bluuebunny/crossref_metadata_2025 huggingface dataset:
Kardiyopulmoner Resüsitasyon Eğitimine Etki Eden Faktörler: Sakarya Örneği
Authors: ASLAN Nuray , GUNER Necip Gökhan , DURGUN Yeşim , DURMUŞ Ensar , YURUMEZ Yusuf
Published: March 2023

Amaç: Bu çalışmada, hekim dışı sağlık çalışanlarına yönelik olarak yapılan Kardiyopulmoner Resüsitasyon (KPR) eğitimindeki başarı durumuna etki eden faktörlerin araştırılması amaçlanmıştır.

Gereç ve Yöntemler: Bu çalışma Sakarya İl Sağlık Müdürlüğü Acil Sağlık Hizmetleri Şubesi koordinatörlüğü ve sorumluluğunda Eylül 2021 tarihinde düzenlenen, KPR eğitimine katılan 285 hemşire ve ebe tarafından eğitim sırasında doldurulan ön test ve son test formlarının değerlendirilmesi ile gerçekleştirildi. Elde edilen veriler IBM SPSS 21 programı ile analiz edildi.

Bulgular: Katılımcıların yaş ortalaması 25,06±3,45 yıl ve %85’i kadındı. Eğitime katılanların (n=285) son test başarı puanlarının 74,84±20,11 olduğu tespit edildi. Bu sonucun ön test başarı puanından (38,35±17,15) istatistiksel olarak anlamlı derecede yüksek olduğu saptandı (p
Más allá del positivismo en la filosofía del derecho internacional: Bianchi y el enfoque lúdico de la interpretación
Authors: Rosales Zamora Pablo César
Published: March 2023

El presente trabajo tiene como finalidad explorar la consideración científica del derecho internacional desde el positivismo, para sostener que la posición postmoderna que pone énfasis en la labor interpretativa es la que resulta más adecuada para explicar el fenómeno jurisdiccional del derecho de gentes actual, sobre todo por la presencia de múltiples tribunales internacionales permanentes. Para esta investigación, se ha considerado a Kelsen y a Bianchi como representantes, respectivamente, de ambos abordajes epistemológicos. En ese sentido, se examina la postura de Bianchi sobre la interpretación, la cual considera que la interpretación es una actividad lúdica, por poseer un objetivo, un contexto definido, reglas, jugadores, y estrategias.
Discovery of Calm Astronomical Sites Over the Antarctic Continent
Authors: Yang Qike , Wu Xiaoqing , Qing Chun , Luo Tao , Li Xuebin , Cui Shengcheng , Wu Pengfei , Qian Xianmei , Wang Zhiyuan , Hu Xiaodan , Guo Yiming , Yan Chong , Qiao Zhi
Published: March 2023

A calm astronomical site means a site where astronomical observation would be less likely to be interfered with by optical turbulence. Previous turbulence measurements at a few sites in Antarctica have demonstrated very calm atmospheric conditions here. So far, to realize a wide range of measurements of the turbulence conditions above the Antarctic plateau will be a great hardship. Thus, in this study, the numerical weather model outputs provided by the Antarctic Mesoscale Prediction System (AMPS) have been used. Based on the AMPS outputs, the boundary layer height and the atmospheric Richardson number were obtained, from which the turbulence conditions above the Antarctic plateau have been evaluated. Finally, a statistical conclusion evaluating the total atmospheric turbulence above the whole Antarctic continent for an entire year is first reported. We find some sites (or regions) have a calmer atmosphere than Dome A; this is of great instructional significance for planning the next generation of ground-based optical astronomical telescopes.
Entretien croisé avec Xavière Siméoni, Régis de Jorna et Jean-Louis Périès
Authors: Siméoni Xavière , de Jorna Régis , Peries Jean-Louis
Published: March 2023

Régis de Jorna, qui a été pendant longtemps coordinateur de la cour d'assises de Paris, a présidé le procès des attentats de janvier 2015 mais aussi les procès du génocide rwandais dans lesquels il a pu réfléchir au sens d'un procès de masse. Xavière Siméoni était juge assesseur au procès dit « V13 », elle a présidé pendant longtemps la cour d'assises de Paris et a aussi officié dans les procès du génocide rwandais. Jean-Louis Périès, après une longue carrière au pénal, a été le président du procès « V13 ». Au cours de leur dialogue, tous trois s'interrogent sur la dimension historique de ces procès, le poids des images, la part des émotions et l'impact de la présence des parties civiles.
Entretien avec Safya Akorri, avocate au barreau de Paris
Authors: Akorri Safya , Besnier Christiane
Published: March 2023

Safya Akorri est avocate au barreau de Paris. Ancienne lauréate du prestigieux concours de la Conférence, elle s'est spécialisée dans le droit pénal et plus particulièrement dans la défense des mis en cause dans les affaires de terrorisme. Dans cet entretien, elle revient sur sa carrière, sur la façon dont elle est choisie par ses clients, sur son travail avant et pendant l'audience, sur ses rapports avec ses clients, leurs proches et les autres auxiliaires de justice. Surtout, Safya Akorri livre, au regard de son expérience, une analyse critique sur la façon dont la justice est rendue dans les affaires de terrorisme et donne des pistes de réflexion sur ce qui pourrait être amélioré et proposé, notamment pour concilier place de la victime et nécessité de la défense pénale.
Quelles technologies pour décarboner les transports ?
Authors: Auverlot Dominique , Sauvant Alain
Published: March 2023

