bluuebunny/crossref_metadata_2025 huggingface dataset:
Fortified Structures in Cilician An Evaluation on Conservation Problems
Authors: Sökmen Kök Derya , Kahya Sayar Yegan
Published: June 2021

Cilicia has been considered as a settlement territory for centuries due to its location that connects Anatolia to Mesopotamia as well as its favourable geographical conditions. In the region where various civilizations wanted to take control, fortified structres were needed since ancient ages in order to ensure the security of roads, agricultural areas, important centers and the people due to conflicts, invasions and wars. Especially, when long-term peace and security could not be maintained, existing buildings were renewed and new ones were built. These monumental structures are extremely valuable with their unique architecture that fits the features of the topography, cultural layers and fortified systems. Therefore, it is important to ensure their sustainability. However, while some of the buildings try to survive despite various adverse effects, some of them are in danger of disappearing. Presenting individual fortresses together as a joint cultural heritage in the context of their common geographical and historical characteristics, preserving them with a shared approach, and securing their sustainability are only possible with the identification of the current problems. In this context, the study includes the evaluation and results of the data obtained from the area regarding the conservation problems of these structures.
Cosmological Evolution of the Formation Rate of Short Gamma-Ray Bursts with and without Extended Emission
Authors: Dainotti M. G. , Petrosian V. , Bowden L.
Published: June 2021

Originating from neutron star–neutron star or neutron star–black hole mergers, short gamma-ray bursts (SGRBs) are the first electromagnetic emitters associated with gravitational waves (GWs). This association makes the determination of SGRB formation rate (FR) a critical issue. We determine the true SGRB FR and its relation to the cosmic star formation rate (SFR). This can help in determining the expected GW rate involving small mass mergers. We present nonparametric methods for the determination of the evolutions of the luminosity function (LF) and the FR using SGRBs observed by Swift, without any assumptions. These are powerful tools for small samples, such as our sample of 68 SGRBs. We combine SGRBs with and without extended emission (SEE), assuming that both descend from the same progenitor. To overcome the incompleteness introduced by redshift measurements we use the Kolmogorov–Smirnov (KS) test to find flux thresholds yielding a sample of sources with a redshift drawn from the parent sample including all sources. Using two subsamples of SGRBs with flux limits of 4.57 × 10−7 and 2.15 × 10−7 erg cm−2 s−1 with respective KS p = (1, 0.9), we find a 3σ evidence for luminosity evolution (LE), a broken power-law LF with significant steepening at L ∼ 1050 erg s−1, and an FR evolution that decreases monotonically with redshift (independent of LE and the thresholds). Thus, SGRBs may have been more luminous in the past with an FR delayed relative to the SFR as expected in the merger scenario.
Discovery of 13 New Orbital Periods for Classical Novae
Authors: Schaefer Bradley E.
Published: June 2021

I report new orbital periods (P) for 13 classical novae, based on light curves from TESS, AAVSO, and other public archives. These new nova periods now constitute nearly one-seventh of all known nova periods. Five of my systems have P > 1 day, which doubles the number of such systems that must have evolved companion stars. (This is simply because ground-based time series have neither the coverage nor the stability required to discover these small-amplitude long periods.) V1016 Sgr has a rare P below the period gap, and suddenly becomes useful for current debates on evolution of novae. Five of the novae (FM Cir, V399 Del, V407 Lup, YZ Ret, and V549 Vel) have the orbital modulations in the tail of the eruption after the transition phase. Soon after the transition, YZ Ret shows a unique set of aperiodic diminishing oscillations, plus YZ Ret shows two highly significant transient periods, 1.1% and 4.5% longer than the orbital period, much like for the superhump phenomenon. I also report an optical 591.27465 s periodicity for V407 Lup, which is coherent and must be tied to the white dwarf spin period.
The Science Case for Spacecraft Exploration of the Uranian Satellites: Candidate Ocean Worlds in an Ice Giant System
Authors: Cartwright Richard J. , Beddingfield Chloe B. , Nordheim Tom A. , Elder Catherine M. , Castillo-Rogez Julie C. , Neveu Marc , Bramson Ali M. , Sori Michael M. , Buratti Bonnie J. , Pappalardo Robert T. , Roser Joseph E. , Cohen Ian J. , Leonard Erin J. , Ermakov Anton I. , Showalter Mark R. , Grundy William M. , Turtle Elizabeth P. , Hofstadter Mark D.
Published: June 2021

The 27 satellites of Uranus are enigmatic, with dark surfaces coated by material that could be rich in organics. Voyager 2 imaged the southern hemispheres of Uranus’s five largest “classical” moons—Miranda, Ariel, Umbriel, Titania, and Oberon, as well as the largest ring moon, Puck—but their northern hemispheres were largely unobservable at the time of the flyby and were not imaged. Additionally, no spatially resolved data sets exist for the other 21 known moons, and their surface properties are essentially unknown. Because Voyager 2 was not equipped with a near-infrared mapping spectrometer, our knowledge of the Uranian moons’ surface compositions, and the processes that modify them, is limited to disk-integrated data sets collected by ground- and space-based telescopes. Nevertheless, images collected by the Imaging Science System on Voyager 2 and reflectance spectra collected by telescope facilities indicate that the five classical moons are candidate ocean worlds that might currently have, or had, liquid subsurface layers beneath their icy surfaces. To determine whether these moons are ocean worlds, and to investigate Uranus’s ring moons and irregular satellites, close-up observations and measurements made by instruments on board a Uranus orbiter are needed.
Development and characterization of a mobile γ spectrometer and its field deployment for in situ radioactivity measurements
Authors: Mertzimekis T. J. , Andrikopoulos C. , Fakiola C. , Kotsovolou A. , Lampridou D. , Kazana S.
Published: June 2021

