bluuebunny/crossref_metadata_2025 huggingface dataset:
Ekonomik büyüme, küreselleşme ve enerji tüketimi arasındaki asimetrik nedensellik ilişki: OECD ülkelerinden kanıtlar
Authors: DİNÇ Mehmet , BEŞER Murat
Published: March 2023

1980’li yıllardan itibaren küresel ekonomi hacminin genişlemesiyle birlikte ülkeler arasındaki ticari duvarlar kaldırılmış ve dünya ticareti farklı boyutlar kazanmıştır. Bu çalışma OECD ülkelerinde 1972-2020 döneminde ekonomik büyüme, küreselleşme ve enerji tüketimi arasındaki ilişkinin asimetrik nedensellik testleriyle incelenmesini amaçlamaktadır. Panel asimetrik nedensellik testlerinin kullanıldığı çalışmada sonuçların ülkenin kendi dinamiklerine ve şokların türlerine göre farklılık gösterdiği ortaya çıkmıştır. OECD ülkelerinden İsveç’te değişkenler arasında herhangi bir nedensellik ilişkisi bulunmazken, Belçika Yunanistan, İtalya, İngiltere ve ABD’de değişkenler arasında güçlü nedensellik ilişkisinin olduğu sonucuna ulaşılmıştır.
Pazarlama bilim yazınında piramidin tabanına pazarlama ve yoksulluk pazaryeri: Bibliyometrik bir araştırma
Authors: ÖZDEMİR Şefika
Published: March 2023

Şirketler tarafından tüketici potansiyeli tam olarak değerlendirilmemiş ve ihtiyaçları tam olarak karşılanmamış ekonomik piramidin tabanında yer alan önemli büyüklükte bir pazar olarak yoksul tüketiciler dikkat çekmektedir. Nüfus verilerine göre dünya nüfusunun yarısından fazlası piramidin tabanında yer bireylerden oluşmakta ve bu pazarlar hızlı bir büyüme eğilimi göstermektedir. Gelişmekte olan ekonomilerde düşük ücretlerle günde 2 dolardan daha az parayla yaşayan tüketiciler piramidin tabanında yer alan bireyleri tanımlamaktadır. Piramidin tabanında yer alan bireylerin küresel pazar ekonomisine bütünleşmesi ve bundan faydalanması için bu alanda pazarlama stratejileri tasarlanmaktadır. Pazarlama stratejileri yoksullukla mücadele, ekonomik ve sosyal kalkınma için kendini bir çözüm önerisi olarak sunmaktadır. Piramidin tabanı pazarlar ve bu pazarlara yönelik stratejileri konu alan işletmecilik ve pazarlama alanında çok sayıda akademik çalışma bulunmaktadır. Araştırmada piramidin tabanına pazarlama konusuna ilişkin akademik ilgiyi ve çalışma yoğunluğunu ortaya koymak üzere bu alanda yapılan çalışmaların belirlenen kriterlere göre bibliyometrik analizi yapılmıştır. Bibliyometik analiz için Web of Science (WoS) veri tabanında yer alan yayınlar kullanılmıştır. Verilerin bilimsel haritalamasını gerçekleştirmek için VOSviwer 1.6.18 programında piramidin tabanına pazarlamaya ilişkin yayınların ortak yazarlık, ortak oluşum, bibliyografik eşleştirme, atıf, ortak atıf analizleri yapılarak bulgular değerlendirilmiştir.
Kişisel satış kavramı algısında metaforlar: Lojistik regresyon ile değerlendirilmesi
Authors: CANDAN Selva Seza , BAYRAM Seliha Seçil
Published: March 2023