Dans leur article publié précédemment dans ce numéro, Dominique Auverlot et Alain Sauvant ont présenté l’exercice de prospective mené par France Stratégie et l’Inspection générale de l’environnement et du développement durable sur les transports et la mobilité à 2040-2060, dans la perspective de réalisation de l’objectif de la neutralité carbone que s’est assigné la France. Pour compléter cette présentation et donner un exemple concret des dispositions qui pourraient accompagner cette transition vers la neutralité carbone, ils proposent ici un focus sur les technologies à mobiliser pour la décarbonation des transports. Les transports sont aujourd’hui le premier secteur émetteur de gaz à effet de serre en France (30 % des émissions) ; ils constituent donc une étape essentielle de la transition écologique. Les auteurs présentent ici les options technologiques ouvertes pour les décarboner, en commençant par la motorisation (électrique, hybride, hydrogène, biocarburants…) des véhicules utilisés en transport routier. C’est selon eux un angle incontournable dans une stratégie visant à atteindre la neutralité carbone. Côté transport aérien, il faut, selon eux, miser sur la recherche et privilégier la conversion vers les biocarburants. Enfin, dans le transport maritime, troisième pan du secteur, l’heure est aux expérimentations, comme le montre cet article, avec deux voies prometteuses : le gaz naturel liquéfié avec capture du CO 2 et l’électricité pour les courts trajets. Au final, si la technologie ne peut résoudre à elle seule tous les problèmes d’émissions des transports, elle constitue toutefois, avec l’incitation à la sobriété, un levier essentiel de la décarbonation. Les pouvoirs publics doivent donc en tenir compte dans les incitations politiques et économiques qu’ils établissent pour mettre en œuvre leur stratégie bas-carbone. S.D.
Enhanced disease-disease association with information enriched disease representation
Authors: Kartheeswaran Karpaga Priyaa , Rayan Arockia Xavier Annie , Varrieth Geetha Thekkumpurath
Published: March 2023

Objective: Quantification of disease-disease association (DDA) enables the understanding of disease relationships for discovering disease progression and finding comorbidity. For effective DDA strength calculation, there is a need to address the main challenge of integration of various biomedical aspects of DDA is to obtain an information rich disease representation. Materials and Methods: An enhanced and integrated DDA framework is developed that integrates enriched literature-based with concept-based DDA representation. The literature component of the proposed framework uses PubMed abstracts and consists of improved neural network model that classifies DDAs for an enhanced literaturebased DDA representation. Similarly, an ontology-based joint multi-source association embedding model is proposed in the ontology component using Disease Ontology (DO), UMLS, claims insurance, clinical notes etc. Results and Discussion: The obtained information rich disease representation is evaluated on different aspects of DDA datasets such as Gene, Variant, Gene Ontology (GO) and a human rated benchmark dataset. The DDA scores calculated using the proposed method achieved a high correlation mainly in gene-based dataset. The quantified scores also shown better correlation of 0.821, when evaluated on human rated 213 disease pairs. In addition, the generated disease representation is proved to have substantial effect on correlation of DDA scores for different categories of disease pairs. Conclusion: The enhanced context and semantic DDA framework provides an enriched disease representation, resulting in high correlated results with different DDA datasets. We have also presented the biological interpretation of disease pairs. The developed framework can also be used for deriving the strength of other biomedical associations.
Dynamic Spatial General Equilibrium
Authors: Kleinman Benny , Liu Ernest , Redding Stephen J.
Published: March 2023

We incorporate forward‐looking capital accumulation into a dynamic discrete choice model of migration. We characterize the steady‐state equilibrium; generalize existing dynamic exact‐hat algebra techniques to incorporate investment; and linearize the model to provide an analytical characterization of the economy's transition path using spectral analysis. We show that capital and labor dynamics interact to shape the economy's speed of adjustment toward steady state. We implement our quantitative analysis using data on capital stocks, populations, and bilateral trade and migration flows for U.S. states from 1965–2015. We show that this interaction between capital and labor dynamics plays a central role in explaining the observed decline in the rate of income convergence across U.S. states and the persistent and heterogeneous impact of local shocks.
Is Attention Produced Optimally? Theory and Evidence From Experiments With Bandwidth Enhancements
Authors: Bronchetti Erin T. , Kessler Judd B. , Magenheim Ellen B. , Taubinsky Dmitry , Zwick Eric
Published: March 2023

This paper develops and deploys a methodology for testing whether people correctly value tools that reduce attention costs. We call these tools bandwidth enhancements (BEs) and characterize how demand for BEs varies with the pecuniary incentives to be attentive, under the null hypothesis of correct perceptions and optimal choice. We examine if the theoretical optimality conditions are satisfied in three experiments. The first is a field experiment (
n = 1373) with an online education platform, in which we randomize incentives to complete course modules and incentives to utilize a plan‐making tool to complete the modules. In the second experiment (
n = 2306), participants must complete a survey in the future. We randomize survey‐completion incentives and how long participants must wait to complete the survey, and we elicit willingness to pay for reminders. The third experiment (
n = 1465) involves a psychometric task in which participants must identify whether there are more correct or incorrect mathematical equations in an image. We vary incentives for accuracy, elicit willingness to pay to reduce task difficulty, and examine the impact of learning and feedback. In all experiments, demand for reducing attention costs increases as incentives for accurate task completion increase. However, in all experiments—and across all conditions—our tests imply that this increase in demand is too small relative to the null of correct perceptions. These results suggest that people may be uncertain or systematically biased about their attention cost functions, and that experience and feedback do not necessarily eliminate bias.
Expanding Multilingual Learning as a Pathway to Equity during the COVID-19 Pandemic
Authors: Utunen Heini , Attias Melissa , Ndiaye Ngouille , Tokar Anna
Published: March 2023