A mobile γ–ray spectrometer (AMESOS) has been developed using a 3”×3” NaI(Tl) detector, a custom–made mounting holder, and portable electronics to perform in situ measurements of radioactivity. The spectrometer was calibrated using standard point sources and its absolute efficiency was determined. As a field test operation, AMESOS was deployed on the premises of the University of Athens Zografou campus focusing on estimating the NORM levels. Data were analyzed and used to create radiological maps for the metropolitan UoA campus for the first time. Besides natural radioactivity levels, trace concentrations of 137Cs were also detected, attributed to the Chernobyl fallout in Greece. An overall steady performance of the spectrometer was observed throughout the field operation. AMESOS is ready to be deployed for in situ studies of environmental radioactivity and radwaste management.
International. Stagnation des accords d’entreprise internationaux et recul des accords européens
Authors: Rehfeldt Udo
Published: June 2021

La dynamique des accords d’entreprise transnationale a atteint son sommet en 2008. Depuis, on observe une stagnation des accords internationaux et un essoufflement des accords européens. L’article analyse les facteurs déterminants de ces dynamiques sur les entreprises françaises et allemandes, en partant des stratégies et pratiques des acteurs. Il révèle le rôle des procédures de mandatement adoptées par les fédérations syndicales européennes et internationales.
Le bio et la nature : ce que la consommation biologique révèle des rapports nature-culture
Authors: Sommier Béatrice
Published: June 2021

Cet article vise à comprendre le rôle que la consommation biologique joue dans la relation entre nature et culture. La recherche se fonde sur une ethnographie conduite sur l’enseigne Biocoop et auprès de consommateurs bio. L’analyse démontre comment ces consommateurs demeurent, par certains côtés, dans une séparation nature/culture typique de la société occidentale, tout en faisant preuve, par d’autres côtés, d’une évolution ontologique vers une relation hybride entre ces deux entités. Il préconise enfin des actions pouvant être mises en place par les distributeurs pour accompagner cette évolution des mentalités chez ces consommateurs.
Quand l’expérientiel en luxe se construit sur Instagram : synergie ou bataille entre marques et directeurs artistiques ?
Authors: Mercanti-Guérin Maria , de Lassus Christel , Bèzes Christophe
Published: June 2021

Instagram est devenu le réseau social privilégié des marques de luxe qui y développent leur évènementiel de façon active. Parmi les multiples stratégies de présence sur ce réseau, figure la mise en avant des contenus et des comptes des directeurs artistiques (DA). Or, certains développent des stratégies propres qui rendent floue l’expression des positionnements des marques de luxe pour lesquels ils travaillent. Une méthodologie innovante, par mobilisation de l’intelligence artificielle et par analyse des contenus et objets postés sur Instagram (textes et « captions ») a permis d’étudier l’expérientiel construit sur Instagram par les DA. Les résultats proposent une typologie de la collaboration entre DA et marques. Ils soulignent la difficulté de gérer de multiples émetteurs sur les réseaux sociaux. Les conclusions de cette recherche ouvrent la voie à une réflexion plus globale sur la difficile gestion des influenceurs dans le secteur du luxe.
Signification des packagings et dynamiques d’innovation dans un secteur de luxe traditionnel : l’exemple des champagnes de vignerons
Authors: Ringeval-Deluze Aurélie , Ndione Louis César
Published: June 2021

À partir d’une analyse sémiotique du packaging de 100 champagnes de vignerons complétée par 19 entretiens d’experts, nous identifions les « codes champagne » traditionnels ainsi que les leviers de l’innovation-packaging et les grandes tensions qu’ils révèlent pour cette catégorie de produits. Nous complétons ainsi la littérature marketing portant sur le packaging des vins de prestige.
Image de la pensée et pensée sans image chez Deleuze & Guattari
Authors: Bénit Bernard
Published: June 2021

« Comme toute grande philosophie, celle de Deleuze avant Guattari et avec Guattari renouvelle la définition de la pensée. Depuis Différence et répétition , la pensée n’est pour Deleuze ni naturelle ni spontanée, elle est le produit d’une genèse : Deleuze part d’une critique de l’image représentative de la pensée qui lui permet de dégager le vrai commencement de la pensée, ses conditions réelles. Avec cette genèse, grâce à laquelle la pensée se cherche un sol autre que la représentation en renonçant en même temps à tout fondement, Deleuze résout, pour son propre compte, le problème du commencement en philosophie, en faisant surgir une pensée sans image. Par la suite, Deleuze et Guattari construisent ensemble une nouvelle métaphysique qui semble se passer, en apparence seulement, des notions d’image de la pensée et de pensée sans image. En réalité, à l’unique « Image de la pensée » qu’il s’agissait de détruire dans Différence et répétition , Deleuze et Guattari substituent, dès Mille plateaux, une pluralité d’images de la pensée, chacune étant historiquement et singulièrement déterminée. Ils esquissent même dans cet ouvrage l’idée d’une « noologie » qu’ils prendraient pour objet d’étude. Ces images deviendront les plans d’immanence de Qu’est-ce que la philosophie ? . Quant à la pensée sans image, nous montrerons que, loin de disparaître, elle prend différentes formes, notamment celle du chaos, dans leur dernier ouvrage. Notre hypothèse est donc que, sous des vocables changeants, ces deux idées, comme leur relation mise à jour par Deleuze, ne disparaissent pas de leur métaphysique commune. »
Les paradis fiscaux : de la corruption au développement
Authors: Vernier Éric , Houanti L’Hocine , Chevallier Matthieu
Published: June 2021

