bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis of Antibiotic Treatment and Microbiological Findings and Its Implication on Outcome in Patients with Parapneumonic Effusions
Authors: Petrusevska-Marinkovic Sanja
Published: July 2024

BACKGROUND: Parapneumonic effusion (PPE), as a complication of community-acquired pneumonia, sometimes progresses into complicated PPE (CPPE) and empyema, thus becoming a significant clinical problem. There is a lack of guidelines for antibiotic therapy and reports on local microbiological status and resistance of microorganisms.
AIM: Тhe paper is focused on the analysis of antibiotic therapy and microbiological findings that are affecting patient outcomes and length of treatment.
METHODS: We analyzed 94 patients, 50 with uncomplicated PPE (UCPPE) and 44 with CPPEs.
RESULTS: More patients (59.57%) were male, average age 53.82 ± 17.5 years. Alcoholism was the most common comorbidity in patients with CPPE registered in 25% of patients. A positive pleural punctate culture was present in 31.82% of patients with CPPE. Peptostreptococcus was most often isolated in 28.57%. Blood culture was positive in 12.76% of patients. Most of the patients were treated with combined therapy that also covered anerobes (64.89%). Statistical differences existed in terms of days of hospital treatment with a longer hospital stay for patients with CPPE (p < 0.0001). The average time of hospital treatment in patients with UCPPE was 15 days, and in patients with CPPE, it was 21 days.
CONCLUSION: As soon as a pleural infection is noted, patients should receive antibiotic therapy, which should be based on pleural fluid culture. Anerobic coverage is required. In this way, the development of CPPE and empyema will be prevented, and thus, mortality and long hospital stays will be reduced.
Estimating the demand for certified chickpea seeds among smallholder farmers in the Eastern and South Western Shewa Zones of Oromia, Ethiopia
Authors: Gemechu Abera , Gemechu Bekele
Published: July 2024

Previous studies in Ethiopia have primarily focused on the adoption of improved chickpea varieties along with complementary inputs. However, there is a significant research gap when it comes to investigating the determinants that influence the demand for certified seeds in the country. This study aims to examine these determinants and their impact on the demand for certified chickpea seeds among farmers in Ethiopia. Data were collected from 186 randomly selected sample farmers using a multistage sampling approach. A double hurdle model was used to analyze the data, considering that the decisions to participate in certified seed purchase and the quantity of seeds purchased are influenced by different factors. The results show that land size, household size, age, education level, cooperative membership, access to extension services, seed price, and distance to the cooperative office were found to significantly influence participation in seed purchase. Moreover, household size, education level, land size, livestock holding, seed price, and cooperative membership were identified as significant factors influencing the quantity of certified chickpea seeds purchased. In conclusion, by improving the skill of farmers, guaranteeing the availability of certified seeds through collaborative efforts, and implementing a program that offers subsidies on seed prices, it is possible to boost crop productivity for farmers with limited resources. The study suggests that supporting certified seed producers and implementing a seed price subsidy program could enhance crop productivity for farmers with limited resources. It also recommends policies to prioritize improving the availability and quality of certified seeds for farmers in Ethiopia.
La course aux ports africains ? Contributions chinoises au développement portuaire africain
Authors: Aurégan Xavier
Published: July 2024

Depuis le milieu des années 2000, la transition portuaire est à l’œuvre sur les façades maritimes africaines. Terminalisation, spécialisation et modernisation des ports africains sont autant le fait de stratégies de développement nationales et régionales que celui de la présence accrue d’opérateurs mondialisés, dont les entreprises chinoises. Cet article tend à analyser les différentes modalités d’intervention des acteurs portuaires chinois en Afrique et, partant, leur contribution au développement portuaire africain. Parmi les quatre principaux groupes chinois présents sur les littoraux du continent, China Merchants semble actuellement la plus à même d’incarner ce big push portuaire et logistique avant tout provoqué par l’Union africaine et ses États membres.
Tous les chemins mènent à Nouakchott. Routes, usages et territoires dans la Mauritanie contemporaine
Authors: Mareï Nora , Lombard Jérôme
Published: July 2024

Alors que les infrastructures ont servi de support au développement territorial de la Mauritanie, depuis la route de Rosso jusqu’à celle de Nouadhibou, sans compter les plus récentes qui longent le fleuve Sénégal au sud ou qui, au centre, relient Atar et Tidjikja, il convient de regarder autrement leurs effets sur les circulations de personnes et de marchandises qui se déploient à l’intérieur comme à l’extérieur du pays. Nouakchott, capitale créée ex-nihilo au moment de l’indépendance, devient au rythme des transformations du pays un carrefour singulier. Les grandes routes du pays rayonnent, depuis ce pôle urbain, selon trois orientations principales : un axe littoral Nord-Sud, maillon des relations entre Maroc, Mauritanie et Sénégal ; la route vers Tindouf en Algérie, qui nous projette, dans le jeu diplomatique régional ; la route de l’Espoir enfin ou Transmauritanienne qui traverse le sud du pays d’ouest en est, jusqu’aux portes du Mali. En tentant de dépasser l’image que se donne la Mauritanie en Afrique de l’Ouest, celle d’un pays reliant ses voisins les uns aux autres, notre objectif est de saisir la manière dont, dans l’histoire récente du pays, les pouvoirs politiques successifs ont construit le réseau d’infrastructures, et surtout l’usage qu’en font les différentes catégories de la population mauritanienne.
Aeromobility, space and modernity: civil aviation in postcolonial African history
Authors: Lecocq Baz , Bersselaar Dmitri van den
Published: July 2024