Real-time learning in health emergencies is a critical mechanism to provide frontline health workers, responders, decision-makers and the public with access to the latest knowledge to save lives, reduce disease transmission and protect the vulnerable. The World Health Organization (WHO) established the OpenWHO.org learning platform to meet this need. Courses are free, self-paced, accessible in low-bandwidth and offline formats, and available in national and local languages. Multilingual production was prioritized and expanded to meet the learning needs of the COVID-19 pandemic. Enrolment data from the introductory COVID-19 course, which has more than 1 million enrolments across 45 language versions, were examined according to language and geographical reach to assess how multilingual availability contributes to equity in learning. The analysis found that most language versions had uptake clustered in key countries where native speakers are concentrated, while use of some translations was more broadly dispersed. In nearly ¾ of the available language versions of the course, more than ⅓ of enrolments were found in the top country of use. The findings suggest that multilingual courses served as entryways for learners who may not have otherwise been able to participate, even as enrolment numbers likely underestimate the impact. A production policy that prioritizes translation of open online courses into diverse languages contributes to equity in access to public health knowledge at the global and country levels during health emergencies.
Individual and institutional discrimination: Theoretical and methodological contributions of social psychology
Authors: Guimond Serge
Published: March 2023

In France, as in many other countries, research has established the existence of origin-based discrimination. Where does this racial or ethnic discrimination come from, and why does it seem to last despite efforts to eradicate it? This article outlines the main findings on the issue in social psychology, whose contribution is still largely ignored in France. First, I describe the intergroup approach by discussing three major theories of intergroup relations developed in social psychology: realistic conflict theory, social identity theory, and social dominance theory. These theories have spurred much research, mostly about stereotyping and prejudice, but more rarely about discriminatory behavior. The reason for this neglect is that it is difficult to measure discriminatory behavior in a laboratory. In the second section, I present an experimental procedure inspired by social dominance theory, which aimed precisely at measuring discrimination. The first results obtained with this method are promising. The objective, in this case, was to measure individual discriminatory behaviors. However, discrimination and racism are not limited to individual attitudes or behaviors. In the third and final section on institutional discrimination, I show how social dominance theory and research developed in the United States to measure unintended racist bias provide an original and novel approach for understanding the contemporary manifestations of institutional discrimination. The findings of a series of studies conducted in France using different methods appear to be theoretically consistent with those obtained in the United States.
Peut-il y avoir une « intelligence des masses » ?
Authors: Delobel Manon
Published: March 2023

L’expression « intelligence des masses » s’est construite comme un oxymore. Cet article, qui revient sur les tensions historiques entre ces deux concepts (en se bornant aux années 1780-1920), pose la question suivante : faut-il conserver le concept de « masse », au risque de cristalliser une conception erronée de l’intelligence, ou l’abandonner, au risque de nier une réalité sociologique indéniable ? Nous soutiendrons avec le philosophe John Dewey qu’une théorie de l’« intelligence des masses » nécessite au préalable de procéder à deux réformes conceptuelles majeures : celle de l’intelligence, qui ne doit plus être considérée comme une propriété innée et exclusivement individuelle mais comme une capacité sociale, mais aussi celle de la « masse », qui ne saurait désigner un état naturel et nécessaire du collectif démocratique mais une énergie potentielle, étouffée par certaines conditions institutionnelles et politiques.
Liouville equation in statistical mechanics is not applicable to gases composed of colliding molecules
Authors: Wang Huai-Yu
Published: March 2023

Liouville equation is a fundamental one in statistical mechanics. It is rooted in ensemble theory. By ensemble theory, the variation of the system’s microscopic state is indicated by the moving of the phase point, and the moving trajectory is believed continuous. Thus, the ensemble
density is thought to be a smooth function, and it observes continuity equation. When the Hamiltonian canonical equations of the molecules are applied to the continuity equation, Liouville equation can be obtained. We carefully analyze a gas composed of a great number of molecules colliding
with each other. The defects in deriving Liouville equation are found. Due to collision, molecules’ momenta changes discontinuously, so that the trajectories of the phase points are actually not continuous. In statistical mechanics, infinitesimals in physics and in mathematics should
be distinguished. In continuity equation that the ensemble density satisfies, the derivatives with respect to space and time should be physical infinitesimals, while in Hamiltonian canonical equations that every molecule follows, the derivatives take infinitesimals in mathematics. In the course
of deriving Liouville equation, the infinitesimals in physics are unknowingly replaced by those in mathematics. The conclusion is that Liouville equation is not applicable to gases.
The Reasons Leading Businesses to Concordat and Solution Suggestions
Authors: Karaca Halime
Published: March 2023

