platelet count and PaO2/FiO2 ratio were higher in the Ang-(1–7) group. Mean arterial lactate at the end of the experiment was 1.6 mmol/L in the Ang-(1–7) group compared to 7.4 mmol/L in the control group.

Conclusions

In this experimental septic shock model, early Ang-(1–7) infusion prevented the development of septic shock, reduced norepinephrine requirements, limited interleukine-6 increase and prevented renal dysfunction.
Subsurface structure identification at the blind prediction site of ESG6 based on the earthquake-to-microtremor ratio method and diffuse field concept for earthquakes
Authors: Nagashima Fumiaki , Kawase Hiroshi , Nakano Kenichi , Ito Eri
Published: March 2023

We participated in the blind prediction exercise organized by the committee of the blind prediction experiment during the 6th International Symposium on Effects of Surface Geology on Seismic Motion (CBP-ESG6). In response to the committee's request, we identified the ground velocity structure from microtremors observed at a target site as the first step of the exercise. First, we calculated the horizontal-to-vertical spectral ratio of microtremors (MHVR) at the target site from the distributed microtremor data collected in the vicinity of the target site in Kumamoto Prefecture. Then, we converted the MHVR into a pseudo horizontal-to-vertical spectral ratio of earthquake (pEHVR) using the previously proposed and validated earthquake-to-microtremor ratio (EMR) method, where an empirically obtained EMR is used to convert MHVR into pEHVR. Next, we inverted the S-wave and P-wave velocity structures based on the pEHVR and the diffuse field concept for earthquakes. The theoretical EHVR calculated from the identified velocity structure reproduced the pEHVR quite well in the frequency range of 0.1–22 Hz. After the collection of the blind prediction results by all the participants, the CBP-ESG6 released the observed earthquake records, a preferred model based on the P–S logging data from the in-situ borehole measurement combined with the generic deeper structure, and the average of all the predicted structures by the participants. Notably, our inverted structure was found to be close to the preferred model and the averaged one of all the blind prediction participants, despite some minor differences in the horizontal site amplification factor around the maximum peak frequency at 0.8–1 Hz.

Graphical Abstract
Reservoir characteristics of lacustrine mixed siliciclastic-carbonate sedimentary rocks: A case study of the Paleogene Funing second member in the Subei Basin, China
Authors: Li Wei , Zhu Xiaomin , Liu Qidong
Published: March 2023

Unique lacustrine mixed siliciclastic-carbonate sedimentary rocks accumulated during the deposition of the second member of the Paleogene Funing Formation in the Jinhu and Gaoyou Sags, Subei Basin, which has significant scientific and petroleum exploration value. The reservoir characteristics of the deposits were summarized by means of core observation, petrographic analyses, scanning electron microscope analysis, porosity and permeability tests, carbonate content measurement, and X-ray diffraction clay mineral analyses. These special deposits consisting of siliciclastics and allochems were mainly found in a shallow lake at the front and side of the deltas and also were found in the gravity flow deposits of a deep lake. The results indicate that the lithology and dissolution of early calcite blocks of cement together influence the reservoir performance. From a sedimentological perspective, two types of lacustrine deposits are present in the study area. The first one preserves massive or graded bedding composed of allochems (ooids and intraclasts) and siliciclastics (mainly quartz) of various grain sizes as well as marl; this type of reservoir is poorly sorted. The second one preserves wavy cross-lamination composed of ooids and quartz of similar size; this type of reservoir is well sorted. The diagenesis of the reservoirs in the study area mainly includes compaction, cementation, and dissolution. Reservoirs with massive or graded bedding were impacted by compaction, with current porosity of less than 5%. Reservoirs with wavy cross-lamination could form high-quality reservoirs with porosity of up to 22%, in which the secondary dissolution pores represent the main type of porosity. The early calcite cementation may have inhibited compaction prior to the formation of solution vugs and the formation of high-quality reservoirs.
Narratives and Empirical Strategies in Zvi Griliches's Early Research
Authors: Biddle Jeff E.
Published: March 2023

Zvi Griliches was one of the leading econometricians of his generation. His early work involved empirical analyses of the sources of productivity growth in twentieth-century US agriculture, including his dissertation on the diffusion of hybrid corn and his analysis of the long-run growth in fertilizer use by US farmers. In this research Griliches developed theoretical explanations of these phenomena in the form of narratives of rational, profit-seeking people responding to changing circumstances and novel information, and he used these narratives to inform his decisions about what statistical techniques to employ and how to implement them. Narratives served the same purposes for Griliches that mathematical models were coming to serve in the work of his contemporaries, but they made more sense for Griliches, given his belief that he was analyzing transitions between economic equilibria, a process for which economists had not developed useful mathematical models.
Probing Arts and Emergent Forms of Life
Authors: Fischer Michael M. J.
Published: March 2023

In Probing Arts and Emergent Forms of Life Michael M. J. Fischer calls for a new anthropology of the arts that attends to the materialities and technologies of the world as it exists today. Fischer examines the work of key Southeast and East Asian artists within the crucibles of unequal access, geopolitics, reverberating past traumas, and emergent socialities. He outlines the work of artist-theorists---including Entang Wiharso, Sally Smart, Charles Lim, Zai Kuning, and Kiran Kumar---who speculate about changing the world in ways that are attuned to its cultivation, repair, and rethinking in the Anthropocene. Their artistic vocabulary not only undoes Western art models and categories; it probes the unfolding future, addresses past trauma, and creates contested, vibrant, and flourishing spaces. Throughout Indonesia, Korea, Singapore, Thailand, and Vietnam---and from Kumar’s experimental dance to Kuning’s rattan and beeswax ghost ships to Lim’s videography of Singapore from the sea---Fischer argues that these artists’ theoretical discourses should be privileged over those of the curators, historians, critics, and other gatekeepers who protect and claim art worlds for themselves.
Διαχρονική έρευνα των μεταβολών καλύψεων/χρήσεων γης για τη διαχείριση και διοίκηση γαιών και φυσικών οικοσυστημάτων υδρολογικής λεκάνης απορροής της Μυγδονίας με χρήση Γεωγραφικών Συστημάτων Πληροφοριών και Τηλεπισκόπησης
Authors: Βογιατζής Μόσχος
Published: March 2023