Dans cet article, nous transposons l’histoire de l’aviation civile africaine dans un aperçu général de l’histoire économique, sociale et politique postcoloniale du continent. L’objectif est d’explorer comment les études de cas empiriques de l’histoire de l’aviation peuvent nous fournir de nouvelles perspectives sur l’histoire contemporaine du continent. Nous proposons que les concepts d’aéromobilité, divisé entre aéromobilité et reconfiguration de l’espace, aéromobilité et reconfiguration de la modernitée vitesse commerciale contribuent à la structuration de ces histoires, car ils permettent de combiner les explorations du développement technique, de la production matérielle et de la consommation de l’aviation avec les imaginaires, les attentes, la politique, l’accès et le statut. Après avoir introduit ces termes, nous les appliquerons à une brève histoire générale de l’aviation civile en Afrique, basée sur une bibliographie éparse et incomplète sur le sujet. À l’heure actuelle, l’histoire de l’aviation du continent reste à écrire.
La modernisation urbaine depuis la portière d’un minibus à Yopougon (Abidjan). Les effets du nouvel ordre infrastructurel sur les vies citadines
Authors: Spire Amandine , Lanne Jean-Baptiste , Kouakou Léopold
Published: July 2024

Cet article explore les effets de l’amorce d’un nouvel ordre infrastructurel sur les vies citadines liées au transport artisanal à Abidjan. Il vise à comprendre ce que signifie restructurer un ensemble d’acteurs et de lieux qui, pris ensemble, constituent plus qu’un secteur économique ou un service urbain, mais un milieu d’ancrage et de circulation des vies précaires en ville. À l’aide de la métaphore du milieu empruntée à M. Foucault, l’objectif de l’article réside dans l’examen d’une technique de gouvernement consistant à intervenir sur un espace donné pour infléchir des circulations existantes (de normes, de personnes, d’objets). Cette approche offre un double questionnement de recherche : à quelles conditions une norme institutionnelle vient-elle concurrencer, infléchir ou invisibiliser un ensemble de normes déjà existantes au sein d’un milieu ? Que touche-t-on à distance, quels équilibres risque-t-on de bouleverser, que laisse-t-on de côté et à quelles échelles, lorsqu’un nouvel ordre infrastructurel s’immisce dans un milieu existant ? Pour répondre à ces questions, nous avons mené une enquête de terrain en avril 2023, en nous concentrant sur une petite ligne de gbaka (minibus) dans la commune populaire de Yopougon, selon une démarche qualitative. Depuis janvier 2022, l’AMUGA expérimente sur cette ligne la mise en place d’arrêts-minute afin de mettre fin à des usages jugés désordonnés en vue de l’arrivée du Bus Rapid Transit (BRT) Yopougon-Bingerville. Les changements en cours font de cette ligne un observatoire singulier d’une tentative de gouvernement à distance lorsqu’un nouvel ordre s’immisce dans un milieu.
Mobilités et transformation numérique : l’exemple de Kigali au Rwanda
Authors: Boutueil Virginie , Lesteven Gaële
Published: July 2024

Le gouvernement rwandais mène depuis le début des années 2010 une politique volontariste de modernisation de l’offre en transports en commun dans la capitale du Rwanda, Kigali. À partir d’un travail de terrain mené en 2019, la note analyse le rôle du numérique dans cette transformation. Elle conclut à une réforme en profondeur du secteur des transports (minibus informels interdits de circulation, modernisation de la flotte de bus, gares routières restructurées et arrêts de bus installés), en partie adossée à des outils numériques (cartes à puce pour la billettique, obligation d’équiper les taxis-motos et taxis de compteurs électroniques). Ces changements accentuent les contrôles sur les transactions commerciales et les mobilités, allant jusqu’à exacerber le risque d’exclusion économique ou technique de certaines populations.
On general Kirchhoff type equations with steep potential well and critical growth in $ \mathbb{R}^2 $
Authors: Lou Zhenluo , Zhang Jian
Published: July 2024

In this paper, we study the following Kirchhoff-type equation:   $ \begin{equation*} M\left(\displaystyle{\int}_{\mathbb{R}^2}(|\nabla u|^2 +u^2)\mathrm{d} x\right)(-\Delta u+u) + \mu V(x)u = K(x) f(u) \ \ \mathrm{in} \ \ \mathbb{R}^2, \end{equation*} $ where $ M \in C(\mathbb{R}^+, \mathbb{R}^+) $ is a general function, $ V \geq 0 $ and its zero set may have several disjoint connected components, $ \mu > 0 $ is a parameter, $ K $ is permitted to be unbounded above, and $ f $ has exponential critical growth. By using the truncation technique and developing some approaches to deal with Kirchhoff-type equations with critical growth in the whole space, we get the existence and concentration behavior of solutions. The results are new even for the case $ M \equiv 1 $.
Pricing green financial options under the mixed fractal Brownian motions with jump diffusion environment
Authors: Chen Kung-Chi , Chen Kuo-Shing
Published: July 2024

To cope with severe climate change, traditional emission reduction and environmental protection measures must be supported by financial instruments. The paper investigates green financial options, measured by the green cryptocurrency (Solana) and carbon emissions allowances, under fractal Brownian motions with jump detection. To this purpose, after observing the dynamic price correlations between all the variables. We introduce a mixed fractional Brownian motion model for the two types of green financial assets with possible jumps driven by an independent Poisson process. Then, pricing European green crypto options and carbon options in a generalized mixed fractional Brownian Motion with jumps detection. This research aims to explore the strategy of European contingent claims written on the underlying asset of green financial assets. When the underlying asset prices follow the mixed fractional Brownian motion with jumps the valuation of European call and put green financial options can be discovered. The finding provides a meaningful and enlightening reference to avoiding green investment risk. More generally, it could be beneficial for responsible investment and risk management in green financial markets under green financial regulations to protect investors and public interests.
Leçon inaugurale au Collège de France (1987)
Authors: Granger Gilles-Gaston
Published: July 2024