There are many factors that lead businesses to bankruptcy. The risk environment created as a result of changes in some macroeconomic indicators such as exchange rates, interest rates, inflation, and financial instability as a result of the inability to manage risk properly cause businesses to go bankrupt or an economic crisis. The bankruptcy of a business imposes a cost not only on stakeholders, but on society as a whole. In this context, in order to ensure economic welfare and maintain the economic existence of enterprises, the function of the institution of concordat in the execution and bankruptcy law has been increased; the way of restructuring their debts in accordance with the final decision of the court in line with the consent of their creditors has been opened for the debtors. In the study, the institution of concordat was examined in outline, the reasons leading businesses to concordat were evaluated, and solution suggestions were developed.
The Effect of Bankruptcy Risk and Financial Stress on Firm Value
Authors: Karyağdı Nazan Güngör , Şit Ahmet
Published: March 2023

The aim of this study is to investigate the effects of firm bankruptcy risk and auditing factors on the market value of firms and to investigate the effect of auditing on firm bankruptcy risk. The period of the research is 2011-2021. In the study on BIST Sustainability-25 Index, in the first model, the dependent variable is the market value/book value; the independent variables are Springate S Score, Fulmer H Score, Altman Z Score, Çolakoğlu MFA Score; the ratio of the number of independent auditor members to the total number of members; the number of members in the supervisory board; and the number of early risk detection committee members.
Impact of Land Use Change on Ecosystem Services in a Coastal Town of Bangladesh
Authors: Al-Amin Md. , Islam G M Tarekul
Published: March 2023

There is an interplay between land use change and ecosystem services. The relationship between land use change and ecosystem services was explored in Barisal Sadar Upazila, a small coastal town in Bangladesh. Land use changes in this municipality were analyzed using Landsat satellite images from 1980 to 2010 at 10 years intervals. It was found that the town experienced a rapid change in its ecosystem services in proportion to land use change, especially the conversion of agricultural land to urban settlement. In the town, the agricultural land, wetlands, and water bodies decreased by 30%, 47%, and 6% respectively from 1980 to 2010. On the contrary, urban land and rural land area increased by 201% and 23% respectively during the same period. Even though the land use change had brought economic development to the people of the town, there had been a negative impact on ecosystem services which calls for a balancing trade-off between economic development and conservation of ecosystem services for the greater benefit of the society, especially for the sustenance of the ecosystem.
Land Subsidence in Ho Chi Minh City and the Mekong Delta Region, Vietnam
Authors: Van Le Trung , Vo Phu L. , Ha Quang Khai , Thi Van Tran , Luu Hiep Dinh
Published: March 2023

Land subsidence and its consequences are at an alarming level in the Southern and low-lying areas of the Mekong Delta. This chapter will discuss the situation of groundwater uses and urban development activities that caused the negative impacts of land subsidence and sea level rise in Ho Chi Minh City and the Mekong Delta region of Vietnam. The PSInSAR technique was applied for land subsidence monitoring and showed that an average subsidence rate at 15 mm/year which is 5 times greater than the effects resulting from the rise of sea level. This implies that land subsidence coupled with sea level rise have been as a major factor contributing to increasing the depth of annual flood and causing inconveniences to the daily lives of residents that suffered waterlogging of between 0.4 – 0.5m. Apart from the restriction of groundwater abstraction, rainwater harvesting – an alternative water sources – is a humanitarian engineering solution to minimize groundwater extraction which in turn to prevent from flood risks caused by land subsidence and the rise of sea level.
Lifting the Veil of Time
Authors: Kapogianni Elena
Published: March 2023

Cultural heritage sites are fundamental elements of national and international heritage and are regarded as sensitive and critical structures of high and of national importance, exposed to a range of natural hazards, leading often structural failures. Cultural heritage sites include structures and monuments with effectively limitless lifetime, while admitting only limited intervention options. Therefore, the efficient assessment of their structural risk forms a very demanding task in comparison to similar analyses applied to modern structures. The current study is involved with natural hazards and natural disasters that have affected cultural heritage sites in the past and their consequences regarding their structural integrity. After a description of the aforementioned, specific scientific tools and advanced methods for the investigation of the geophysical/hydrological and climatological/meteorological natural hazards and their consequences at cultural heritage sites, regarding their structural integrity are presented and discussed.
A Review for Neuroimaging Techniques in Multimedia Learning
Authors: Ozel Pınar , Bayraktar Duygu Mutlu , Altan Tugba , Coskun Veysel , Olamat Ali
Published: March 2023

The purpose of this study was to examine neuroimaging technologies for quantifying cognitive load in intelligent interactive multimedia systems for experimental applications by conducting a systematic review of all relevant papers published up to April 2020. The study's most striking finding is that electroencephalography, functional magnetic resonance imaging, functional near-infrared spectroscopy, and transcranial doppler ultrasonography are the most frequently used neuroimaging equipment in cognitive load research in multimedia learning. Forty papers were selected depending on the equipment that should be understood in the field of neuroimaging in examining cognitive load in multimedia learning, the benefits and drawbacks of neuroimaging devices, and the experimental protocol for cognitive load in multimedia research. The study's findings were analyzed, and numerous discrepancies in the research on cognitive load and multimedia learning were discovered.
What Vietnamese Employers and Educators Want in Impactful Engineering Degree Programmes
Authors: Nguyen Thuy Tien , Thi Anh Pham , Nguyen Tuan Anh , Mai Luu , Mottram J. Toby , Kremmyda Georgia , Koumpouros Yiannis , Georgoulas Angelos , Van Dong Doan
Published: March 2023