Bu çalışmada, temel olarak, Tıbbi Tanıtım ve Pazarlama Programı öğrencilerinin metaforlar yardımıyla kişisel satış kavramına ilişkin algılarının belirlenmesi amaçlanmıştır. Araştırmanın örneklemini, Karabük Üniversitesi, Sağlık Hizmetleri Meslek Yüksekokulu Tıbbi Tanıtım ve Pazarlama Programında öğrenim gören öğrenciler ve bu programdan mezun olup çalışma hayatına atılmış 191 katılımcı oluşturmaktadır. Çalışmada, nitel bir araştırma yaklaşımı olan olgubilim (phenomenology) yöntemi kullanılmıştır. Elde edilen kavram ve olgular, öncelikle, betimsel içerik analizi yönteminden faydalanılarak analize tabi tutulmuştur.  Sonrasında, IBM SPSS Statistics 21 paket programı kullanılarak, katılımcıların demografik özelliklerine yönelik frekans ve yüzdelik değerleri, lojistik regresyon analizi ve Ki-kare analizi uygulanmıştır. Elde edilen sonuçlar; öğrencilerin kişisel satış kavramı algısına yönelik olarak, hayvan, bitki ve renk metaforları yardımı ile geliştirdikleri metaforlar ve bunların açıklamalarının çok büyük bir bölümünün olumlu algı içerisinde olduklarını göstermiştir. Öğrencilerin kişisel satış kavramını algıladıkları metafor ile mezuniyet durumunun karşılaştırıldığı ki-kare analizi sonucuna göre ise; kişisel satış kavramını mezuniyet durumuna göre açıklayan tek metaforun “bitki” olduğu sonucuna ulaşılmıştır. Ayrıca lojistik regresyon analizi ile “satış alanında çalışma durumu” bağımlı değişkenini açıklayan metaforları belirlemek için model kurulmuştur. Hayvan ve bitki metaforları modeli anlamlı olarak açıklamıştır.
Evaluation of the positive impacts of e-customs implementations on foreign trade by fuzzy AHP method
Authors: DANACI ÜNAL Tuğçe
Published: March 2023

This study aims to evaluate the positive impacts of e-customs implementations on international trade and rank these impacts hierarchically according to their importance weights. For this purpose, Fuzzy Analytical Hierarchy Process (AHP) method was applied to analyze the importance weights of each impact. Data were collected from the experts by conducting a survey prepared following the study's research method. Questionnaire forms were structured within the conceptual model framework created in line with the literature review and expert decisions. Questionnaires were sent via e-mail to the experts and fully completed seven of them were included in the analysis. Results of the study demonstrate that the Time criterion has the highest impact on e-customs implementations among the main criteria. Besides, the first three important impacts of e-customs implementations among the sub-criteria are ease of transactions, reduced bureaucracy, and faster transactions. The findings obtained from this study are supposed to contribute to the studies concerning e-customs applications.
Sosyal medyada mobbing: Youtube ve Twitter kullanıcı yorumları analizi
Authors: KAYGISIZ Esra Gökçen
Published: March 2023

Bu çalışmanın amacı, tüm dünyada yaygın olarak kullanılan sosyal medya uygulamalarında mobbing kavramının nasıl ifade edildiğini araştırmaktır. Bununla birlikte mobbing mağdurlarının ve iş yaşamındaki bireylerin mobbing hakkındaki düşüncelerini analiz etmek ve mobbing süreci sonucunda yaşanan sonuçlarını belirlemek de amaçlanmaktadır. Bu amaçlar doğrultusunda 15.11.2022-20.12.2022 tarihleri arasında YouTube platformunda Türkçe mobbing videolarına yapılan kullanıcı yorumları ile Twitter platformunda mobbing kelimesi geçen Türkçe yorumlar içerik analizi yöntemiyle analiz edilmiştir. Oluşturulan iki veri seti ayıklama, özetleme ve dönüştürme işlemlerine tabii tutulduktan sonra kodlanmıştır. Elde edilen bulgulara göre eğitim ve sağlık çalışanlarının mobbingi daha fazla dile getirdikleri, mobbing mağdurlarının daha çok ruh sağlıklarında sorunlar yaşadıkları ve bu kişilerin istifa ettikleri söylenebilir. Çalışmanın bir başka sonucu ise mobbing mağdurlarının hukuki süreç ve ALO 170 dair olumsuz görüşlere sahip olduklarıdır. Bu doğrultuda iş yaşamındaki bireylere mobbinge ilişkin uzmanlardan doğru bilgiler alarak farkındalıklarını artırmaları, yöneticilere mobbing izin vermeyen bir örgüt kültürü oluşturmaları önerilmektedir.
Turizmin etkilerinin turizmin gelişimine destek üzerindeki etkisi: Yerel halkın yaşam kalitesinin aracı rolü
Authors: ALAGÖZ Gürkan , GÜNEŞ Erkan , USLU Abdullah , TAŞ Muhammed
Published: March 2023