Gilles-Gaston Granger est une figure majeure de l’épistémologie de la seconde moitié du xxe siècle. Son œuvre, où l’ontologie des objets scientifiques joue un rôle important, reste cependant encore trop méconnue, en particulier au niveau international. Plusieurs raisons contribuent à le remettre au centre des débats contemporains : l’importance du structuralisme philosophique et mathématique dans la philosophie des mathématiques récente ; les études menées récemment sur la tradition francophone à laquelle il appartient ; ou encore le développement d’un intérêt général en philosophie des sciences et au-delà pour l’épistémologie historique. Sa leçon inaugurale au Collège de France occupe une place spécifique dans son œuvre. Il s’agit d’un texte important, en lui-même et pour la compréhension du philosophe aixois. Granger s’y positionne dans la tradition française, mais surtout y énonce ses convictions profondes – sur les rapports entre philosophie et histoire, par exemple – et son programme intellectuel, indissociable de la notion d’épistémologie comparative, à laquelle son nom restera associé. La leçon est rééditée ici dans son intégralité, accompagnée d’un texte de présentation et contextualisation par Gabriella Crocco et Frédéric Patras.
Las didascalias en los manuscritos autógrafos de Lope. A vueltas sobre su doble realización gráfica
Authors: Blasut Giada
Published: July 2024

Con la presente contribución me propongo estudiar las didascalias en los manuscritos dramáticos autógrafos de Lope de Vega. En particular, aspiro a describir las didascalias autógrafas de Lope centrándome en la indicación del locutor propiamente dicha, la posición que las didascalias ocupan en el folio y respecto a la caja de escritura del texto y su realización gráfica.
En busca de una imposible autonomía del arte: el compromiso literario de Leonardo Padura en La neblina del ayer
Authors: Merlos Lucas
Published: July 2024

En La neblina del ayer, un conjunto de dispositivos estéticos y narrativos construyen la idea de una capacidad de la creación artística para autonomizarse del poder político, medio por el cual, en un contexto dictatorial, el acto creador puede precisamente resultar subversivo. Sin embargo, esta crítica sufre limitaciones y sigue siendo excepcional en Cuba.
Entre el culto al epos y el amor a Tasso: el Discurso preliminar de Sas a su traducción de la Liberata (1817)
Authors: Mondola Roberto
Published: July 2024

El artículo estudia el Discurso preliminar que Melchor de Sas antepone a su traducción en verso blanco de la Gerusalemme Liberata, editada en 1817. A través del análisis de las modalidades con las cuales Sas desarrolla su apología del epos y defiende los principios en los que fundó su labor de traducción, el artículo arroja luz sobre un capítulo significativo en la historia de la irradiación de la Gerusalemme en las letras hispánicas.
L’exil de Kallipos et la révolte des δοῦλοι argiens
Authors: Pierrot Antoine
Published: July 2024

F. Ruzé et H. van Effenterre avaient inclus dans le deuxième volume de Nomima l’inscription sur plomb découverte en 1977 par V. Lambrinoudakis, dans laquelle l’exilé argien Kallippos, accompagné de ses ϝοικιᾶται, demandait l’asile aux Épidauriens vers 460 avant J.‑C. Lambrinoudakis voyait dans cet exil la conséquence de la défaite des δοῦλοι argiens, dont Kallippos était censé avoir épousé la cause, au terme de la longue guerre civile qui avait opposé ces derniers à leurs anciens maîtres dans les décennies suivant la bataille de Sépéia (Hérodote, Histoires, VI, 83). L’étude chronologique des événements argiens montre l’impossibilité d’une telle hypothèse, et il paraît plus vraisemblable de supposer que Kallippos avait en réalité fui l’établissement de la démocratie dans sa cité vers 460 avant J.‑C., et contraint ses propres esclaves ou serfs (ϝοικιᾶται) à le suivre dans son exil. Il se pourrait même que Kallippos ait été l’une des premières victimes de la procédure d’ostracisme nouvellement instaurée par la jeune démocratie argienne.
Introduction
Authors: Wolkenstein Julie
Published: July 2024

Cette brève introduction présente les deux pistes de réflexion ouvertes par ce second volume de « La Nouvelle Vague à la lettre », travail collectif consacré à la présence de la lettre sous toutes ses formes dans les films des cinéastes de la Nouvelle Vague : leur conception et leur pratique de l’adaptation littéraire d’une part et leurs manières d’inscrire matériellement le texte dans l’image d’autre part. Pour plus de détails sur l’origine scientifique de ce projet de recherche et les questions qu’il soulève, on se reportera à l’avant-propos du précédent volume (Recherches & Travaux, no 101, 2022).
Le roman d’une actrice : Madame Bovary par Claude Chabrol et Isabelle Huppert
Authors: Salha Agathe
Published: July 2024

Cet article analyse le rôle central joué par l’interprétation d’Isabelle Huppert dans l’adaptation de Madame Bovary au cinéma par Claude Chabrol.
(S’)Écrire, (s’)envoyer des images : Truffaut et les échanges épistolaires
Authors: Amiel Vincent
Published: July 2024

L’un des aspects les plus novateurs du cinéma de François Truffaut est sa capacité à scander les récits par l’usage de la narration épistolaire. Cette dernière accélère ou ralentit l’apport d’informations comme ne peuvent le faire le suivi de l’action ou les simples dialogues. Raconter des histoires autrement aura été la grande affaire de Truffaut, et de ses contemporains de la Nouvelle Vague.
D’une rive à l’autre. Les génériques de la Nouvelle Vague
Authors: Mauffrey Nathalie
Published: July 2024