Η γεωχωρική καταγραφή και παρακολούθηση των μορφών κάλυψη γης/χρήσεων γης μέσω χρονικών σειρών δορυφορικών δεδομένων αποτελεί πρόκληση για την επιστημονική κοινότητα. Η διατριβή αυτή εστιάζει στην αξιολόγηση μεθόδων για την γεωχωρική αναγνώριση και καταγραφή των μορφών κάλυψης/χρήσεων γης και την ανίχνευση μεταβολών τους σε βάθος δεκαετίας. Με βάση την προτεινόμενη μεθοδολογία, ερευνήθηκε σε βάθος η διαχρονική αναγνώριση και καταγραφή των μορφών κάλυψης γης και οικοσυστημάτων της λεκάνης απορροής με την επεξεργασία και αντιπαραβολή διαθέσιμων γεωχωρικών δεδομένων από διάφορες πηγές (δορυφορικά δεδομένα, χαρτογραφικά υπόβαθρα ΕΚ, LPIS, δεδομένα κτηματογράφησης, δασικών χαρτών και τύπων οικοτόπων του δικτύου «Natura2000»). Διαπιστώθηκε μεγάλη ετερογένεια τοπίου και χωρική εναλλαγή των οικοσυστημάτων. Με βάση χρονικές σειρές εικόνων Landsat-5 TM και 8 OLI εξετάστηκαν οι διεποχιακές και διαχρονικές διακυμάνσεις της αντανάκλασης των υφιστάμενων μορφών κάλυψης γης μέσω φασματικών μετασχηματισμών (NDVI, EVI, MNDWI, NDMI, SAVI και MSAVI). Τα παραδείγματα που παρουσιάζονται είτε αφορούν αμετάβλητα στο χρόνο χαρακτηριστικά είτε μεταβολές αυτών, τεκμηριώνουν τη συσχέτισή τους με τις καταγραμμένες τιμές αντανάκλασής τους σε εικόνες Landsat ανά εποχή και σε βάθος χρόνου. Αναπτύχθηκαν και αξιολογήθηκαν διάφορα σενάρια ταξινόμησης μορφών κάλυψης γης με διαφορετικούς αλγόριθμους (RF, ML και Κ-ΝΝ) σε επίπεδο περιοχής έρευνας αλλά και ανά υποπεριοχή (δάση, υγρότοποι, λοιπές περιοχές) για τη διερεύνηση της ετερογένειας τοπίου. Ως προς την ταξινόμηση εικόνων Landsat, αναγνωρίστηκαν 8 κατηγορίες γης και η μεγαλύτερη ολική ακρίβεια (93,02%) επιτεύχθηκε με τον αλγόριθμο Κ-ΝΝ, με βάση διεποχιακές εικόνες Landsat 8 OLI (κανάλια 12: 2-7, EVI και NDMI). Σε επίπεδο ταξινόμησης ανά υποπεριοχή, αναγνωρίστηκαν περισσότερες κατηγορίες γης ενώ η ολική ακρίβεια αυξήθηκε σημαντικά στα δάση (RF: 95,58%) και στους υγροτόπους (RF: 98,94%). Συγκριτικά, στην ταξινόμηση εικόνων Sentinel-2a MSI λήψης θέρους (κανάλια 10: 2-8, 8A, 11 και 12) αναγνωρίστηκαν περισσότερες κατηγορίες γης (12) και η ολική ακρίβεια ανήλθε σε 90,91% (RF). Συνολικά, σε επίπεδο λεκάνης απορροής, ανιχνεύθηκαν διάσπαρτες μεταβολές μικρής επιφάνειας, κυρίως λόγω αλλαγής καλλιεργειών. Οι μεγαλύτερες μεταβολές στο χρόνο παρατηρήθηκαν στις υγροτοπική περιοχή, με τη διαδοχική εναλλαγή τύπων οικοτόπων, οι οποίες οφείλονται στις μετακινήσεις των υδάτων της λίμνης Κορώνειας.
Παράλιες και νησιωτικές κοινότητες στο Βορειοανατολικό Αιγαίο κατά την 5η και 4η χιλιετία π.Χ.
Authors: Χαλκιώτη Αρετή
Published: March 2023