De nombreuses études ont montré que dans le secteur extractif, les multinationales cherchent à éviter l’impôt, privant ainsi les pays concernés de budgets conséquents. Ces montages reposent sur des constructions légales, mais aussi illégales. Il semble donc que les paradis fiscaux jouent un rôle déterminant dans ces pratiques. Nous avons interrogé des experts pour mieux comprendre ce jeu.
La colonne Vendôme et le sacrifice des symboles
Authors: González Horacio , Sferco Senda , Girondo Odile
Published: June 2021

Ce texte croise deux commentaires philosophiques relatifs à la colonne Vendôme et à sa destruction, constatée par Nietzsche et anticipée par Marx.
L’humanisme à l’œuvre dans la pensée pédagogique arabe classique (IX e -XII e siècles)
Authors: Zouari Yassine
Published: June 2021

La pensée arabe classique a fait de l’éducation et des savoirs un souci pédagogique, si bien que différents courants pédagogiques, dont principalement le courant rationaliste, furent l’expression de cette dynamique productive de l’art de pratiquer l’éducation et de la penser. Dans cet article, nous explorons l’humanisme à l’œuvre dans le courant pédagogique rationaliste arabe. Notre souci étant d’identifier, par la voie de l’analyse des idées pédagogiques développées par des pédagogues rationalistes arabes (IX e -XII e  siècles), des indicateurs de cet humanisme, nous démontrons en quoi ce dernier constitue un potentiel de sécularisation et de modernité. C’est ce qui apparaît clairement à travers la problématique de la quête des savoirs, l’idée de perfectionnement théorico-pratique de la nature humaine par et dans les savoirs, l’ancrage rationnel du rapport au religieux et la conception universelle de la raison où s’articule religion et philosophie. Toujours est-il que ce potentiel de sécularisation a été occulté dans la pensée arabe de la Renaissance du XIX e  siècle, comme en témoignent l’examen de la pensée éducative des réformistes progressistes et le questionnement des images qu’ils se sont faites de la modernité.
En relisant Tintin. Le génie d’Hergé, entre humour et réalisme
Authors: Duchesne Jean
Published: June 2021

Le « père » de Tintin n’a jamais eu l’ambition de devenir un maître ni de laisser un message. Son génie réside dans un mélange d’humour et de réalisme. Les épisodes sont souvent comiques, mais les innombrables rebondissements ne sont pas moins réjouissants. Et le cadre de ces aventures ébouriffantes n’est pas seulement représenté avec une impressionnante exactitude, car c’est aussi celui d’une actualité devenue historique. De plus, les principaux personnages ont fini par prendre au fil des publications une consistance qui assure leur survie.
Le perspectivisme est-il une « image de la pensée » ?
Authors: Chamois Camille
Published: June 2021

Cet article vise à analyser et clarifier le programme de recherche « géo-philosophique » avancé par Gilles Deleuze et Félix Guattari et développé par Eduardo Viveiros de Castro. Nous montrons qu’il s’agit d’un projet anthropologique d’envergure – dont l’objectif est de décrire la diversité des modalités d’énonciation et des pratiques discursives qui y sont liées – qui n’a cependant pas reçu les développements qu’il mérite. Dans cet article, nous tentons de préciser le sens de ce projet en évaluant dans quelle mesure le « perspectivisme », et notamment sa version amazonienne, peut être considéré comme une « image de la pensée ». Pour ce faire, nous identifions dix problèmes qui se répartissent en deux grands champs : la définition théorique du perspectivisme, d’une part, et la définition pratique du programme géophilosophique, d’autre part. Nous espérons ainsi montrer que le programme qui cherche à faire du perspectivisme une « image de la pensée sauvage » reste philosophiquement et anthropologiquement fécond mais sous-déterminé.
Marxisme et christianisme. La Lettre de Louis Althusser à Jean Lacroix
Authors: Rezzesi Riccardo
Published: June 2021

Ancien étudiant de la khâgne de Lyon (au Lycée du Parc), Louis Althusser écrit une grande Lettre (d’environ 70 pages) à Jean Lacroix, son ancien (célèbre et estimé) enseignant, philosophe personnaliste, co-fondateur de la revue Esprit avec Mounier en 1932. Critique féroce du livre Marxisme, Existentialisme, Personnalisme de Lacroix, publié en 1949, la Lettre s’avère être un règlement de compte philosophique, aboutissant à la rupture avec Mounier et le mouvement personnaliste. Dès son retour de la captivité en Allemagne, l’itinéraire intellectuel (et spirituel) du jeune philosophe prend un tournant brusque : de fervent catholique, quasi mystique, à militant communiste, tel est le chemin parcouru depuis la Libération. Qu’est-il arrivé aux espoirs de sa jeunesse chrétienne ? Véritable manifeste de sa conversion au marxisme, la Lettre à son mentor catholique exprime la conviction que le christianisme est un idéal dé-passé.
Rire au début du Moyen Âge
Authors: de Saxcé Anne
Published: June 2021

Était-il interdit de rire au Moyen Âge ? Les historiens pensent généralement que ce fut fortement le cas au début de la période médiévale. On se propose d’étudier l’influence de saint Augustin sur un certain nombre d’auteurs des débuts du Moyen Âge, pour montrer qu’en réalité, le rire, à cette époque, n’est contesté que lorsqu’il exprime une affirmation excessive de sa propre puissance, mais qu’il est au contraire encouragé lorsqu’il permet de se rapprocher de Dieu.
Modeling the Way: Strategies to Enhance Nurse Certification
Authors: Young Christine
Published: June 2021

Specialty certification demonstrates RNs' commitment to high levels of clinical achievement and continuous learning. This column provides a chief nursing officer's perspective on how an organization can support nursing professional development while focusing on the value of specialty certification.