Par une analyse sémiologique, stylistique et figurale des génériques, ce texte double la partition politique entre les deux rives de la Nouvelle Vague d’une dimension poétique : rive droite, les textoclastes qui brisent et font exploser l’écrit pour lui substituer leurs figures ; rive gauche, les iconoclastes qui déconstruisent par l’écrit les images de l’intérieur.
Luc Moullet et le littéral
Authors: Eugène Pierre
Published: July 2024

À rebours du goût littéraire de ses contemporains de la Nouvelle Vague, Luc Moullet (né en 1937) déploie dans son œuvre critique et cinématographique une étonnante pratique du littéral. Cet article, à travers de multiples exemples dans ses films et textes, mais aussi ses interventions polémiques (contre Christian Metz, notamment) qui le rapprochent des sophistes de l’Antiquité, étudie comment son œuvre met en place toutes sortes de jeux sur le signifiant, donné à voir et à entendre comme un objet parmi d’autres, dépouillant les prétentions métaphysiques du langage pour viser une réalité matérielle, non sans humour.
Le dispositif de la lettre ouverte dans Letter to Jane de Jean-Luc Godard (1972)
Authors: De Vita Philippe
Published: July 2024

Letter to Jane est une lettre ouverte : en s’adressant aussi au public, Godard et Gorin veulent témoigner d'un refus de se laisser enfermer dans un « tête à tête » avec l’instance de pouvoir que représente une star hollywoodienne. S’il y a dialogue, ce n’est pas tant avec Jane Fonda que dans la mise en correspondance entre le discours en voix off, la photo de Fonda parue dans la presse et les images de Tout va bien.
« Tupi or not guarani ». Les Notre Père des XVIe-XVIIe siècles
Authors: Boidin Capucine , Barros Cândida , Monserrat Ruth
Published: July 2024

Nous comparons dix versions du Notre Père dans des variantes de la famille linguistique tupi-guarani telles qu’elles ont été manuscrites ou imprimées entre 1575 et 1716, pour identifier les différentes stratégies de traduction de concepts chrétiens (par équivalence ou emprunt) ainsi que la circulation des copies. Nous prenons en compte les filtres sonores et orthographiques des scribes coloniaux, les erreurs communes des typographes pour mieux comparer les versions et ce avec trois points d’attention complémentaires : ne pas prendre pour acquise l’existence d’une langue tupi unifiée, ni d’un guarani homogène, ni d’une claire distinction entre deux ensembles linguistiques tupi/guarani avant la colonisation mais plutôt montrer comment la colonisation et l’évangélisation contribuent à cette distinction.
Un spécimen qui parle de lui-même : les fonctions des collections multilingues du Notre Père au XVIe siècle
Authors: Sergeev Michail , Van Hal Toon
Published: July 2024

Cet article explore l’intérêt des érudits de la Renaissance pour les traductions multilingues de l’oraison dominicale pendant le « long seizième siècle », en examinant les diverses approches adoptées. Durant cette période, de nombreux humanistes ont, en effet, initié des recueils de versions traduites de l’oraison dominicale à des fins diverses. Le rôle didactique est une caractéristique notable des premières publications polyglottes, visant à enseigner la lecture et l’écriture des alphabets étrangers pour familiariser les élèves à ces lettres inconnues. Dans le domaine de la chorographie, l’inclusion de l’oraison dominicale offre un aperçu des caractéristiques linguistiques des peuples décrits. Avec la publication, en 1555, du Mithridates de Conrad Gessner, l’oraison dominicale a servi d’outil pour la comparaison des langues, soulignant à la fois les différences et les affinités linguistiques. Par ailleurs, il existe également des manuscrits qui présentent une collection d’oraisons dominicales dans diverses langues et écritures, afin de mettre en évidence le potentiel esthétique de cette prière. La période s’est conclue avec la publication de la première compilation multilingue indépendante, mettant en évidence un intérêt croissant pour les différences linguistiques.
In viaggio
Authors: Scelsi Silvia
Published: July 2024

Di recente la FNOPI ha riunito la consulta delle società scientifiche per “tracciare la rotta” per il prossimo futuro degli infermieri. Grandi cambiamenti ci attendono, stiamo maturando una cultura professionale più specifica, nella quale riconosciamo giustamente i colleghi esperti in settori particolari, stiamo diventando una comunità che parla e si confronta sulle evidenze e sulle buone pratiche.
Ma siamo sicuri di essere pronti ad un nuovo salto? Mi ha colpito la considerazione di una persona esperta di comunicazione che mi ha restituito, chiaramente dietro mia espressa domanda, una immagine di noi come professione divisa e litigiosa, pronta a seguire interessi particolari senza, spesso, nemmeno considerare l’orizzonte complessivo. Non è stato facile vedersi raccontati così, ma devo ammettere che per alcuni aspetti è profondamente vero. [...]
The eastern Cape frontier zone 1660-1980: A cartographic guide for historical research
Authors: Oberholster A.G.
Published: July 2024

No abstract available.
Rediscovering Woodstock
Authors: Badham Andrea
Published: July 2024

Originally known as Papendorp, the Caperonian suburb of Woodstock has a rather neglected and run-down appearance. This article looks at the "bustling, sprawling mixture of crumbling residences and grimy industry" in what once was "a peaceful country village" with a rural air. Things, however, changed when a railway line was completed, stimulating suburbanization and industrialization. Population returns, industrial development, the influence of St Mary's Anglican Church and establishment of a municipality (1882) are analysed and described in an attempt to rediscover the Woodstock of yesterday and today.
Ruptured Aortic Aneurysm in Pregnancy, Anesthetic Management of Endovascular Procedure
Authors: Chauhan Richa , Balakrishnan Ira , Mishra Keshabanand , Kumar Virendra
Published: July 2024