Η παρούσα διδακτορική διατριβή έχει ως στόχο να αναπτύξει μια μεθοδολογία έρευνας της παράλιας ζώνης και μελέτης των ενάλιων διαστάσεων του πολιτισμού κατά τη Νεολιθική περίοδο στο Βορειοανατολικό Αιγαίο, με έμφαση στην 5η και 4η χιλιετία π.Χ. Βασίζεται στην άποψη ότι η ενάλια αρχαιολογική έρευνα θα πρέπει να ξεφύγει από τη διερεύνηση μεμονωμένων θέσεων και να υιοθετήσει μια τάση για περισσότερο εκτεταμένες έρευνες και σε ευρύτερη κλίμακα που θα συμπεριλαμβάνει τη μελέτη των συσχετισμών ανάμεσα στο ενάλιο τοπίο της παράλιας ζώνης και τις αρχαιολογικές θέσεις. Ενστερνίζεται την άποψη που τα τελευταία χρόνια έχει αρχίσει να αναγνωρίζεται από πολλούς ερευνητές για την ανάγκη να διευρυνθεί η οπτική της ενάλιας αρχαιολογίας και να συμπεριλάβει στην έρευνά της αρχαιολογικές θέσεις που δεν είναι υποβρύχιες, βρίσκονται μεν στη στεριά αλλά ουσιαστικά έχουν ναυτικό προσανατολισμό. Στα πλαίσια αυτά εξετάζεται η χωρική κατανομή και τα αρχαιολογικά δεδομένα των εντοπισμένων παράλιων και νησιωτικών οικισμών του ΒΑ Αιγαίου σε συνάρτηση με τα γεωμορφολογικά χαρακτηριστικά, τα παλαιοκλιματικά και ωκεανογραφικά δεδομένα αυτής της περιοχής. Το πως χρησιμοποιείται το θαλάσσιο περιβάλλον, οι σχέσεις που αναπτύσσονται μεταξύ των παράλιων και νησιωτικών κοινοτήτων σε αυτό το γεωγραφικό χώρο και πως (και αν) η θαλάσσια επικοινωνία επιδρά στα πολιτισμικά χαρακτηριστικά της περιοχής, όπως αυτά εκδηλώνονται μέσω των αρχαιολογικών δεδομένων, είναι θεμελιώδη ζητήματα που επιδιώκεται να διερευνηθούν καθώς μπορούν να αναδείξουν σημαντικές πληροφορίες όσον αφορά την ίδρυση και οργάνωση των προϊστορικών οικισμών στο ΒΑ Αιγαίο. Αναλύονται οι αλλαγές στη στάθμη της θάλασσας κατά το δεύτερο μισό του Ολόκαινου, οι παράγοντες που την επηρεάζουν και η δυνατότητα ανασύστασης της παλαιοακτογραμμής με βάση τα γεωμορφολογικά χαρακτηριστικά του ευρύτερου τοπίου και τα τοπικά χαρακτηριστικά των ως τώρα εντοπισμένων νεολιθικών οικισμών. Δίνεται βαρύτητα στον εντοπισμό κομβικών σημείων του ενάλιου πολιτισμού κατά χρονικές περιόδους (Νεότερη και Τελική Νεολιθική) και στη χαρτογράφηση πιθανών περιοχών εντοπισμού νεολιθικών οικισμών που συνδέονται με την ακτογραμμή της περιόδου. Ο δεύτερος τόμος της διατριβής περιλαμβάνει παράρτημα με τον κατάλογο των παράλιων και νησιωτικών αρχαιολογικών θέσεων της Νεολιθικής περιόδου που εξετάζονται στα πλαίσια αυτής της έρευνας. Ο κατάλογος είναι χωρισμένος σε οκτώ ενότητες, μια για κάθε περιοχή έρευνας, όπου εντάσσονται οι αντίστοιχες θέσεις (Α. Δυτική Θράκη, Β. Ανατολική Θράκη, Γ. Θάσος, Δ. Σαμοθράκη, Ε. Λήμνος, ΣΤ. Ίμβρος, Ζ. Τένεδος, Η. Βορειοδυτική Μικρά Ασία). Η περιγραφή της κάθε θέσης ακολουθεί τριμερή διάρθρωση που περιλαμβάνει το χρονολογικό πλαίσιο στο οποίο εντάσσεται, τη γεωγραφική της θέση και περιγραφή και τέλος τα αρχαιολογικά της δεδομένα.
Από την «ανόρθωση» στην «ανασυγκρότηση»
Authors: Παπακονδύλης Ιωάννης
Published: March 2023

Αντικείμενο της διδακτορικής διατριβής αποτελούν η διαμόρφωση του θεσμού της τοπικής αυτοδιοίκησης και η αλληλόδρασή του με το κεντρικό κράτος στο πρώτο μισό του 20ού αιώνα. Αφετηρία της έρευνας είναι η θέσπιση του Νόμου ΔΝΖ΄ (4057)/1912 επί κυβέρνησης Ελευθέριου Βενιζέλου. Ο νόμος αυτός αναδιάρθρωσε την τοπική αυτοδιοίκηση για πρώτη φορά μετά την εγκαθίδρυση του δημοτικού συστήματος από τη βαυαρική Αντιβασιλεία το 1833. Η κυριότερη καινοτομία του Νόμου ΔΝΖ΄/1912 ήταν η καθιέρωση ενός ακόμη οργανισμού τοπικής αυτοδιοίκησης δίπλα στους δήμους: των κοινοτήτων. Στόχος της έρευνας είναι να καταδείξει ότι η αναδιοργάνωση της τοπικής αυτοδιοίκησης αντιμετωπίστηκε σταθερά ως μια αναγκαία και βασική παράμετρος για την αναμόρφωση του συνολικού κρατικού μηχανισμού. Έτσι, η εργασία ξεκινά την εποχή της γενικευμένης απαίτησης για «ανόρθωση» του ελληνικού κράτους, στο γύρισμα του αιώνα, και καταλήγει στις αρχές της δεκαετίας του 1950 κατά την περίοδο της μεταπολεμικής ανασυγκρότησης. Σε πρώτο στάδιο, εξετάζονται τα αίτια που οδήγησαν στη μεταρρύθμιση του 1912, τα προβλήματα που επιχείρησε να διευθετήσει, καθώς και οι προσδοκίες που καλλιέργησε. Στη συνέχεια, παρακολουθείται η εφαρμογή της συγκεκριμένης μεταρρύθμισης μέχρι την κύρωση του πρώτου μεταπολεμικού δημοτικού και κοινοτικού κώδικα το 1954. Η παρούσα μελέτη επιχειρεί να αναδείξει τις σχέσεις και τη δυναμική ανάμεσα στην τοπική αυτοδιοίκηση και στην κεντρική διοίκηση, εξετάζοντας τον πολιτικό, κοινωνικό και οικονομικό αντίκτυπο γεγονότων που σημάδεψαν την ελληνική ιστορία στο πρώτο μισό του 20ού αιώνα, όπως ήταν για παράδειγμα ο Εθνικός Διχασμός, η Μικρασιατική Καταστροφή, η πτώχευση του 1932, η Κατοχή και ο Εμφύλιος, τόσο σε κεντρικό όσο και σε τοπικό επίπεδο. Στο πλαίσιο αυτό, δίνεται έμφαση στην εξέλιξη του νομικού και θεσμικού πλαισίου, στα οικονομικά της τοπικής αυτοδιοίκησης, στη διεξαγωγή των αυτοδιοικητικών εκλογών και στη δράση που ανέπτυξαν οι δήμοι και οι κοινότητες, είτε μεμονωμένα είτε συλλογικά. Για τις ανάγκες της έρευνας, αξιοποιήθηκε ένα ευρύ φάσμα αρχειακών πηγών, τις σημαντικότερες εκ των οποίων συνιστούν οι δημοσιεύσεις στην Εφημερίδα της Κυβερνήσεως, τα πρακτικά των συνεδριάσεων της Βουλής, δημοτικά αρχεία –ιδιαίτερα τα πρακτικά του δημοτικού συμβουλίου του Δήμου Αθηναίων–, αρχεία πολιτικών προσώπων, τα πρακτικά της διευθύνουσας επιτροπής της ένωσης των δήμων και κοινοτήτων της Ελλάδας, καθώς και τα πρακτικά των συνεδρίων που διοργάνωσε.
Μοντέλα της Παιδαγωγικής Γνώσης Περιεχομένου Φυσικών Επιστημών: επιστημολογική προσέγγιση και συνοπτική περιγραφή
Authors: Χαϊτίδου Μαρία
Published: March 2023