This chapter presents results and analysis from the ENHANCE project survey for the views of employers and educators towards the impactful improvement of engineering degree programs in Vietnam. This building capacity project aims to find ways of strengthening the employability of engineering graduates by improving the quality of engineering programs. The survey was carried out by inviting respondents from industry (employers) and from higher education (educators) to answer online questionnaires. The number of respondents was 116, of which 69 are educators and 47 are employers. This chapter presents results that encompass the following three topics: university graduate attributes, capabilities, knowledge, and understanding; the teaching and learning methods used in universities; and the future of engineering programs in Vietnam.
An Autoethnographic Study of an Asian, Non-Mainstream-English-Speaking Teacher in TESOL
Authors: Song Zhiwen
Published: March 2023

Despite efforts to acknowledge the legitimacy of nonnative English speakers (NNES) in English language education, the unequal treatment of them and the superiority attributed to mainstream-English-speaking teachers from inner circle countries persist. Conceptualized as a dynamic process rather than as a predetermined product, race has been given more visibility in TESOL scholarship to promote anti-racist educational practices. From a raciolinguistic perspective, this study delineates the racialized experiences of an Asian, non-mainstream-English-speaking teacher, and elucidates the shifts in her conceptualization of race, as well as the (re)construction of her identities and ideologies as a teacher. It illuminates how language, race, and other interrelated categories are discursively (un)marked in the racializing process. The chapter concludes with suggestions to promote anti-racism research and to enact socially just practices.
Music and Politics in Afghanistan
Authors: Dastgeer Shugofa , Obaidi Hamid
Published: March 2023

This study analyzed Afghanistan's national anthems in the last seven decades. This qualitative textual analysis found that national anthems from both secular and Islamic regimes included political visions of the ruling groups. In particular, during the Taliban, the Mujahedeen, and the communist eras, the national anthems had more aggressive tones. Although the Taliban regimes are known as Islamic extremists, the national anthem of the first Taliban era did not include anything about religion; rather, it focused on the history of defeating Western occupation of Afghanistan.
A novel technique of handling the blade for videolaryngoscopy intubation in patients with a semi-rigid neck collar: a prospective randomized controlled trial
Authors: Kim Myoung Hwa , Kim Ji Young , Lee Jong Seok , Jo Arim , Kim Do-Hyeong
Published: March 2023

Background: Semi-rigid neck collars to protect the cervical spine can limit the extent of neck movement and mouth opening; this may further complicate orotracheal intubation. We aimed to compare intubation environments obtained with videolaryngoscopy using the technique of gliding a blade under the epiglottis and that obtained using the conventional Macintosh blade technique of blade tip placement on the vallecula.Methods: This prospective randomized study included patients aged ≥ 20 years with American Society of Anesthesiologists physical status I–III scheduled for cervical spine surgery between October 2020 and August 2021. Patients were divided into two groups according to the placement of the blade of the McGrathTM videolaryngoscope: the gliding and conventional groups. The percentage of glottic opening (POGO) score was the primary endpoint. We also recorded the time to obtain the optimal laryngoscopic view, intubation duration, and ease and satisfaction of the researcher performing intubation.Results: Among 176 patients, the POGO scores were significantly higher in the gliding group than in the conventional group (88.9 ± 14.7 vs. 63.8 ± 27.4, P < 0.001). The time to achieve the optimal glottic view for intubation and duration of intubation were also shorter, and ease and satisfaction in performing intubation were better in the gliding group than in the conventional group.Conclusion: Our findings demonstrated a superior glottic view and more favorable intubation environments when the blade tip was placed under the epiglottis than using the conventional Macintosh technique in patients with immobilized cervical spine.
Postoperative norepinephrine versus dopamine in patients undergoing noncardiac surgery: a propensity-matched analysis using a nationwide intensive care database
Authors: Aoki Yoshitaka , Nakajima Mikio , Sugimura Sho , Suzuki Yasuhito , Makino Hiroshi , Obata Yukako , Doi Matsuyuki , Nakajima Yoshiki
Published: March 2023

Background: Choosing catecholamines, such as norepinephrine and dopamine, for perioperative blood pressure control is essential for anesthesiologists and intensivists. However, studies specific to noncardiac surgery are limited. Therefore, we aimed to evaluate the effects of postoperative norepinephrine and dopamine on clinical outcomes in adult noncardiac surgery patients by analyzing a nationwide intensive care patient database.Methods: The Japanese Intensive care PAtient Database (JIPAD) was used for this multicenter retrospective study. Adult patients in the JIPAD who received norepinephrine or dopamine within 24 h after noncardiac surgery in 2018–2020 were included. We compared the norepinephrine and dopamine groups using a one-to-one propensity score matching analysis. The primary outcome was in-hospital mortality. Secondary outcomes were intensive care unit (ICU) mortality, hospital length of stay, and ICU length of stay.Results: A total of 6,236 eligible patients from 69 ICUs were allocated to the norepinephrine (n = 4,652) or dopamine (n = 1,584) group. Propensity score matching was used to create a matched cohort of 1,230 pairs. No differences in the in-hospital mortality was found between the two propensity score matched groups (risk difference: 0.41%, 95% CI [−1.15, 1.96], P = 0.608). Among the secondary outcomes, only the ICU length of stay was significantly shorter in the norepinephrine group than in the dopamine group (median length: 3 vs. 4 days, respectively; P < 0.001).Conclusions: In adult patients after noncardiac surgery, norepinephrine was not associated with decreased mortality but was associated with a shorter ICU length of stay than dopamine.
Formulation design and physicochemical evaluation of an anti-inflammatory hydrogel patch containing Crinum asiaticum L. extract
Authors: Kongkwamcharoen Chonthicha , Itharat Arunporn , Ketjinda Wichan , Lee Hyang-Yeol , Moon Gi-Seong , Davies Neal M.
Published: March 2023