Advanced pregnancy is associated with a higher risk of complicated aortopathies owing to the physiologic changes in pregnancy. The diagnosis can be elusive due to its rare incidence. The optimal treatment strategy is chosen based on the clinical condition of the patient, gestational age, and the severity of the aortic disease. A healthy young primigravida presented with acute chest pain in the early second trimester, diagnosed as a thoracic aortic aneurysm that had ruptured causing hemothorax. She underwent emergency endovascular repair under general anesthesia. Aortic disease should always be ruled out early in acute chest pain in pregnancy. Expeditious and strategic management helps improve maternal and fetal outcomes.
Venoarterial Extracorporeal Membrane Oxygenation for “Protected” Percutaneous Coronary Intervention Secondary to Refractory Polymorphic Ventricular Tachycardia and Cardiac Arrest
Authors: Phillips Jordan D. , Spratt John R. , Choi Calvin Y. , Scali Salvatore T. , Maybauer Marc O.
Published: July 2024

We present a case of cardiogenic shock secondary to refractory polymorphic ventricular tachycardia associated with coronary ischemia resulting in cardiac arrest. Following the return of spontaneous circulation, the patient was cannulated for peripheral venoarterial extracorporeal membrane oxygenation (V-A ECMO) in anticipation of high-risk “protected” percutaneous coronary intervention (PCI). Under full V-A ECMO support, inotropes and vasopressors were weaned off, and the patient underwent uneventful PCI of left circumflex and obtuse marginal lesions. After 48 hours, the patient was decannulated and could be discharged home alive 16 days after his initial cardiac arrest.
Intraoperative Aortic Dissection in a Case of Aneurysmal Dilatation of the Ascending Aorta Posted for Surgery
Authors: Nanda Chinmaya , Rawat Sarven Kumar Singh , Hakhoo Sushane , Mishra Manisha
Published: July 2024

Intraoperative aortic dissection is a life-threatening emergency. The prognosis of patients with aortic dissection has markedly improved in recent years due to prompt diagnosis and the institution of effective medical and surgical therapy. Transesophageal echocardiography (TEE) is helpful in the evaluation of this life-threatening disorder.
Ischemic Heart Disease with In-Stent Re-Stenosis with Complete Heart Block and Isolated Persistent Left Superior Vena Cava – Rare Case Report with Challenges and Clinical Implications
Authors: Yedurupaka Santhi Sree , Raj B Sanjay Soloman , Prasad R Maruthi Vara
Published: July 2024

Isolated persistent left superior vena cava (PLSVC) is a very rare congenital thoracic venous system anomaly and is commonly an incidental finding, usually detected during central venous access, cardiac catheterization, or cardiothoracic surgeries. This is a rare case report wherein the patient is a known case of ischemic heart disease with s/p percutaneous transluminal coronary angioplasty (PTCA) with a stent to left anterior descending (LAD) artery with in-stent re-stenosis presented with complete heart block and had an unanticipated discovery of isolated PLSVC on facing difficulty during the transvenous approach of permanent pacemaker implantation (PPI). In this case report, we inspect the challenges associated with and various clinical implications of isolated PLSVC.
Combined Stellate Ganglion Blockade and Epidural Thoracic Anesthesia for the Management of Ventricular Storm: A Case Report
Authors: Balão João , Sepúlveda Daniela , Borges Alexandra , Fonseca Cristiana , Rodrigues Susana Santos
Published: July 2024

The term “ventricular storm (VS)” is defined as the occurrence of two or more separate episodes of ventricular tachycardia or fibrillation (VT/VF) or three or more appropriate discharges of an implantable cardioverter defibrillator for VT/VF during a 24-h period. A patient in his early 40s was observed in the emergency department of our hospital and was admitted to the cardiac intensive care unit due to multiple episodes of VT. This led to the need for deep sedation with orotracheal intubation and mechanical ventilation. Intravenous lidocaine treatment was started; however, the patient had a recurrence of the episodes of VT. We decided to combine stellate ganglion block with epidural thoracic anesthesia. After the sympathetic block, there was no recurrence of the arrhythmic episodes. The patient was then transferred for ablation treatment. We demonstrated the efficacy of both techniques in managing a patient with multiple episodes of ventricular storm.
Venovenous ECMO for Acute Chronic Heart Failure after Bilateral Lung Transplantation
Authors: Carr Casey , Gries Cynthia J. , Rackauskas Mindaugas , Becker Torben K. , Saha Biplap K. , Emtiazjoo Amir , Maybauer Marc O.
Published: July 2024

Venovenous (VV) ECMO is rarely used during decompensated circulatory states. Although VA ECMO is the routine option, VV ECMO may be an option in selected patients. We present a case of pulmonary edema due to acute heart failure in a patient 4- and 12-year post-lung transplantation who received VV ECMO. Using a thoughtful cannulation strategy, VV ECMO, and aggressive ultrafiltration, the patient was successfully decannulated, extubated, and discharged from the hospital. In cardiogenic pulmonary edema, VV ECMO represents an additional, and likely under-utilized tool, especially in patients who are at high risk for ventilator-associated lung injury. Cannula location and size should be given additional consideration to potentially transition to V-AV ECMO configuration if necessary.
Novel Peri-Operative Strategy for Sickle Cell Disease with Tetralogy of Fallot
Authors: Khan Naveed , Dhabe Vaibhav , Kaskar Ameya , Kuppusamy Parthiban , Sen Supratim , Kumar Gaurav
Published: July 2024