Το άρθρο αφορά βιβλιογραφική επισκόπηση των μοντέλων της Παιδαγωγικής Γνώσης Περιεχομένου (ΠΓΠ) Φυσικών Επιστημών (ΦΕ). Τα 21 μοντέλα της ΠΓΠ ΦΕ, τα οποία προέκυψαν από τη σχετική βιβλιογραφική επισκόπηση, παρουσιάζονται ως προς: α) την επιστημολογική φύση της ΠΓΠ, β) τις ομοιότητες και τις διαφορές των συστατικών της ΠΓΠ, γ) το θεωρητικό τους υπόβαθρο και δ) τις γραφικές αναπαραστάσεις που χρησιμοποιούνται. Επίσης, εξετάζεται η σχέση των μοντέλων της ΠΓΠ με την επαγγελματική ανάπτυξη των εκπαιδευτικών. Ειδικότερα, οι επιστημολογικές προσεγγίσεις της ΠΓΠ περιλαμβάνονται σε ένα νοητό συνεχές που αναπτύσσεται μεταξύ δύο άκρων: το Μοντέλο Ενσωμάτωσης και το Μοντέλο Μετασχηματισμού. Ο αριθμός των μοντέλων στα οποία περιγράφεται το θεωρητικό υπόβαθρο είναι σχετικά μικρός. Τέλος, στα μοντέλα που περιγράφουν την ΠΓΠ, αναγνωρίζονται ποικίλες γραφικές αναπαραστάσεις, όπως ελλείψεις, παραλληλόγραμμα μέσα σε παραλληλόγραμμα, διαγράμματα τύπου Venn και παραλληλόγραμμα που συνδέονται με βέλη.
Graphic Disciplines and Informatization of Engineering Education
Authors: Kozlova I. , Slavin R. , Slavin Boris
Published: March 2023

The development of information technology has given a significant impetus and progress both for various industries and life, as well as for education. The national program "Digital Economy of the Russian Federation" provides for ensuring the introduction of digital technologies in the economy and social sphere, and is associated with the National Project "Education (2019-2024)", which includes the Federal Project "Digital Educational Environment" based on the introduction of the target model of modern digital technologies into educational programs. Innovative methods and forms of training create a strategy for the professional training of specialists, and computer visibility of the forms of the part gives an idea of the assembly technology, allows you to perform competent drawings. The purpose of the study is to analyze the methods of solving the problems of descriptive geometry and engineering graphics together with the use of methods of surface formation by geometric methods, as well as on the basis of basic CAD operations COMPASS-3D.

In modern high school, in most cases, drawing is not studied, or only the most general concepts and definitions are studied. The existing course of school computer science deals only with general issues and practically does not give skills in drawing and modeling. As a result, applicants for the most part come to a technical university unprepared for the normal perception of geometric and graphic disciplines. In this regard, two priority tasks of further informatization of engineering education at the technical university have been formulated. On the one hand, this is the improvement of the methodology for teaching geometro-graphic disciplines, including in distance learning. On the other hand, it is the involvement of schoolchildren in various Olympiads and competitions held on the basis of technical universities to develop the initial skills of drawing and modeling simple objects.
Changes to The Competences Requirements of Project Managers Under The Influence Of Sustainability In Russia
Authors: Kalganova Ariana , Ryabtseva Elena , Rakhmankulov Daniil , Khalimon Ekaterina
Published: March 2023

IProject management and sustainable development are ones of the most important concepts that have gained great popularity in the scientific community in recent years. The need to integrate sustainability into project management is increasing every year changing the requirements for project managers` competencies.

Despite of the growing scientific interest in this topic, there is a small number of research papers that consider the impact of the concept of sustainability on the competences of a project manager. Thus, the purpose of this study is to identify the most important knowledge, skills and abilities and personal qualities needed by project managers for successful sustainable project management.

The research is based on the analysis of the sources of scientific literature, international, and national standards in the field of project management.