[
J Contin Educ Nurs
. 2021;52(7):304–306.]
Adapting “Shut Up & Write!
®”
to Foster Productive Scholarly Writing in Graduate Nursing Students
Authors: Micsinszki Samantha K. , Yeung Lily
Published: June 2021

Productive scholarly writing is important for succeeding in graduate nursing programs such as thesis-and practice-based master's or doctoral degrees. Nurses pursuing graduate-level programs are expected to produce high-level scholarly writing manuscripts. However, writing typically is an independent and isolating endeavor. This article describes a student-led writing group (“Sit Down & Write!”) that was adapted from the “Shut Up & Write!” (SUAW) structure. Five strategies were incorporated to meet the unique needs of graduate nursing students and foster productivity: (a) provide space for diverse groups of nursing students to participate, (b) offer flexible scheduling, (c) accommodate a flexible group structure, (d) host longer sessions, and (e) allow time to discuss writing goals. Overall, Sit Down and Write! provided a community of productive writing support. Future adaptations may consider providing a virtual option so sessions are accessible to students who are unable to join in-person.

[
J Contin Educ Nurs
. 2021;52(7):313–318.]
Non-autonomous weakly damped plate model on time-dependent domains
Authors: Zhang Penghui , Feng Zhaosheng , Yang Lu
Published: June 2021

We are concerned with dynamics of the weakly damped plate equation on a time-dependent domain. Under the assumption that the domain is time-like and expanding, we obtain the existence of time-dependent attractors, where the nonlinear term has a critical growth.
Le patologie di Giustiniano e le profilassi mediche in voga nella Proto Bisanzio. Gli Adynata come eccezionale cura
Authors: Di Cosmo Antonio Pio
Published: June 2021

[it] Questa ricerca confronta i dati raccolti dai testi riguardanti l’imperatore Giustiniano con le informazioni concernenti la casistica delle malattie sessuali nel contesto della Proto Bisanzio. Un testo agiografico, la Vita di San Sansone, racconta: una grave malattia colpisce Giustiniano agli organi genitali e i medici non sono in grado di curarla. La patologia viene risolta da un miracolo di San Sansone. Questo adynaton pone l’imperatore in uno ‘spazio di copertura’. Dopo il 23° o 24° anno del suo regno, Giustiniano soffre disturbi ad una gamba, accompagnati da dolore durante la minzione. Körbler ipotizza che questi sintomi siano dovuti alla sifilide. Il disturbo alla gamba viene curato dall’intercessione dei santi Cosma e Damiano. La malattia dell’imperatore si rivela dunque come luogo della letteratura agiografica. L’adynaton poi conferma l’istituzione imperiale ed afferma l’adeguatezza del sovrano.
La enfermedad de las gentes del mar a través de la historia del español: revisión diacrónica de escorbuto y sus sinónimos
Authors: Molina Sangüesa Itziar
Published: June 2021

En este trabajo se estudia la terminología que, en mayor o menor medida y durante más de cuatro siglos, se ha empleado en lengua española para referirse a la que se considera, históricamente, como la enfermedad de las gentes del mar por excelencia: el escorbuto (y algunas de sus variantes, como el escorbuto petequial, el muriático, el pedregoso, etc.). Asimismo, se constata la multiplicidad denominativa que este término desencadena para dar nombre a un tipo de enfermedad avitaminosa caracterizada por el déficit de vitamina C en el organismo (a saber: los vocablos berbén, loanda, mal de loanda, mal del gusanillo, peste del mar, escelotirbe, estomacace, gingibraquio, gingipedio y pequitirbo). Para ello, se analiza y se expone la documentación que tanto las bibliotecas como hemerotecas digitales, los bancos de datos de referencia del español y los repertorios lexicográficos hispánicos ofrecen sobre esta selección léxica.
Desarrollo de un sistema de aspas transformable en las cubiertas plegables
Authors: Morales Guzman Carlos Cesar
Published: June 2021

La presente investigación se centra en diseñar y construir un sistema transformable basado en el método desarrollado por el Dr. Félix Escrig, que nos brindó los conceptos para desarrollar una mejor propuesta y generar sistemas transformables más rápidos, por lo cual se construyó una serie de prototipos que verifiquen y validen nuestro proceso de diseño geométrico para crear una estructura plegable.
Por lo que conllevo a analizar los modelos con el software WinTess que realizo la simulación estructural de dichas estructuras plegables con una membrana textil y nos ayudó a verificar la seguridad estructural del modelo, se abordó el diseño del nodo con el software Solid Work que nos auxilió para diseñar los detalles industriales de conexión por medio de CAD (Computer-Aided-Desing) ya que su paquetería tiene la capacidad para desarrollar prototipados experimentales y realizar los detalles estructurales.
De tercero en amores a cortesano: el ascenso del enano Urbanil en la corte del emperador Palmerín
Authors: Casado Gutiérrez M.ª del Pilar
Published: June 2021

El objetivo de este trabajo es analizar la figura del enano Urbanil y profundizar en algunos rasgos de su personalidad, como su ambición por ascender en la corte. Se planteará cómo el personaje va perdiendo utilidad como escudero, debido, en gran parte, a sus limitaciones físicas y a su falta de ánimo, y cómo sus funciones se desplazan hacia lo cortesano, prestando sus servicios en asuntos amatorios.
Efficacité du tutorat et étude des profils « efficaces » des tutorés
Authors: Abid-Zarrouk Sandoss Ben , Weisser Marc
Published: June 2021