Peri-operative management of cyanotic congenital heart disease in a patient of sickle cell disease (SCD) can be challenging. We report a case of Tetralogy of Fallot and homozygous SCD with history of multiple blood transfusions and sickle cell crises who underwent intracardiac repair. Hemoglobin S level was reduced from 75% pre-operative to 21.8% postoperative with a combination of pre-operative blood transfusion, intraoperative exchange transfusion, and normothermic cardiopulmonary bypass (CPB). Pre-operative optimization and safe intraoperative conduct were essential to avoid sickling crises.
Comparison of Transesophageal Echocardiography Probe as Surface Probe with Vascular Probe During Right Internal Jugular Vein Catheterization in Cardiac Surgeries
Authors: Antony Nishant R , Sundarsingh Subash , Radhakrishnan Anil , Sasidharan Swapna
Published: July 2024

Transesophageal echocardiography (TEE) has become an essential monitor for the management of most patients undergoing cardiothoracic surgery. TEE and central venous catheter placement are often used during cardiac surgeries. Here we conducted a study comparing TEE 3D probe as a surface probe with the ultrasound-guided (USG) vascular probe for guiding right internal jugular vein (IJV) catheterization.

Context:

USG vascular probe and TEE probe can help during central venous catheterization (CVC) and can confirm the location of guide wire in the neck vessels. We proposed this study, as there are only few studies comparing between TEE probe as surface probe and USG vascular probe for right IJV cannulation.

Aims:

To compare the TEE probe as a surface probe and USG vascular probe during right IJV catheterization in cardiac surgeries.

Settings and Design:

Prospective, comparative study.

Methods and Material:

One twenty-four patients of either sex posted for major elective cardiac surgery were included in this study. Patients were divided into two groups (TEE group and USG group) of 62 by assigning the study participants alternatively to each group. The goal of this study was to compare the puncture time, visualization of IJV to first successful puncture, quality of the imaging with needle tip positioning, and catheter positioning using both TEE probe and vascular probe. The primary outcome was comparison of time from visualization of the IJV to successful puncture using both TEE probe as a surface probe and vascular probe. Secondary outcome was to compare the quality of image with respect to needle tip positioning and compare quality of image with respect to catheter position using both probes.

Statistical Analysis Used:

Statistical analyses were performed by using a statistical software package SPSS, version 20.0.

Results:

The observation and results of our study clearly show the feasibility of TEE as surface probe for guiding central venous catheter in right IJV just like the vascular linear probe. There was no significant difference between the two groups (P > 0.05). No statistical differences were found in the puncture time, image quality, needle tip positioning, wire positioning, and catheter positioning between the two groups. All the P values were greater than 0.05.

Conclusions:

The TEE probe can be used as an alternative method to guide IJV puncturing and catheterization when the vascular probe is not available. It is feasible especially in cardiac surgeries where the TEE monitoring machine is a must in modern anesthesia and readily available than an ultrasound machine.
Continuous Positive Airway Pressure versus Differential Lung Ventilation during One Lung Ventilation for Thoracic Surgery
Authors: Purayil Aswathy Puthan , Nair Suresh Gangadharan , Abraham Jobin , Vazhakatt Joel Devasia , Rajmohan Nisha , Shaji Anupama
Published: July 2024

Introduction:

One lung ventilation (OLV) is a technique used during lung resection surgery to facilitate optimal surgical conditions. However, this may result in severe hypoxemia due to the right-to-left shunt created in the collapsed lung. Several techniques are used to overcome hypoxemia, one of which is continuous positive airway pressure (CPAP) to the non-dependent lung. Another technique is ventilating the non-dependent lung with a minimal volume, thus creating differential lung ventilation (DLV) or split lung ventilation (SLV). In this study, we compared the efficacy of CPAP to DLV during video-assisted thoracoscopic (VATS) lung resection.

Materials and Methods:

In this single-center randomized controlled, cross-over study, each patient acted as his control as well as the study. Patients crossed over from SLV to CPAP (or vice versa) with an interval period during which only OLV was used (control period). The primary objective of the study was to observe the changes in oxygenation, ventilation, and the surgeons’ perception of the surgical field using CPAP or SLV to the non-ventilated lung during the period of OLV in patients undergoing thoracic surgery.

Results:

The study revealed that oxygenation was significantly better when using SLV to the non-ventilated lung during the period of OLV (P = 0.03). However, the surgeon found a significantly better surgical field when applying CPAP to the surgical field.

Conclusions:

The study showed that using SLV to the non-ventilated lung during the period of OLV was superior in terms of oxygenation, although it interfered more with the surgical field.
Characteristics, management, and outcomes of patients with lung cancer admitted to a tertiary care intensive care unit over more than 20 years
Authors: Al-Dorzi Hasan M. , Atham Sadeem , Khayat Faten , Alkhunein Jullanar , Alharbi Bushra T. , Alageel Norah , Tlayjeh Mohamed , Tlayjeh Haytham , Arabi Yaseen M.
Published: July 2024

RATIONALE:

The prognosis of patients with lung cancer admitted to the intensive care unit (ICU) is often perceived as poor. We described the characteristics, management, and outcomes of critically ill patients with lung cancer and determined the predictors of mortality.

METHODS:

We retrospectively studied patients with lung cancer who were admitted to the ICU of a tertiary care hospital between 1999 and 2021 for the reasons other than routine postoperative care. We noted their characteristics, ICU management, and outcomes. We performed the multivariable logistic regression analysis to determine the predictors of hospital mortality.