The results showed that over the past 5 years the project manager profession has undergone significant changes, and in order to achieve sustainability project managers need to develop new professional competencies based on knowledge, skills and abilities, and personal qualities.
Intrathoracic kidney
Authors: Blanco Saez Rosario , Pereira Rafaela Costa , Sá Lopes Ramiro , Caleça Emídio Fábio , Lazenko Iryna
Published: March 2023

Intrathoracic kidney is a very rare finding, representing less than 5% of all renal ectopias. Because of the location of the liver, thoracic kidney on the right side is much less common than thoracic kidney on the left side. Although an increasing number of case reports are being published in the literature, few describe the impact of the ectopia on kidney function. We report the case of a woman with intrathoracic right kidney and chronic kidney disease that was initially misdiagnosed as pneumonia because of its presentation on chest x-ray. We highlight the need to including this condition in the differential diagnosis[2] as the literature rarely links it to changes in kidney function.
The care of patients with secondary hypothalamic amenorrhoea
Authors: Watson Chloe
Published: March 2023

Secondary hypothalamic amenorrhoea is a common menstrual disorder affecting women of reproductive age. In some cases, periods become absent due to prolonged stress on the body, caused by undereating, overexercising and psychological stress. Secondary hypothalamic amenorrhoea is often underdiagnosed and undertreated, and patients may be prescribed oral contraception, which can mask the problem. This article will mainly focus on lifestyle factors associated with this condition and its association with disordered eating.
Changes in NMC language proficiency standards will benefit everyone
Authors: Foster Sam
Published: March 2023

Sam Foster, Chief Nurse, Oxford University Hospitals, welcomes the outcome of the nursing regulator's review of English language requirements for international nurses seeking registration in the UK
Intrathecal drug delivery for cancer pain at the end of life: a case study
Authors: Nursey Florence , Gillett Karen
Published: March 2023

Two-thirds of patients with advanced cancer have pain and, of these, approximately 10–20% do not respond to conventional pain management approaches. This case study concerns a hospice patient who received intrathecal drug delivery for intractable cancer pain at the end of life. This involved working in partnership with a hospital-based interventional pain team. Despite side-effects and complications associated with intrathecal drug delivery and the requirement for inpatient nursing care, intrathecal drug delivery was the best option for the patient. The case identifies the importance of a patient-centred approach to decision-making, effective partnerships between hospice and acute hospital teams, and nurse education as key factors contributing to the provision of safe and effective intrathecal drug delivery.
GELENEKSEL TÜRK GELİNİNİN BÜYÜSEL ERGİNLENME YOLCULUĞU
Authors: DEMİR Turan
Published: March 2023

Toplumsal ve bireysel yaşamda kendine yer edinmeye çalışan insan, dünyadaki varlığı boyunca çeşitli evrelerden geçmektedir. Bireyin dünyaya hem psikolojik hem de sosyolojik bir uyum sağlaması için gerçekleşen bu evreler doğumla başlayıp evlilikle devam eder ve de ölümle sonlanır. Söz konusu bu evreler genel bağlamda geçiş dönemleri/ritleri olarak adlandırılır. Birey, bu geçiş dönemlerine ilkel zamanlardan beri büyüsel ve mitolojik özellikler taşıyan törenlerle/ritüellerle hazırlanır. Geçiş dönemleri krizlerle dolu bir süreçtir ve birey, biyolojik yeterliliğinin yanında psikolojik olarak da erginlenme süreçlerini atlatarak toplum içindeki yeni statüsüne bir kabul töreni ile kavuşur.

Evlilik, geçiş dönemleri içerisinde doğumu ve ölümü hazırlayan önemli bir süreçtir. Soyun devamı kültürel kodlarla örülmüş evlilik ile sağlanırken yaşayan her varlığın ölümü gerçekleşeceğinden bu süreç geçiş dönemlerini bütünleştiren bir işleve sahiptir. Evlilik bağlamında gerçekleşen geçiş döneminde kadının erginlenme süreci büyüsel pek çok anlam ve ritüel içermektedir. Evlilik, geleneksel Türk gelininin genç kızlığa veda etme törenidir. Evlilik süreçlerinde krizin merkezi gelin adayı kızdır ve gelin olacak kız, doğup büyüdüğü yerden ayrılıp doğurduğu çocuğu büyüteceği yeni bir alana öteki bireye dönüşerek geçer. Bu kriz döneminin rahat atlatılması için de birçok büyüsel ritüel sergilenir. Ortaya konan bu çalışmada da geleneksel Türk gelinin büyüsel erginlenme yolculuğu ele alınmıştır.
NEONATAL HIP ASSESSMENT: PREDICTABLE FAILURE
Authors: Burt J. , AlKandari N. , Campbell D.M. , Maclean J.G.B.
Published: March 2023

The UK falls behind other European countries in the early detection of Developmental Dysplasia of the hip (DDH) and there remains controversy surrounding screening strategies for early detection. Clinical detection of DDH is challenging and recognised to be dependent on examiner experience. No studies exist assessing the number of personnel currently involved in such assessments.

Our objective was to study the current screening procedure by studying a cohort of new-born babies in one teaching hospital and assess the number of health professionals involved in neonatal hip assessment and the number of examinations undertaken during one period by each individual.

This was a retrospective observational study assessing all babies born consecutively over a 14-week period in 2020. Record of each initial baby check was obtained from Maternity or Neonatal Badger. Follow-up data on ultrasound or orthopaedic outpatient referrals were obtained from clinical records.

1037 babies were examined by 65 individual examiners representing 9 different healthcare professional groups. The range of examinations conducted per examiner was 1- 97 with a mean of 15.9 examinations per person. 49% individuals examined 5 or less babies across the 14 weeks, with 18% only performing 1 examination. Of the 5 babies (0.48%) treated for DDH, one was picked up on neonatal assessment.

In a system where so many examiners are involved in neonatal hip assessment the experience is limited for most examiners. It is unsurprising that high current rates of late presentation of DDH are observed locally, which are in accordance with published national experience.
RE-REVISION KNEE ARTHROPLASTY: THE EFFECT OF TIME FROM PRIMARY TO FIRST REVISION. A STUDY OF 4,723 PATIENTS FROM THE SCOTTISH ARTHROPLASTY PROJECT
Authors: Jabbal A. , Burt J. , Moran M. , Clarke J. , Jenkins P.J. , Walmsley P.
Published: March 2023

Revision Total Knee Arthroplasty (rTKA) is predicted to increase by more than 600% between 2005 and 2030. The survivorship of primary TKA has been extensively investigated, however more granular information on the risks of rTKA is needed. The aim of the study was to investigate the incidence of re-revision TKA, with explanatory variables of time from primary to revision, and indication (aseptic vs septic). Secondary aim was to investigate mortality.