Bu araştırmada amaçlanan, turizmin etkilerinin, turizmin gelişimine desteğe etkisini belirleyebilmek ve aralarındaki ilişkide yaşam kalitesinin aracı rolünü tespit etmektir. Araştırmanın evrenini Amasra’da yaşayan yerel halk oluşturmaktadır. Bu kapsamda 27 Aralık 2022- 14 Ocak 2023 tarihleri arasında Amasra’da yaşayan yerel halktan anket tekniğiyle veri toplanmıştır. 364 örneklem üzerinden veri analiz edilmiştir. SPSS ve Smart PLS paket programları aracılığıyla doğrulayıcı faktör analizi, yol analizleri ile aracılık analizi yapılmıştır. Araştırma sonucunda turizmin etkilerinin, yerel halkın yaşam kalitesi ve turizmin gelişimine destek üzerinde anlamlı ve pozitif etkisi tespit edilmiştir. Turizmin etkileri ile turizmin gelişimine destek arasında yerel halkın yaşam kalitesinin kısmi aracılık rolü olduğu tespit edilmiştir. Elde edilen bulgular doğrultusunda sektöre ve politika oluşturuculara öneriler sunulmuştur.
Hava yolu şirketlerinde sunulan yiyecek içecek ikramlarına yönelik yapılan çevrim içi şikâyetlerin değerlendirilmesi
Authors: KEŞKEKCİ Defne , GENÇER Kansu
Published: March 2023

Bu araştırmanın amacı hava yolu şirketlerinde sunulan yiyecek içecek ikramlarına yönelik yapılan çevrim içi şikâyetlerin değerlendirilmesidir. Bu kapsamda nitel araştırma yöntemlerinden içerik analizi kullanılmıştır. Buna göre, Tripadvisor internet sitesi üzerinden müşterilerin yaptığı yorumlar analiz edilerek tema ve alt temalara uygun olarak incelenmiştir. Böylelikle, şikâyetlerin daha fazla hangi konularda yoğunlaştığı saptanmıştır.  Araştırma kapsamında elde edilen bulgular incelendiğinde en çok şikâyetin “yiyecek / içecekle ilgili şikâyetler” ana teması altında oluşturulduğu gözlemlenmiştir. Bununla birlikte yolcuların, “ikramların içeriğinin belirtilmemesi (dini hassasiyet ve sağlık açısından)”, “ikramların sunumu için kullanılan servis malzemelerinin sağlıksız materyallerden elde edilmiş olması”, “kabin ekiplerinin hizmet sunumu aşamasında aceleci davranması”, “çocuklar için hazırlanan ikramların görsel açıdan ilgi çekici olmayışı” konularında da çok sayıda şikâyet bulunduğu dikkat çekmektedir.
Bu araştırma hava yolu ulaşım sektöründen yararlanan tüketicilerin yorumlarının değerlendirilerek ikram hizmetleri konusunda eksikliklerin ortaya çıkarılması açısından önem taşımaktadır. Etkili bir rekabet süreci yürütmek isteyen hava yolu işletmeleri için uçak içi ikram konusunun önemli bir noktaya geldiği bilinmektedir. Bu konuda yolcu taleplerinin neler olduğunun anlaşılması ve alınacak önlemlerin talepler doğrultusunda en doğru şekilde oluşturulması açısından araştırmanın sektörde yer alan hava yolu işletmelerine katkı sağlayacağı düşünülmektedir.
El aporte del trabajo no remunerado a la economía costarricense
Authors: Sandoval Carvajal Irma
Published: March 2023