RESULTS:

In the 23-year period, 306 patients with lung cancer were admitted to the ICU (median age = 63.0 years, 68.3% males, 45.6% with moderate/severe functional disability, most had advanced lung cancer, and median Acute Physiology and Chronic Health Evaluation II score = 24.0). Life support measures included invasive mechanical ventilation (47.1%), vasopressors (34.0%), and new renal replacement therapy (8.8%). Do-Not-Resuscitate orders were implemented during ICU stay in 30.1%. The hospital mortality was 43.8% with a significantly lower rate in patients admitted after 2015 (28.0%). The predictors of mortality were moderate/severe baseline disability (odds ratio [OR] 2.65, 95% confidence interval [CI] 1.22, 5.78), advanced lung cancer (OR 8.36, 95% CI 1.81, 38.58), lactate level (OR 1.45, 95% CI 1.12, 1.88, invasive mechanical ventilation (OR 10.92, 95% CI 4.98, 23.95), and admission period after 2015 (OR 0.37, 95% CI 0.16, 0.85).

CONCLUSIONS:

The mortality rates in patients with lung cancer admitted to the ICU during a 23-year period decreased after 2015. Functional disability, advanced lung cancer stage, vasopressor use, and invasive mechanical ventilation predicted mortality.
A very rare case of the right middle lobe torsion postlower lobectomy due to chronic lung abscess
Authors: Alkadrou Abdulkarim M. , Saleh Waleed N. , Alzamel Huda M. , Ahmed Abdelrahman A.
Published: July 2024

Middle lobe torsion (MLT) is an unusual complication in lung surgery that is usually associated with upper lobe lobectomy and rarely develops postlower lobectomy. In the case of MLT, urgent surgical intervention is required to decrease the risk of mortality and morbidity, and diagnosis is challenging due to the nonspecific symptoms of MLT. In this article, we present a case of a recurring lung abscess treated by the right lower lobectomy, complicated by the right MLT and to our knowledge MLT consider rarest complication postright lower lobectomy.
Interosseous ganglion cyst of the ribs with unusual presentation of hemoptysis
Authors: Hajjar Waseem M. , Hajjar Sundus W. , Alnassar Sami A. , Hajjar Ahmad W.
Published: July 2024

An interosseous ganglion cyst is a very rare entity, found mostly in skeletally mature patients, particularly in long bones such as the tibia and femur. However, we are the first to report here an unusual case of interosseous ganglion cyst of the upper ribs in a young female patient, which she had an unpredicted presentation of cough and hemoptysis and a large painful lump over the anterior left upper chest. The radiological and pathological workup confirmed the presence of a benign interosseous ganglion cyst arising from the left first rib, invading the second rib and the apex of the left lung. The patient has been treated successfully by surgical resection of this rib cyst. However, we could not find any reported cases in the current literature of an interosseous ganglion cyst pathology arising in the ribs with a similar presentation of cough and hemoptysis.
Morphological manifestation of tuberculous pleurisy in children under medical thoracoscope and diagnostic value
Authors: Li Qian , Tang Xiaodi , Yan Xiuli
Published: July 2024

OBJECTIVE:

Our study analyzed the main manifestations of tuberculous pleurisy (TBP) in children under medical thoracoscopy (MT). This article aimed to explore the clinical application value of MT in the diagnosis and treatment of TBP in children.

METHODS:

In our study, we selected 23 TBP patients diagnosed in our hospital. We analyzed the clinical data and thoracoscopic morphology of these patients. At the same time, we also observed the pathological manifestations, acid-fast staining, and treatment effects of the patient’s diseased tissue under MT.

RESULTS:

The MT clinical findings of TBP patients include pleural hyperemia and edema, miliary nodules, scattered or more white nodules, simple pleural adhesion, wrapped pleural effusion, massive cellulose exudation, yellow-white caseous necrosis, pleural hyperplasia and hyperplasia, and mixed pleural necrosis. The positive rate of pleural biopsy was 73.91% and that of acid-fast staining was 34.78%. The main pathologic types of these patients were tuberculous granulomatous lesions (16 cases), caseous necrosis (5 cases), and fibrinous exudative, multinucleated giant cell and other inflammatory cell infiltration lesions (13 cases). The average time of diagnosis of the 23 patients was 8.32 days (5.0–16.0 days), and they were transferred to specialized hospitals for treatment after diagnosis. The mean time of chest drainage was 3.0–5.0 days after treatment. The average time for their body temperature to return to normal was 3.31 days (2.0–5.0 days).

CONCLUSION:

Thoracoscopic lesions of TBP in children are varied. The use of MT is not only helpful for the early diagnosis and treatment of TBP. It also protects and improves lung function. Therefore, the use of MT has high clinical value.
Risk factors analysis of noninvasive positive pressure ventilation in inpatients with overlapping syndrome of chronic obstructive pulmonary disease combined with obstructive sleep apnea
Authors: Liu WenJing , Ding Fang , Guo Hong , Li JieMei , Guo Wei , Wang Jing , Cui ZhaoBo
Published: July 2024

OBJECTIVE:

The aim of the study was to analyze the clinical data of patients with chronic obstructive pulmonary disease and obstructive sleep apnea overlap syndrome (OS) during hospitalization and to evaluate the risk factors of patients treated with Non-Invasive Ventilation (NIV).

METHODS:

Demographic and clinical data of patients with confirmed OS during hospitalization were retrospectively collected. The patients were divided into two groups according to whether noninvasive ventilator was used during hospitalization, including OS treated with NIV (244 cases) and OS without NIV (239 cases). The t-test, χ
2 test, and Kaplan–Meier curve were used to compare the two groups, and multiple logistic regression was used to analyze the risk factors of NIV in patients with OS.