This is an analysis of the Scottish Arthroplasty Project data set, a national audit prospectively recording data on all joint replacements performed in Scotland. The period from 2000 to 2019 was studied.

4723 patients underwent revision TKA. The relationship between time from primary to revision TKA and 2nd revision was significant (p<0.001), with increasing time lowering probability of re-revision (OR 0.99 95% CI 0.987 to 0.993). There was no significant association in time to first revision on time from 1st revision to re-revision (p>0.05). Overall mortality for all patients was 32% at 10 years (95% CI 31-34), Time from primary TKA to revision TKA had a significant effect on mortality: p=0.004 OR 1.03 (1.01-1.05). Septic revisions had a reduced mortality compared to aseptic, OR 0.95 (0.71-1.25) however this was not significant (p=0.69).

This is the first study to demonstrate time from primary TKA to revision TKA having a significant effect on probability of re-revision TKA. Furthermore the study suggests mortality is increased with increasing time from primary procedure to revision, however decreased if the indication is septic rather than aseptic.
FIVE-YEAR SURVIVAL OF VANCOUVER B FRACTURES AROUND A CEMENTED POLISHED TAPERED STEM TREATED WITH FIXATION
Authors: Powell-Bowns M.F.R. , Oag E. , Martin D. , Moran M. , Scott C.E.H.
Published: March 2023

The aim of the study was to report the survival of open reduction and internal fixation (ORIF) of Vancouver B fractures associated with the Exeter Stem (ES) at a minimum of 5 years.

This retrospective cohort study assessed 129 consecutive patients with Vancouver B type fractures treated with ORIF from 2008-2016 at a minimum of 5 years. Patient records were examined, and the following recorded: details of primary prosthesis, details of injury, Vancouver classification, details of operative management, complications, and requirement for reoperation. Data was analysed using SPSS. Survival analysis was undertaken using the endpoint ‘reoperation for any reason’.

Mean age at fracture was 78.2 (SD10.6, 46-96) and 54 (43%) were female. Vancouver subclassifications were: 24% B1, 70.5% B2 and 5.5% B3. For all Vancouver B fractures, Kaplan Meier analysis demonstrated a 5 year survival free from reoperation of 88.8% (82.0-94.7 95%CI). Fourteen patients required reoperation, most commonly within the first year for non-union and plate fracture (5.4%). Five-year survival for any reoperation differed significantly according to fracture type (p=0.016) and was worst in B1s: B1 76.6% (61.3-91.9); B2 92.6% 986.9-98.3); and 100% of B3. Univariate analysis identified B1 type (p=0.008) and a transverse fracture pattern (p=0.003) to be significantly associated with the need for reoperation.

Adopting a strategy of fixation of all Vancouver B fractures involving the ES where the fracture was anatomically reducible and the bone cement interface was well-fixed was associated with a 5 year survival, free from reoperation of 88.8%.
ASSESSING PREOPERATIVE LOWER LIMB CORONAL ALIGNMENT IN THE SETTING OF KNEE ARTHROPLASTY: A COMPARISON OF WEIGHTBEARING HIP-KNEE-ANKLE RADIOGRAPHS WITH INTRAOPERATIVE ASSESSMENT USING CT-BASED NAVIGATION
Authors: Vidakovic H. , Ohly N.
Published: March 2023

Accurate evaluation of lower limb coronal alignment is essential for effective pre-operative planning of knee arthroplasty. Weightbearing hip-knee-ankle (HKA) radiographs are considered the gold standard. Mako SmartRobotics uses CT-based navigation to provide intra-operative data on lower limb coronal alignment during robotic assisted knee arthroplasty. This study aimed to compare the correlation between the two methods in assessing coronal plane alignment.

Patients undergoing Mako partial (PKA) or total knee arthroplasty (TKA) were identified from our hospital database. The hospital PACS system was used to measure pre-operative coronal plane alignment on HKA radiographs. This data was correlated to the intraoperative deformity assessment during Mako PKA and TKA surgery.

443 consecutive Mako knee arthroplasties were performed between November 2019 and December 2021. Weightbearing HKA radiographs were done in 56% of cases. Data for intraoperative coronal plane alignment was available for 414 patients. 378 knees were aligned in varus, and 36 in valgus. Mean varus deformity was 7.46° (SD 3.89) on HKA vs 7.13° (SD 3.56) on Mako intraoperative assessment, with a moderate correlation (R= 0.50, p<0.0001). Intraoperative varus deformity of 0-4° correlated to HKA measured varus (within 3°) in 60% of cases, compared to 28% for 5-9°, 17% for 10-14°, and in no cases with >15° deformity. Mean valgus deformity was 6.44° (SD 4.68) on HKA vs 4.75° (SD 3.79) for Mako, with poor correlation (R=0.18, p=0.38).

In this series, the correlation between weightbearing HKA radiographs and intraoperative alignment assessment using Mako SmartRobotics appears to be poor, with greater deformities having poorer correlation.
impact of the Covid-19 pandemic on teaching and learning Business English:
Authors: Ruiz Cirlot Andrea
Published: March 2023

This paper explores the impact of the Covid-19 pandemic on the effectiveness of face-to-face, online and the combination of both modalities in the teaching and learning of Business English, which is a discipline included in the English for Specific Purposes approach, known by its acronym ESP. In order to determine the differences between these two modalities, I created a questionnaire to gather information from fourth-year undergraduate students of Business Administration and Management from the University of Barcelona, and also from teachers who have taught Business English and other modes of English language teaching. This research analyzes the benefits and pitfalls of traditional and virtual classrooms, and emphasizes that the meeting of these two modalities affects not only student-teacher communication but also the performance of exams, tasks, oral presentations and practical exercises. The results of the questionnaire may elucidate whether the two modalities are compatible and to what extent merging them will enhance teachers’ performance and will strengthen learners’ knowledge of the target language.
Association of severe mental illness and septic shock case fatality rate in patients admitted to the intensive care unit: A national population-based cohort study
Authors: Lakbar Ines , Leone Marc , Pauly Vanessa , Orleans Veronica , Srougbo Kossi Josue , Diao Sambou , Llorca Pierre-Michel , Solmi Marco , Correll Christoph U. , Fernandes Sara , Vincent Jean-Louis , Boyer Laurent , Fond Guillaume
Published: March 2023

Background

Patients with severe mental illness (SMI) (i.e., schizophrenia, bipolar disorder, or major depressive disorder) have been reported to have excess mortality rates from infection compared to patients without SMI, but whether SMI is associated with higher or lower case fatality rates (CFRs) among infected patients remains unclear. The primary objective was to compare the 90-day CFR in septic shock patients with and without SMI admitted to the intensive care unit (ICU), after adjusting for social disadvantage and physical health comorbidity.