Background and purpose:

Crinum asiaticum L. has long been used in Thai traditional medicine to treat osteoarthritis and inflammation by placing it on painful areas without further formulation design which is suboptimal for therapeutic use. Thus, this research aims to formulate a topical hydrogel patch containing C. asiaticum L. extracts (CAE) for anti-inflammatory effects.

Experimental approach:

The hydrogel patches are made from carrageenan, locust bean gum, with glycerin as a plasticizer and contain CAE formulated by using response surface methodology based on Box-Behnken design for design, determination of the effect of independent factors on the tensile strength, and optimization of the hydrogel patch formulation. In vitro release and skin permeation studies using a modified Franz diffusion cell and anti-inflammatory activity were evaluated.

Findings/Results:

The optimized CAE hydrogel patch showed a good correlation between predicted and observed tensile strength values and exerted its maximum cumulative lycorine release and permeation at 69.38 ± 2.78% and 48.51 ± 0.45%, respectively which were fit to Higuchi's kinetic model. The release rates were found to decrease with an increase in the polymer proportion of carrageenan and locust bean gum. In addition, the patch exerted potent in vitro anti-inflammatory activity with an IC50 value of 21.36 ± 0.78 μg/mL.

Conclusion and implication:

The optimized CAE hydrogel patch application was successfully formulated with excellent mechanical properties, cumulative release, permeation, and anti-inflammatory effects. Thus, it has the potential to be further developed as a herbal application to relieve pain and inflammation. The in vivo anti-inflammatory effect of this delivery system should be further investigated.
The effects of kindling during pregnancy on long-term potentiation (LTP) induction and M1 muscarinic acetylcholine receptors in male rat offspring
Authors: Pourmotabbed Ali , Naghizadeh Razieh , Moradpour Farshad , Veisi Mozhgan , Nedaei Seyed Ershad , Zarei Fatemeh , Salimi Zahra
Published: March 2023

Background and purpose:

Neonates of pregnant women with epilepsy may compromise normal neurodevelopment and hippocampal morphology. Memory and learning disorders and a decrease in verbal IQ scores are seen in these children later in life. In the previous study, we suggested that the central muscarinic cholinergic receptors had an important role in learning and memory deficits induced by prenatal pentylenetetrazol-kindling in pups born to kindled mothers. This study aimed to investigate the effects of kindling during pregnancy on long-term potentiation (LTP) induction and the role of M1 muscarinic acetylcholine receptors in the hippocampus of male offspring.

Experimental approach:

Twenty female Wistar rats were divided into two groups on the 13th day of their gestation (kindled and control; n = 10). Animals in the first group were kindled by i.p. injections of 25 mg/kg body weight pentylenetetrazol every 15 min until seizures occurred and the control group received normal saline. The effect of maternal seizures and perfusion of specific M1 muscarinic receptors antagonist (telenzepine at doses of 0.01, 0.1, and 1 nmol) on the LTP induction of 80 pups were tested at 12 weeks of age by field potential recordings.

Findings/Results:

The results of the electrophysiological study revealed that recurrent seizures during pregnancy impaired field excitatory postsynaptic potentials (fEPSP)-LTP induction and normal development of M1 muscarinic receptors in the hippocampus of male offspring. Also, the results demonstrated that maternal seizure did not significantly affect the paired-pulse indexes and population spike-LTP in the hippocampus of male offspring.

Conclusion and implications:

Our study showed that recurrent seizures during pregnancy cause impaired fEPSP-LTP induction and abnormal development of the M1 muscarinic receptor in the hippocampus.
Impact of Cardiac Rehabilitation on Psychological Factors, Cardiorespiratory Fitness, and Survival: A Narrative Review
Authors: Abelhad Nadia Isabel , Kachur Sergey M. , Sanchez Alexandra , Lavie Carl J. , Milani Richard V.
Published: March 2023

Cardiac rehabilitation (CR) is a form of prescribed exercise that is a multidisciplinary approach designed to improve cardiac function and quality of life following major adverse cardiovascular events. In this comprehensive overview, we will describe the individual components of exercise training and discuss the preset doses for effective CR based on recent meta-analyses. We will also review the effects of prescribed exercise medicine on outcomes such as psychosocial stress factors, cardiorespiratory fitness, and survival and their individualized impact on special populations.
Improving Fitness Through Exercise Will Improve Our Heart and Mind
Authors: Lavie Carl J. , Zhang Icey , Yang Doris , Liu Meiyan
Published: March 2023