RESULTS:

Compared with the OS group without NIV, the pulmonary hypertension, lymphocyte count, and left ventricular ejection fraction% of OS patients with NIV were lower, whereas PCO2, uric acid, C-reactive protein, procalcitonin, and N-terminal pro-B-type natriuretic peptide were higher, with statistical differences (P < 0.05). During hospitalization and follow-up, OS patients with NIV had a longer hospital stay (P < 0.001), and there was no significant difference in the rate of readmission within 28 days. The logistic regression analysis showed that the history of diuretic use, previous history of noninvasive ventilator use, and ischemic heart disease were independent risk factors for NIV treatment in OS patients during hospitalization.

CONCLUSION:

Patients with OS undergoing NIV during hospitalization exhibited more severe overall illness and had prolonged hospital stays compared to OS patients not receiving NIV. History of diuretic use, history of NIV use, and ischemic heart disease are independent risk factors for NIV treatment in OS patients during hospitalization.
Beyond borders: Exploring the mental, emotional, and spiritual significance of Hajj
Authors: Alzeer Abdulaziz H. , Abuzinadah Jude
Published: July 2024

For Muslims all across the world, the desire to participate in the religious rites of the Hajj (pilgrimage to Mecca) which stands as one of the five pillars of Islam is a heartfelt longing. It stands for the pinnacle of devotion and spiritual gratification, luring followers to the most sacred city in Islam for a life-changing journey of faith, comradery, and submission to Allah. Muslims hold Mecca in the highest regard; it is a source of endless inspiration and devotion throughout their lives, as seen by their desire to undertake the Hajj and Umrah. The pilgrimage encompasses a series of synchronized rituals and acts of worship, each holding its unique spiritual meaning, and serve as a powerful testament to the universal nature of Islamic teachings. These rituals have a significant impact on Muslims’ mental and spiritual well-being. Hajj elicits a spectrum of feelings; creates unity, humility, and thankfulness; and encourages self-reflection as well as personal development. It also instills a sense of spiritual fulfillment. Hajj transcends personal boundaries, strengthening a pilgrim’s sense of connection to the larger Muslim community that rejuvenates their hearts and souls toward the teaching of Islam. Hence, it is imperative to explore in depth this transformative journey, illuminating the mental, emotional, and spiritual dimensions that bind Muslims across the globe.
Application of zero-inflated Poisson model with heterogeneous random effects to evaluate the effect of oral health education on pregnant women’s dental caries: A longitudinal experimental study
Authors: Ahmadi Gooraji Somayeh , Zayeri Farid , Sharifnejad Yeganeh , Ghorbani Zahra , Deghatipour Marzie , Meymeh Maryam Heydarpour , Baghban Alireza Akbarzadeh
Published: July 2024

Background:

Pregnant women have poor knowledge of oral hygiene during pregnancy. One problem with the follow-up of dental caries in this group is zero accumulation in the decayed, missing, and filled teeth (DMFT) index, for which some models must be used to achieve valid results. The studied population may be heterogeneous in longitudinal studies, leading to biased estimates. We aimed to assess the impact of oral health education on dental caries in pregnant women using a suitable model in a longitudinal experimental study with heterogeneous random effects.

Materials and Methods:

This longitudinal, experimental research was carried out on pregnant women who visited medical centers in Tehran. The educational group (236 cases) received education for three sessions. The control group (200 cases) received only standard training. The DMFT index assessed oral and dental health at baseline, 6 months, and 24 months after delivery. The Chi-square test was used for comparing nominal variables and the Mann–Whitney U test for ordinal variables. The zero-inflated Poisson (ZIP) model was applied under heterogeneous and homogeneous random effects using R 4.2.1, SPSS 26, and SAS 9.4. The level of significance was set at 0.05.

Results:

Data from 436 women aged 15 years and older were analyzed. Zero accumulation in the DMFT was mainly related to the filled teeth (51%). The heterogeneous ZIP model fitted better to the data. On average, the intervention group exhibited a higher rate of change in filled teeth over time than the control group (P = 0.021).

Conclusion:

The proposed ZIP model is a suitable model for predicting filled teeth in pregnant women. An educational intervention during pregnancy can improve oral health in the long-term follow-up.
Laypersons’ perception of smile esthetics from different backgrounds
Authors: Najarzadegan Fereshteh , Eslamipour Faezeh
Published: July 2024

Background:

Smile esthetics can be subjective. This study aims to assess the effect of culture/geographic location on judging smile esthetics by comparing the perception of smile characteristics between American laypersons (Western culture) and Iranians (Eastern).

Materials and Methods:

One hundred residents from each country were recruited for this analytical cross-sectional study. A frontal picture of a posed smile with standard norms which are mentioned in the Contemporary Orthodontics textbook by William R. Proffit was selected. Adobe Photoshop 7 was used to alter midline diastema, gingival display (GD), maxillary midline-to-face discrepancy, buccal corridor (BC), and smile arc. Images were given to groups to determine the most attractive and acceptable smile. Data were analyzed by Chi-square, Mann–Whitney, and Spearman correlation coefficient in SPSS-22 (α =0.05).

Results:

Americans were less critical in judging diastema (P < 0.001), GD (P = 0.013), and BC (P = 0.004) for smile attractiveness than Iranians. No difference was between the two groups in choosing the acceptability threshold and determining the most attractive smile except for BC (P = 0.002).

Conclusion:

Overall, Americans were more tolerant of variations in smile characteristics than Iranians. Both groups agreed on most smiles. Therefore, it seems that it is reasonable to use similar standards for smile characteristics while considering the small differences.