Methods and findings

We conducted a nationwide, population-based cohort study of all adult patients with septic shock admitted to the ICU in France between January 1, 2014, and December 31, 2018, using the French national hospital database. We matched (within hospitals) in a ratio of 1:up to 4 patients with and without SMI (matched-controls) for age (5 years range), sex, degree of social deprivation, and year of hospitalization. Cox regression models were conducted with adjustment for smoking, alcohol and other substance addiction, overweight or obesity, Charlson comorbidity index, presence of trauma, surgical intervention, Simplified Acute Physiology Score II score, organ failures, source of hospital admission (home, transfer from other hospital ward), and the length of time between hospital admission and ICU admission. The primary outcome was 90-day CFR. Secondary outcomes were 30- and 365-day CFRs, and clinical profiles of patients.

A total of 187,587 adult patients with septic shock admitted to the ICU were identified, including 3,812 with schizophrenia, 2,258 with bipolar disorder, and 5,246 with major depressive disorder. Compared to matched controls, the 90-day CFR was significantly lower in patients with schizophrenia (1,052/3,269 = 32.2% versus 5,000/10,894 = 45.5%; adjusted hazard ratio (aHR) = 0.70, 95% confidence interval (CI) 0.65,0.75, p < 0.001), bipolar disorder (632/1,923 = 32.9% versus 2,854/6,303 = 45.3%; aHR = 0.70, 95% CI = 0.63,0.76, p < 0.001), and major depressive disorder (1,834/4,432 = 41.4% versus 6,798/14,452 = 47.1%; aHR = 0.85, 95% CI = 0.81,0.90, p < 0.001). Study limitations include inability to capture deaths occurring outside hospital, lack of data on processes of care, and problems associated with missing data and miscoding in medico-administrative databases.

Conclusions

Our findings suggest that, after adjusting for social disadvantage and physical health comorbidity, there are improved septic shock outcome in patients with SMI compared to patients without. This finding may be the result of different immunological profiles and exposures to psychotropic medications, which should be further explored.
Evaluation of international guidance for the community treatment of ‘personality disorders’: A systematic review
Authors: Zhan Yuen Wong Nicholas , Barnett Phoebe , Sheridan Rains Luke , Johnson Sonia , Billings Jo
Published: March 2023

Background

Guidelines for the treatment and management of ‘personality disorders’ have been introduced to provide guidance on best practice based on evidence and views of key stakeholders. However, guidance varies and there is yet to be an overall, internationally recognised consensus on the best mental health care for people with ‘personality disorders’.

Aims

We aimed to identify and synthesise recommendations made by different mental health organisations from across the world on community treatment for people with ‘personality disorders’.

Methods

This systematic review consisted of three stages: 1. systematic literature and guideline search, 2. quality appraisal, and 3. data synthesis. We combined a search strategy involving both systematic searching of bibliographic databases and supplementary search methods of grey literature. Key informants were also contacted to further identify relevant guidelines. Codebook thematic analysis was then conducted. The quality of all included guidelines was assessed and considered alongside results.

Results

After synthesising 29 guidelines from 11 countries and 1 international organisation, we identified four main domains, with a total of 27 themes. Important key principles on which there was consensus included continuity of care, equity of access, accessibility of services, availability of specialist care, taking a whole systems approach, trauma informed approaches, and collaborative care planning and decision making.

Conclusions

Existing international guidelines shared consensus on a set of principles for the community treatment of ‘personality disorders’. However, half of the guidelines were of lower methodological quality, with many recommendations not backed by evidence.
Research on fault diagnosis system for belt conveyor based on internet of things and the LightGBM model
Authors: Wang Meng , Shen Kejun , Tai Caiwang , Zhang Qiaofeng , Yang Zongwei , Guo Chengbin
Published: March 2023

As an equipment failure that often occurs in coal production and transportation, belt conveyor failure usually requires many human and material resources to be identified and diagnosed. Therefore, it is urgent to improve the efficiency of fault identification, and this paper combines the internet of things (IoT) platform and the Light Gradient Boosting Machine (LGBM) model to establish a fault diagnosis system for the belt conveyor. Firstly, selecting and installing sensors for the belt conveyor to collect the running data. Secondly, connecting the sensor and the Aprus adapter and configuring the script language on the client side of the IoT platform. This step enables the collected data to be uploaded to the client side of the IoT platform, where the data can be counted and visualized. Finally, the LGBM model is built to diagnose the conveyor faults, and the evaluation index and K-fold cross-validation prove the model’s effectiveness. In addition, after the system was established and debugged, it was applied in practical mine engineering for three months. The field test results show: (1) The client of the IoT can well receive the data uploaded by the sensor and present the data in the form of a graph. (2) The LGBM model has a high accuracy. In the test, the model accurately detected faults, including belt deviation, belt slipping, and belt tearing, which happened twice, two times, one time and one time, respectively, as well as timely gaving warnings to the client and effectively avoiding subsequent accidents. This application shows that the fault diagnosis system of belt conveyors can accurately diagnose and identify belt conveyor failure in the coal production process and improve the intelligent management of coal mines.
Incorporating algorithmic uncertainty into a clinical machine deep learning algorithm for urgent head CTs
Authors: Yoon Byung C. , Pomerantz Stuart R. , Mercaldo Nathaniel D. , Goyal Swati , L’Italien Eric M. , Lev Michael H. , Buch Karen A. , Buchbinder Bradley R. , Chen John W. , Conklin John , Gupta Rajiv , Hunter George J. , Kamalian Shahmir C. , Kelly Hillary R. , Rapalino Otto , Rincon Sandra P. , Romero Javier M. , He Julian , Schaefer Pamela W. , Do Synho , González Ramon Gilberto
Published: March 2023