Le tutorat méthodologique est un dispositif visant, généralement, à améliorer les taux de passage de première en deuxième année de Licence, principalement pour les publics primo-entrants. Le but de cette contribution est de montrer l’efficacité de ce dispositif. C’est à partir d’une enquête effectuée en deux temps auprès des tutorés de l’université de Haute-Alsace (UHA) que nous avons pu mettre en évidence dans un premier temps que les étudiants qui suivaient le tutorat étaient proportionnellement plus nombreux à passer de la première à la seconde année de Licence et dans un second temps que les étudiants qui font le choix du tutorat dans une optique de réussite sont proportionnellement plus nombreux à obtenir leur L1 par rapport à ceux qui viennent y chercher un apport méthodologique.
Expanding the search for germline pathogenic variants for breast cancer. How far should we go and how high should we jump? The missed opportunity!
Authors: Abdel-Razeq Hikmat
Published: June 2021

Since the identification of BRCA1 and BRCA2 genes 3 decades ago, genetic testing and genetic counseling have become an integral part of routine clinical practice. The risk of breast cancer among carriers of germline pathogenic variants, like BRCA1 and BRCA2, is well established. Risk-reducing interventions, including bilateral mastectomies and salpingo-oophorectomies are both effective and have become more acceptable. Many researchers and professional societies view current guidelines as restrictive and may miss many at-risk women, and are calling to expand testing to include all patients with breast cancer, regardless of their personal or family history of cancer, while others are calling for wider adoption to even include all healthy women at age 30 or older. This review will address expanding testing in two directions; horizontally to include more patients, and even healthy women, and vertically to include more genes using next-generation sequencing-based multi-gene panel testing.
Evaluation of the Timing of Initiating Continuous Renal Replacement Therapy in Community-Acquired Septic Patients with Acute Kidney Injury
Authors: Xiao Min , Liu Bingqi , Zhou Mao , Wang Daqing , Chen Li
Published: June 2021

Acute kidney injury (AKI) in community-acquired septic patients is often associated with relatively high mortality rate. However, the appropriate timing for continuous renal replacement therapy (CRRT) initiation remains controversial. In the present study, we retrospectively analyzed 123 community-acquired septic patients with AKI admitted to the medical intensive care unit (ICU). The baseline patient characteristics and renal function parameters were compared between survivors and non-survivors. Then, we used the Cox proportional hazard analysis to identify the risk factors for ICU mortality. Moreover, we employed the area under the receiver operating characteristic curve analysis to determine the cutoff time for CRRT initiation. Finally, we used the cutoff time to separate the patients into early (treatment initiated earlier than the cutoff time) and late (treatment initiated later than the cutoff time) CRRT groups and performed the Kaplan–Meier survival analysis to assess the overall mortalities. At the time of ICU release, the mortality rate of the 123 patients was 48.8% (n = 60). We identified several baseline characteristics and renal function parameters that were significantly different between the survivors and the non-survivors. All of them were also identified as the risk factors for community-acquired sepsis. Importantly, the cutoff time point to distinguish the early and late CRRT initiation groups was determined to be 16 h after AKI onset. Based on such grouping, the mortality rate was significantly lower in the early CRRT initiation group at 30, 60 and 90 days. Our data suggest that initiating CRRT within 16 h may help improve the mortality rate of community-acquired septic patients.
Exercise in the Cold Causes Greater Irisin Release but May Not Be Enough for Adropin
Authors: Ulupinar Suleyman , Özbay Serhat , Gençoğlu Cebrail , Altinkaynak Konca , Şebin Engin , Oymak Burak
Published: June 2021

When irisin and adropin were discovered, it was popularly hoped that they would become therapies for metabolic disorders that threaten global health. However, contradictory results have been reported in the subsequent period. Irisin, induced by exercise or cold exposure, is believed to be a myokine that causes the browning of adipose tissue thus increasing energy expenditure. Adropin is thought to be beneficial for health by regulating blood flow, capillary density, and playing an active role in glucose and insulin homeostasis. However, there were no experimental studies investigating the simultaneous effect of exercise and cold exposure in humans. The purpose of this study was to investigate irisin and adropin responses in young healthy individuals performing aerobic exercise in different environmental temperatures. Twenty-seven young, healthy individuals participated in this study. Participants performed 40 min of aerobic running exercise in environmental temperatures of 0°C, 12°C, and 24°C. Venous blood samples were taken pre- and post-exercise. Irisin and adropin levels were analyzed using an enzyme-linked immunosorbent assay. The principal findings showed that while serum irisin concentrations significantly increased after aerobic exercise was performed at an environmental temperature of 0°C, there was no significant difference between pre- and post-exercise recordings for physical activity performed at 12°C and 24°C. Adropin concentrations, however, remained unchanged between pre- and post-exercise at 0°C, 12°C, and 24°C. Interestingly, the exercise at 0°C caused an increase in adropin (12.5%), but this amount was not enough to be a statistically significant result. The findings of this study suggest that aerobic exercise in a cold environment causes greater irisin release. However, the combined effect of exercise and cold exposure may not be enough to statistically increase adropin level.
Prognostic Value of Metabolic Tumor Parameters in Pretreatment 18F-Fluorodeoxyglucose Positron Emission Tomography–Computed Tomography Scan in Advanced Non-Small Cell Lung Cancer
Authors: Mallick Ayan , Das Jayanta , Shaw Manoj Kumar , Biswas Bivas , Ray Soumendranath
Published: June 2021

Objective:

This retrospective study aimed to investigate whether metabolic parameters of primary tumour i.e. maximum standardized uptake value (SUVmax), metabolic tumour volume (MTV) and total lesion glycolysis (TLG) predict overall survival (OS) in patients with advanced stage non-small cell lung cancer (NSCLC).