El objetivo de este artículo es presentar los resultados del valor económico del trabajo no remunerado para Costa Rica y mostrar su importancia para la economía del país. El cálculo se realiza a partir de la Encuesta Nacional de Uso del Tiempo (ENUT) y la Encuesta Nacional de Hogares (ENAHO), ambas del 2017; posteriormente, se compara con el valor del Producto Interno Bruto de ese año. El trabajo no remunerado incluye: la producción de bienes y servicios para el autoconsumo de los hogares, el trabajo doméstico y el voluntario. Para la valoración se utilizó el método input en su variante híbrida, que consiste en homologar las diferentes labores del trabajo no remunerado investigadas en la ENUT 2017, con ocupaciones similares en el mercado (incluyendo servicio doméstico), a partir de la clasificación de ocupaciones para Costa Rica del 2011. Posteriormente, se calculó en la Encuesta Nacional de Hogares del 2017, el salario bruto por hora para cada ocupación. Se realizó un ejercicio metodológico y una estimación para todo el país, con base en la Encuesta de Uso del Tiempo para la Gran Área Metropolitana del 2011 y del Módulo de Uso del Tiempo del 2004. Con la Encuesta Nacional del 2017 se ajustó la metodología y se estimó que el trabajo no remunerado equivale a un 34.21 % del Producto Interno Bruto, en donde el trabajo doméstico equivale al 31.07 % y que las mujeres son las que aportan las tres cuartas partes de este valor.
Avances y tensiones en torno al acceso al aborto terapéutico en Costa Rica en el Siglo XXI
Authors: Preinfalk Fernández María Luisa
Published: March 2023

El aborto terapéutico, procedimiento médico que se practica con el fin de proteger la vida o la salud de la gestante que se encuentra en riesgo debido a complicaciones con el embarazo, está directamente vinculado con el ejercicio de los derechos humanos de las mujeres. En el presente artículo se sistematizan algunos acontecimientos, sucedidos en Costa Rica en el período 2000-2019, que han marcado el rumbo de las acciones del Estado en torno a su obligación de asegurar el acceso al aborto terapéutico, con el objetivo de comprender las limitaciones que han enfrentado las mujeres para su disfrute, así como puntualizar los avances logrados y los retos que se presentan. La metodología utilizada fue la revisión documental de textos producidos en el país y material noticioso nacional en línea. Los resultados muestran que se han dado importantes pasos -de manera reciente- con la aprobación de una norma técnica que regula esta práctica, pero el panorama ha sido complejo y ha estado marcado por intereses de diversos grupos sociales, con posiciones irreconciliables. La existencia de un marco normativo amplio en materia de Derechos Sexuales y Reproductivos y el hecho de que el aborto terapéutico no sea penalizado por ley, no han sido suficientes para garantizar el acceso efectivo a este procedimiento.
Gerardo Budowski: un innovador en la gestión del uso de la tierra
Authors: Borel Rolain
Published: March 2023

To refer to the life and work of Dr. Gerardo Budowski Wolffgang, the definition he provided about himself is very useful: "Although I have training in agriculture and forestry, I would like to call myself a land use manager" use manager”), where environmental concerns are taken into account towards the sustainable management of natural renewable resources.”

Of course one could add more qualifiers to Budowski's various contributions in the second half of the 20th century. However, the quote above sums them up very well, and in a few keywords: renewable resources, land use and sustainable management, with its three "legs" or dimensions: environmental, economic and social.