In the interview, Prof. Carl “Chip” J. Lavie gave suggestions on daily exercise, shared impressive cases of cardiovascular disease (CVD) patients, gave professional explanations of weight management and CVD outcomes, etc. His major viewpoints are: (a) psychological stress is a major risk factor for CVDs, (b) a low-level physical activity contributes to a high prevalence of most CVD risk factors, and regular exercise training can improve cardiac function and aerobic performance, and (c) the prognosis and survival among CVD patients with low physical activity are better in the obese than the lean.
Reversal of Premature Hair Graying Treated with a Topical Formulation Containing α-Melanocyte-Stimulating Hormone Agonist (Greyverse Solution 2%)
Authors: Chavan Dipali
Published: March 2023

With aging, hair graying is a common sign resulting from complex regulation of melanogenesis. Multiple factors control the stimulation of melanogenesis at the level of the hair follicle, including melanin-stimulating hormone (MSH), adrenocorticotropic hormone, endothelin-1, prostaglandins, leukotrienes, neutrophils, fibroblast growth factor, nitric oxide, catecholamines, Vitamins, and minerals. Premature hair graying (PHG) has a major impact on the cosmesis, self-credibility, and social life of the affected individual. Currently, there is no medical treatment available for PHG. We present a case of a 25-year-old female with a history of graying of hair on the scalp. Clinical diagnosis revealed it as a case of premature graying/canities. She was prescribed a topical formulation (Greyverse solution) containing palmitoyl tetrapeptide 20, a biomimetic biopeptide of α-MSH for treating her PHG. The formulation was applied 1 mL twice daily directly on the affected part of the scalp. Hair supplements containing a combination of biotin and calcium pantothenate once daily orally were also prescribed. After 3 months, the patient showed some improvement, and the dose of the topical solution was reduced to 1 mL once daily. After 5 months, the patient achieved >90% conversion of gray hair to black hair.
Ichthyosis Follicularis with Alopecia and Photophobia Syndrome with Coexisting Palmoplantar Keratoderma Treated with Acitretin
Authors: Rajesh Supriya , Loganathan Eswari , Shanmukhappa Asha Gowrappala
Published: March 2023

Ichthyosis follicularis with alopecia and photophobia (IFAP) syndrome is a rare congenital genetic disorder characterized clinically by a triad of follicular ichthyosis, alopecia and photophobia. The genetic inheritance pattern in IFAP syndrome is said to be X-linked with mutations of the membrane-bound transcription factor peptidase, site 2 gene. Histopathology of the skin shows dilated hair follicles with keratin plugs extending above the surface of the skin. In this case report, we describe a 6-year-old girl with clinical features of IFAP along with palmoplantar keratoderma. Skin biopsy was done to confirm the diagnosis after which she was started on acitretin (10 mg per day). Good improvement in cutaneous features was observed after 1 month.
Osteoradionecrosis of the occipitocervical junction
Authors: Sakamoto Masaki , Shimizu Takayoshi , Suehiro Atsushi , Matsuda Shuichi
Published: March 2023

We report the case of a 57-year-old man who developed osteoradionecrosis (ORN) at the occipitocervical (OC) junction after radiation therapy for nasopharyngeal carcinoma. During soft-tissue debridement using a nasopharyngeal endoscope, the anterior arch of the atlas (AAA) was spontaneously disrupted, which was later spat out. Radiographic examination revealed complete disruption of the AAA that caused OC instability. We performed posterior OC fixation. The patient experienced successful postoperative pain relief. AAA disruption secondary to ORN at OC junction can cause severe instability. Posterior OC fixation alone may be an effective procedure if the necrotic pharyngeal region is mild and endoscopically controllable.
Prevalence of lumbosacral transitional vertebra among 4816 consecutive patients with low back pain
Authors: Byvaltsev Vadim A. , Kalinin Andrei A. , Shepelev Valery V. , Pestryakov Yurii Ya. , Aliyev Marat A. , Hozeev Dmitriy V. , Biryuchkov Mikhail Y. , Kundubayev Rustem A. , Riew K. Daniel
Published: March 2023

Study Design:

A retrospective single-center study.

Background:

The prevalence of the lumbosacral anomalies remains controversial. The existing classification to characterize these anomalies is more complex than necessary for clinical use.

Purpose:

To assessment of the prevalence of lumbosacral transitional vertebra (LSTV) in patients with low back pain and the development of clinically relevant classification to describe these anomalies.

Materials and Methods:

During the period from 2007 to 2017, all cases of LSTV were preoperatively verified, and classified according to Castellvi, as well as O’Driscoll. We then developed modifications of those classifications that are simpler, easier to remember, and clinically relevant. At the surgical level, this was assessed intervertebral disc and facet joint degeneration.

Results:

The prevalence of the LSTV was 8.1% (389/4816). The most common L5 transverse process anomaly type was fused, unilaterally or bilaterally (48%), to the sacrum and were O’Driscoll's III (40.1%) and IV (35.8%). The most common type of S1-2 disc was a lumbarized disc (75.9%), where the disc's anterior-posterior diameter was equal to the L5-S1 disc diameter. In most cases, neurological compression symptoms (85.5%) were verified to be due to spinal stenosis (41.5%) or herniated disc (39.5%). In the majority of patients without neural compression, the clinical symptoms were due to mechanical back pain (58.8%).