Materials and Methods:

SUVmax, MTV and TLG of the primary tumors were measured in staging 18F-Fluorodeoxyglucose Positron emission tomography- Computed tomography (18F-FDG PET/CT) scan of 97 NSCLC patients by gradient based tumour segmentation method. Prognostic ability was assessed for overall survival (OS) of the patients.

Result:

The median follow-up period of the study was 15.84 months (range 1.3 to 47.97 months).The estimated median OS was 11.29 months (range 1.37 to 38.63 months). Total of 40 (41.24%) patients had progressive disease and 21 (21.65%) patients died during the follow up period. Receiver Operating Characteristic (ROC) analysis showed that the area under the curve (AUC) for MTV was significant (area = 0.652 ± 0.065; 95% CI = 0.548 – 0.746; P = 0.020). Kaplan-Meier survival curves showed that the OS differences between the groups of patients who were dichotomized by the median value of MTV (38.76 ml, P = 0.0150) and TLG (301.69 ml, P = 0.0046) were significant. MTV (hazard ratio = 4.524; 95% CI = 1.244 – 16.451; P = 0.022) was found to be an independent prognostic factor for OS in multivariate analysis.

Conclusion:

MTV of the primary tumor is a potential prognostic parameter for OS in our population of advanced NSCLC patients independent of other risk factors.
The Radioprotective Effects of Melatonin and Nanoselenium on DNA Double-Strand Breaks in Peripheral Lymphocytes Caused by I-131
Authors: Jafarpour Seyed Masoud , Shekarchi Babak , Bagheri Hamed , Farhood Bagher
Published: June 2021

Background:

One of the treatment modalities for thyroid cancer and hyperthyroidism is radioiodine-131 (I-131) therapy. The use of this therapeutic modality is not completely safe and can lead to oxidative stress, eventually DNA damages. However, these radiation-induced damages can be reduced by antioxidants. This study aimed to investigate the potential radioprotective effects of melatonin and selenium nanoparticles (SeNPs) on DNA double-stranded breaks (DSBs) caused by I-131.

Materials and Methods:

After obtaining informed consent, 6 ml blood was taken from each volunteer. The samples were divided into two general groups of control (without I-131) and with I-131. Each group was also divided into three subgroups, including without antioxidant, melatonin, and SeNPs. The samples of control group were incubated for 2 h after adding the antioxidants. The samples of I-131 group were first incubated for 1 h with the antioxidants and then the samples re-incubated for another 1 h after adding the I-131. Then, the samples were prepared for γH2AX assay.

Results:

The findings showed that after 1 h of incubation with 20 μCi I-131/2 mL, the DSB levels increased by 102.9% in comparison with the control group. In the I-131 group, there were significant reductions of the DSB levels after incubation with melatonin (P < 0.001) and SeNPs (P < 0.001) in comparison with the without antioxidant subgroup. Furthermore, the DSB levels at the melatonin + I-131 and the SeNPs + I-131 subgroups decreased to 38% and 30%, respectively, compared to the I-131 subgroup.

Conclusion:

According to the obtained findings, it can be concluded that the use of melatonin and SeNPs (as radioprotector agents) can reduce the DSB levels induced by I-131 in peripheral lymphocytes.
Importance of Understanding and Analyzing Daily Quality Assurance Test of Positron Emission Tomography/Computed Tomography Equipment in Minimizing the Downtime of Equipment in Remote Places
Authors: Tayal Sachin , Ali Abbas , Kumar Vikrant , Jha Ashish Kumar , Gandhi Arun
Published: June 2021

This article briefly describes the event of a defective detector block in a daily quality assurance scan/blank scan and insists on implementing guidelines to scan or not to scan in such a scenario. The nuclear medicine physicist should have a clear understanding of the blank scan graph, which shall help rectify the right cause of problem and give confidence to the physician in reporting the acquired study. A routine blank scan in positron emission tomography signifies various parameters of the crystal (coincidence count rate, single count rate, dead time, and coincidence time along with energy response) and in some respect is analogous to the daily uniformity flood image for gamma cameras, providing an overall assessment of detector response. We encountered a bad detector block in our routine quality assurance scan/blank scan and analyzed the root cause behind such an error which was finally restored to normalcy by replacing the defected part with a new one and an error-free blank scan was established. The analysis was carried out by performing various possible checks and discussing the issue with service engineer to help identify the defects much before service engineer actually arrived in our department. This allowed us to take the correct decision and enabled us to get the scanner repaired faster. Hence, a good understanding of the daily quality control test and proper analysis of the same may result in swift decision-making and faster repair of equipment leading to minimal disruption in the clinical workflow as well as avoidance of suboptimal scanning leading to the wrong diagnosis.
18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in Postsurgical Setting in Head and Neck Cancers – A Pictorial Essay
Authors: Agrawal Archi , Prakash Anjali , Choudhury Sayak , Manikandan M. V. , Jain Yash , Purandare Nilendu , Puranik Ameya , Shah Sneha , Rangarajan Venkatesh
Published: June 2021