Machine learning (ML) algorithms to detect critical findings on head CTs may expedite patient management. Most ML algorithms for diagnostic imaging analysis utilize dichotomous classifications to determine whether a specific abnormality is present. However, imaging findings may be indeterminate, and algorithmic inferences may have substantial uncertainty. We incorporated awareness of uncertainty into an ML algorithm that detects intracranial hemorrhage or other urgent intracranial abnormalities and evaluated prospectively identified, 1000 consecutive noncontrast head CTs assigned to Emergency Department Neuroradiology for interpretation. The algorithm classified the scans into high (IC+) and low (IC-) probabilities for intracranial hemorrhage or other urgent abnormalities. All other cases were designated as No Prediction (NP) by the algorithm. The positive predictive value for IC+ cases (N = 103) was 0.91 (CI: 0.84–0.96), and the negative predictive value for IC- cases (N = 729) was 0.94 (0.91–0.96). Admission, neurosurgical intervention, and 30-day mortality rates for IC+ was 75% (63–84), 35% (24–47), and 10% (4–20), compared to 43% (40–47), 4% (3–6), and 3% (2–5) for IC-. There were 168 NP cases, of which 32% had intracranial hemorrhage or other urgent abnormalities, 31% had artifacts and postoperative changes, and 29% had no abnormalities. An ML algorithm incorporating uncertainty classified most head CTs into clinically relevant groups with high predictive values and may help accelerate the management of patients with intracranial hemorrhage or other urgent intracranial abnormalities.
Leaving no one behind in health: Financial hardship to access health care in Ethiopia
Authors: Tsega Yawkal , Tsega Gebeyehu , Taddesse Getasew , Getaneh Gebremariam
Published: March 2023

Background

Financial hardship (of health care) is a global and a national priority area. All people should be protected from financial hardship to ensure inclusive better health outcome. However, financial hardship of healthcare has not been well studied in Ethiopia in general and in Debre Tabor town in particular. Therefore, this study aimed to assess the incidence of financial hardship of healthcare and associated factors among households in Debre Tabor town.

Methods

Community based cross sectional study was conducted, from May 24/2022 to June 17/2022, on 423 (selected through simple random sampling) households. Financial hardship was measured through catastrophic (using 10% threshold level) and impoverishing (using $1.90 poverty line) health expenditures. Patient perspective bottom up and prevalence based costing approach were used. Indirect cost was estimated through human capital approach. Bi-variable and multiple logistic regressions were used.

Results

The response rate was 95%. The mean household annual healthcare expenditure was Ethiopian birr 12050.64 ($227.37). About 37.1% (95%CI: 32, 42%) of the households spend catastrophic health expenditure with a 10% threshold level and 10.4% of households were impoverished with $1.90 per day poverty line. Being old, with age above 60, (AOR: 4.21, CI: 1.23, 14.45), being non-insured (AOR: 2.19, CI: 1.04, 4.62), chronically ill (AOR: 7.20, CI: 3.64, 14.26), seeking traditional healthcare (AOR: 2.63, CI: 1.37. 5.05) and being socially unsupported (AOR: 2.77, CI: 1.25, 6.17) were statistically significant factors for catastrophic health expenditure.

Conclusion

The study showed that significant number of households was not yet protected from financial hardship of healthcare. The financial hardship of health care is stronger among the less privileged populations: non-insured, the chronically diseased, the elder and socially unsupported. Therefore, financial risk protection strategies should be strengthened by the concerned bodies.
Characterization of hemodialysis fistulas experienced abrupt thrombosis and determination of a proper follow-up protocol: A retrospective cohort study and an interventionist’s perspective
Authors: Chen Matt Chiung-Yu , Weng Mei-Jui , Chao Lee-Hua
Published: March 2023

Abrupt thrombosis is a form of thrombosis that occurs unexpectedly and without being preceded by hemodialysis fistula (AVF) dysfunction during dialysis. We found that AVFs with a history of abrupt thrombosis (abtAVF) appeared to have more episodes of thrombosis and required more frequent interventions than those without such history. Therefore, we sought to characterize the abtAVFs and examined our follow-up protocols to determine which one is optimal. We performed a retrospective cohort study using routinely collected data. The thrombosis rate, AVF loss rate, thrombosis-free primary patency, and secondary patency were calculated. Additionally, the restenosis rates of the AVFs under the follow-up protocol/sub-protocols and the abtAVFs were determined. The thrombosis rate, procedure rate, AVF loss rate, thrombosis-free primary patency, and secondary patency of the abtAVFs were 0.237/pt-yr, 2.702/pt-yr, 0.027/pt-yr, 78.3%, and 96.0%, respectively. The restenosis rate for AVFs in the abtAVF group and the angiographic follow-up sub-protocol were similar. However, the abtAVF group had a significantly higher thrombosis rate and AVF loss rate than AVFs without a history of abrupt thrombosis (n-abtAVF). The lowest thrombosis rate was observed for n-abtAVFs, followed up periodically under the outpatient or angiographic sub-protocols. AVFs with a history of abrupt thrombosis had a high restenosis rate, and periodic angiographic follow-up with a mean interval of 3 months was presumed appropriate. For selected populations, such as salvage-challenging AVFs, periodic outpatient or angiographic follow-up was mandatory to extend their usable lives for hemodialysis.