Conclusions:

LSTV is a fairly common pathology of the lumbosacral junction, occurring in 8.1% of the patients in our series (389 out of 4,816 cases). The most common types were Castellvi's type IIA (30.9%) and IIIA (34.9%) and were O’Driscoll's III (40.1%) and IV (35.8%).
Our experiences in patients with atlanto-occipital dislocation
Authors: Daneshi Abdoulhadi , Rahimizadeh Abolfazl , Fattahi Arash , Darvishnia Saina , Masoudi Omid , Mohajeri Seyed Mohammad Reza
Published: March 2023

Atlanto-occipital dislocation (AOD) is an injury to the upper cervical spine that occurs after trauma. This injury is associated with a high mortality rate. According to studies, 8%–31% of deaths caused by accidents are due to AOD. Due to the improvement in medical care and diagnosis, the rate of related mortality has decreased. Five patients with AOD were evaluated. Two cases had type 1, one case had type 2, and two other patients had type 3 AOD. All patients had weakness in the upper and lower limbs and underwent surgery to fix the occipitocervical junction. Other complications in patients were hydrocephalus, 6 nerve palsy, and cerebellar infarction. All patients improved in follow-up examinations. AOD damage is divided into four groups: anterior, vertical, posterior, and lateral. The most common type of AOD is type 1 and the most instability is type 2. There are neurological and vascular injuries due to pressure on regional components; vascular injuries are associated with high mortality rate. In most patients, their symptoms improved after surgery. AOD requires early diagnosis and immobilization of the cervical spine along with maintaining the airway to save the patient's life. It is necessary to consider AOD in cases with neurological deficits or loss of consciousness in the emergency unit because earlier diagnosis could cause a wonderful improvement of the patient's prognosis.
Safety and effectiveness of a posterior approach alone for surgical treatment of sacral-presacral tumors
Authors: Demir Fatih , Kaplan Metin , Akgün Bekir , Kök Selman , Öztürk Sait , Erol Fatih Serhat
Published: March 2023

Aim:

We aimed to examine the safety and effectiveness of a posterior approach alone in the surgical treatment of sacral-presacral tumors. In addition, we investigate factors that determine the selection of a posterior approach alone.

Materials and Methods:

Patients with sacral-presacral tumors who underwent surgery in our institution between 2007 and 2019 were examined in this study. Data regarding patient age, gender, tumor size (>6 cm and <6 cm), tumor localization (below or above S1), tumor pathology (benign or malignant), surgical approach (anterior alone, posterior alone, or combined), and extent of resection were recorded. The Spearman's correlation analyses were conducted between surgical approach and tumor size, localization, and pathology. Factors influencing the extent of resection were also examined.

Results:

Complete tumor resection was achieved in 18 of 20 patients. A posterior approach alone was used in 16. No strong or significant relation was detected between surgical approach and tumor size (r = 0.218; P = 0.355). There was no strong or significant relationship between surgical approach and tumor localization (r = 0.145; P = 0.541) or tumor pathology (r = 0.250; P = 0.288). Tumor size, localization, and pathology were not independent factors that determined surgical approach. The only significant independent determining factor for incomplete resection was tumor pathology (r = 0.688; P = 0.001).

Conclusion:

A posterior approach is safe and effective in the surgical treatment of sacral-presacral tumors independent of tumor localization, size, or pathology and is a feasible first-line treatment option.
Arthrodesis versus dynamic neutralization
Authors: Meco Leonard , Finzi Simone Stefano , Scoscina Dalila , Amico Silvia , Sirabella Francesco Saverio , Rotini Marco , Martiniani Monia , Specchia Nicola , Gigante Antonio Pompilio
Published: March 2023

Study Design:

This was a retrospective comparative study.

Objectives:

The aim of this study was to perform a clinical and radiological retrospective evaluation of the most used techniques for the lumbar degenerative disk disease (DDD) treatment: arthrodesis versus dynamic neutralization (DN)-Dynesys dynamic stabilization system.

Methods:

The study included 58 consecutive patients affected by lumbar DDD, 28 treated with rigid stabilization and 30 with DN at our department between 2003 and 2013. The clinical evaluation was performed through the Visual Analog Scale (VAS) and the Oswestry Disability Index (ODI). The radiographic evaluation was performed through standard and dynamic X-ray projections and magnetic resonance imaging.

Results:

Both techniques determined a clinical improvement in the postoperative period compared to the preoperative one. There were no significant differences between the postoperative VAS of the two techniques. The DN group postoperative ODI percentage showed a significant improvement (P = 0.026) compared to the arthrodesis group. During the follow-up, no clinically significant differences were highlighted between the two techniques. At a long term follow up period, radiographic results showed, in both groups, a L3–L4 disk mean height reduction and an increase of segmental and lumbar lordosis without significant differences between the two techniques. During an average of 96-month follow-up period, 5 (18%) patients developed an adjacent segment disease in the arthrodesis group and 6 (20%) patients developed this syndrome in the DN group.

Conclusions:

We are confident in recommending arthrodesis and DN as effective techniques for lumbar DDD treatment. Both techniques are potentially burdened, with similar frequency, by the development of long-term adjacent segment disease.