This pictorial essay depicts normal appearances, complications, and findings of residual and/or recurrent disease on fluorodeoxyglucose positron emission tomography/computed tomography (18F- FDG PET/CT) studies in the postsurgical setting. Reading and reporting 18F- FDG PET/CT in the postoperative scenario is demanding due to the multiple false positives seen during this period. This article which contains two parts will familiarize the readers with the normal appearance and pitfalls seen in 18F- FDG PET/CT studies during the postoperative period so as to avoid misinterpretations. This pictorial will discuss 18F- FDG PET/CT in the postoperative scenario in head and neck cancers.
A Comparative Study of Pharmacopoeial Quality Standards and Regulations of Radiopharmaceuticals
Authors: Thota Prasad , Thota Anusha , Pandey Manoj Kumar , Sarma Phulen , Medhi Bikash , Sharma Rakesh Kumar , Prakash Jai , Teotia Anil Kumar
Published: June 2021

Radiopharmaceutical preparations are the important pharmaceutical dosage forms used for the diagnosis and therapeutic purposes. Various pharmacopoeias are having methods for the quality control of these preparations in the form of monographs. Indian Pharmacopoeia (IP) also included these monographs in IP 2014 first time with the help of an experts' group on radiopharmaceutical, drawing expertise from elite stakeholder institutions and the core team of Indian Pharmacopoeia Commission. Since then, these standards are regularly updated through the IP addendum and bringing out new edition of IP. IP is a book of official methods as per Drugs and Cosmetic Act, 1940. These standards can be used in government laboratories, private laboratories, or academia in India and abroad. This review provides an overview of the journey of radiopharmaceuticals' standard setting in IP. A comprehensive comparative information of regulatory perspectives of radiopharmaceuticals in different jurisdictions such as the US, EU, and India is also presented.
Assessing caregiving burden among primary caregivers in a medical intensive care unit setup
Authors: Ramdurg Santosh Iranna , Biradar Siddanagouda M. , Reddy Pallavali Janardhana
Published: June 2021

Objective:

Caregiver burden in caring patients in intensive care unit (ICU) settings are stressful and challenging place. Caregivers also play very important role in doctor–patient relationship. In India, there is a skewed trend in doctor–patient relationship. Without addressing caregiver's psychological issues, we may not able to deliver good medical services. “Caregiver burden in primary caregivers of patients admitted to medical ICU (MICU) was measured.

Methodology:

Its cross-section observational study. We collected the information from total of 100 caregivers whose patient got admitted to MICU. We took only one caregiver. We administered socio-demographic data, Zarit Caregiver Burden Interview (ZBI) for assessing burden in caregivers.

Results:

The mean age of the caregivers was 38 years with 66% males were being primary caregivers and mean age of education was 8.61 years. The mean duration of patient stay in hospital was 4.67 days with range of 4–18 days. Mean duration of illness in patient was 466 days with range of 4 days to 10 years. Mean score caregivers burden as per ZBI was 5.10 with range of 0–25. Thirty-five percentage of caregiver were felt caregiving was the burden. Correlation analysis shows ZBI negative relationship with caregivers' age and education and patients total duration of illness. There was a positive co-relationship with the duration of ICU admission.

Conclusion:

Higher burden was observed in caregivers and caregivers felt more burden if patients stays longer duration in ICU. More research is needed in this area.
An unusual cause of cavitating nodules in the lung
Authors: Chetambath Ravindran , Pavithran K.
Published: June 2021

A case of fever, cough, and hemoptysis in a young female which could not be diagnosed by routine investigations is presented here. Confirmatory diagnosis was established after a long period of 2 years. Difficulty in diagnosis itself points to a rare cause for this presentation. The case is presented here with expert comments from specialists working in related specialties.
Recurrent Hemoptysis in a Patient with Bronchial Asthma
Authors: Sharma M. Vishnu , Walikar Baseer Ahmmad
Published: June 2021

Hemoptysis is not a common symptom in bronchial asthma. We aim to discuss the approach to a patient with uncontrolled asthma with recurrent hemoptysis in this case-based discussion. Causes in such cases include pulmonary tuberculosis, bronchiectasis, endobronchial lesions, bronchial carcinoid, factitious hemoptysis, allergic bronchopulmonary aspergillosis, granulomatosis with polyangiitis, allergic angiitis (hypersensitivity vasculitis), Churg-Strauss syndrome, and valvular heart disease which can coexist with asthma.
The Yield of Thoracoscopic Biopsy Truenat in the Diagnosis of Tuberculous Pleural Effusion
Authors: Kurian Thomas , Paramez A. R. , Chandra Rohita S. , Jose Nimmy
Published: June 2021

Background and Objective:

Extrapulmonary tuberculosis (EPTB) affects about 25% of patients presenting with Tuberculosis (TB). Tuberculous pleural effusion is the second-most common type of EPTB, after lymph node TB. Although the molecular TB diagnostics have lower turnaround time compared to traditional testing methods, the sensitivity in microscopy negative specimens are low. Higher cost and infrastructure requirements are other disadvantages. Truenat, developed by Mobilio diagnostics and validated by ICMR, is a rapid, polymerase chain reaction (PCR)-based diagnostic test to detect Mycobacterium Tuberculosis (MTB) and also rifampicin resistance. According to the WHO, the accuracy of Truenat is comparable to Xpert PCR. We report our experience in using Truenat for EPTB, specifically, pleural TB.

Methods:

We retrospectively analyzed data from thoracoscopy over the past 2 years. All data pertaining to the use of Truenat for TB in pleural fluid and thoracoscopic biopsy specimens, histopathology, and mycobacterial cultures were analyzed.

Results:

We had a total of 114 patients with undiagnosed pleural effusion who underwent thoracoscopy during the study. Forty-five patients (39%) had a diagnosis of TB, among the total 114 patients. The sensitivity of tissue Truenat was 51.11 (95% confidence interval [CI]: 35.77–66.30), tissue culture 37.50% (95% CI: 22.73–54.20), pleural fluid Truenat 20% (95% CI: 8.44–36.94), and fluid culture 14.29% (95% CI: 5.43–28.54). The specificities of all the confirmatory tests were 100% when compared to a reference standard which was taken as a combination of histology and culture as the reference standard with or without acid-fast bacilli in the histology samples. Tissue Truenat was significantly more sensitive than fluid Truenat (P < 0.05). Likewise, tissue culture was more sensitive than fluid culture (P < 0.05). Among all microbiology confirmatory tests performed, Truenat of pleural tissue had the highest yield (51.11).

Conclusion:

Thoracoscopic pleural biopsy Truenat results in improved sensitivity in cases of EPTB.
A New Approach to Tobacco Cessation by Using Chart of 5A's Based on National Guidelines
Authors: Mhaske Rupali V. , Kale Lata M. , Sodhi Sonia , Kadam Vishwas D. , Bansode Amruta M. , Pawar Kapil
Published: June 2021

Background:

The use of tobacco is linked to cultural and social practices in India. It is the primary cause of oral cancer. Dental health professionals are trained to identify signs of tobacco use following visual examinations of the oral cavity. Through the establishment of Tobacco cessation centers in dental colleges, the dentist receives training in providing tobacco cessation counseling to tobacco users. Thus each patient that seeks dental treatment in dental colleges is also screened for tobacco use and then counseled as appropriate.

Aim and objectives:

(1) To assess the nicotine dependence. (2) To assess the prevalence of oral diseases. (3) To carry out a detailed and effective tobacco cessation program.(4) To use the newly made chart of 5A's and assess the usefulness of the chart in tobacco cessation counseling.

Materials and Methods:

The sample size of 100 patients who were tobacco users age 15 to 80 years was selected. 06 questions from the Fagerstrom test for nicotine dependence were used to elicit the nicotine dependence. The tobacco cessation program and detailed counseling were carried out.

Statistical Analysis:

Data collected were subjected to statistical analysis.

Results:

Of 100 patients, 57 were highly dependent, 38 were moderately dependent, and 5 were minimally dependent on Nicotine. After Tobacco cessation counseling patients reported back within 8 months, and their nicotine dependence was assessed again using the Fagerstrom questionnaire and was found that: 28 patients were tobacco-free having 0 scores of nicotine dependence, 67 patients were minimally dependent having scored from 1 to 3, 06 patients were moderately dependent having score from 4 to 7. Not a single patient of 100 was highly dependent on nicotine.

Conclusions:

Establishing a Tobacco cessation center using cognitive and behavioral counseling through the pictorial chart of 5AS, informative leaflets, awareness videos, and regular follow-up has proven effective in helping tobacco users to quit tobacco.
Evaluation of Serum Immunoglobulin (IgG, IgM, IgA) in Oral Cancer Patients – A Case Control Study
Authors: Tarsariya Vivek M. , Raval Nilesh , Mehta Dhaval N. , Asrani Mukesh K. , Asrani Vijay K. , Barot Kaushik S.
Published: June 2021

Background:

Very few studies have been done to evaluate the level of serum immunoglobulins (IgG, IgM, and IgA) in patients with oral cancer as tumor markers.

Aims and Objectives:

The aim of this study was to estimate the serum immunoglobulins level (IgG, IgM, and IgA) in oral cancer patients and its comparison with control groups and whether these values can be used to predict the severity of disease or not.

Materials and Methods:

A total of 30 patients with different clinical stages oral cancer and 30 healthy controls were selected at random and subjected for analysis of serum IgG, IgA, and IgM. Statistical methods used were the mean, standard deviation and t test.

Results:

Significantly elevated levels of all the immunoglobulins was observed in oral cancer patients when compared with the control group and levels were increasing with clinical stages (P < 0.05).

Conclusion:

All these immunoglobulins are indicative of tumor burden or transformation of malignancy in higher stage and might be used as prognostic indicators in oral cancer.
Obstructive Sleep Apnea
Authors: Rout Rupsa N. , Bhuyan Sanat K. , Priyadarshini Arpita , Bhindhani Damodhar , Singh Mamata , Mohapatra Satya
Published: June 2021

Aim:

To evaluate diagnostic cephalometric parameters and their influence on skeletal and soft tissue components in obstructive sleep apnea (OSA).

Materials and Methods:

The study is a prospective case study of 40 diagnosed cases (as diagnosed by Type IV level study) of obstructive sleep apnea who were reported to the Department of Oral Medicine and Radiology with their age ranging from 28 to 75 years. Lateral cephalometric radiographs in upright and supine posture were taken, with teeth in centric relation, and the head aligned with Frankfort horizontal (FH) plane parallel to the floor. The focus-coronal plane distance was 5 feet, the film-coronal plane distance was 15 cm, and the magnification was 10%.

Results:

OSA patients experience an increase in values of sella nasion point A (SNA) and sella nasion point B (SNB) at the supine position with respect to the upright position and experience a decrease in values of nasion sella turcica odontoid process tangent (NSL-OPT) and nasion sella turcica- cervical vertebra tangent (NSL-CVT) at the supine position with respect to the upright position. The parameters of paramount importance in the pathogenesis of OSA are soft palate thickness, length, and tongue length.

Conclusion:

SNA, SNB and NSL-OPT, NSL-CVT are inversely related to each other and play a role in the consequence or pathogenesis of OSA. Tongue height is of the least significance in the pathogenesis of OSA. The cephalometric findings are of paramount importance to know the exact site of obstruction in the pathogenesis of OSA.