Budowski's career headed in that direction, somewhat surprisingly, starting from a base with a productive agricultural and forestry focus. For someone with less vision and ability than him, this platform could have led to a very different and probably less extensive journey.
UAV systems for multipurpose heterogeneous networks: a review of design, development and performance
Authors: Rodriguez-Pirateque German-Wedge
Published: March 2023

The technological fusion between wireless sensor networks and the UAS capabilities allows a fast, easy, and inexpensive deployment with multipurpose heterogeneous networks like a communication system for replicable nodes. For a UAV proposed, this paper studies the heterogeneous communication networks with their design, development, and performance where the configurations and design requirements, systems, subsystems required, preliminary sizing study, and services and capabilities were analyzed. Consequently, preliminary dimensions such as wingspan, length, height, maximum take-off weight, and performance specifications were obtained to give introductory considerations about the avionics, routing protocols, and human interaction which infers in an implementation challenge but with several advantages in military and civil applications.
An analytical computation of aircraft’s longitudinal trimmed conditions considering its fuel mass flow rate
Authors: Bovet Laurent
Published: March 2023

The aim of this article is to give simple expressions of aircraft’s longitudinal trimmed conditions taking into account the instantaneous fuel mass flow rate, i.e. the variation of total mass. The computation of aircraft trim points is not a new problem. Nevertheless, current analytical computations are classically performed with a constant total weight of the aircraft, hence assuming that the rate of decrease of the weight due to the fuel mass flow rate has insignificant effects on the results. Thus, the goal of this study has been to assess the effect of weight variation on aircraft trimmed condition and to compute correctly “extended trimmed conditions” defined as the equilibrated conditions in flight considering the weight decrease of the aircraft. It has been demonstrated that the weight variation must have an ad-hoc form to lead to extended trimmed conditions. Moreover, extended trimmed conditions do not correspond to a perfect level flight as it is the case at constant weight, but must present a slightly positive flight path angle leading to a regular increase in altitude. And the corrected longitudinal commands including throttle and elevator positions at a given airspeed and altitude have been computed for extended trimmed conditions and compared to the basic case at constant weight. Finally, all the analytical expressions given in this article have been verified through a numerical simulation performed in the case of a twin-engine aircraft representative of the Airbus wide-body family.
Parametric study of deformation and breakup of non-Newtonian droplet
Authors: Shirani Ebrahim , Lotfizadeh Mohammad , Ghadiri Fatemeh
Published: March 2023

In this paper deformation and breakup of a non-Newtonian shear thinning droplet are studied parametrically. The effects of physical and geometrical properties are investigated by means of numerical methods. The flow is simulated in the range of 716 up to 2864 for Reynolds number and 8.5 to 70 for the Weber number. The VOF numerical method is used for capturing the droplet deformation and Carreau model is used to simulate non-Newtonian physical properties. The results are compared with those exist in literature. It is found that various non-Newtonian parameters of the fluid properties do affect the critical Weber number and the deformation of the droplet.
Immersion and invariance based adaptive attitude control of asteroid-orbiting spacecraft using modified Rodrigues parameters
Authors: W Lee Keum , N Singh Sahjendra
Published: March 2023

The attitude control of an asteroid-orbiting spacecraft based on immersion and invariance (I&I) theory is the subject of this paper. It is assumed that the moment of inertia matrix and the gravitational parameters are not known. The objective is to attain nadir pointing attitude on an elliptic orbit. First, based on the I&I principle, an adaptive attitude control system using the Modified Rodrigues Parameters (MRPs) is derived. Through the Lyapunov stability analysis, the asymptotic convergence of the MRP trajectories to the origin is established. Interestingly, in contrast to traditional adaptive systems, the trajectories of the closed-loop system converge to an attractive manifold in an extended state space. Then, for the purpose of comparison, this MRPs-based control law and a quaternions-based control system (also designed using the I&I principle) are simulated for the attitude control of the spacecraft in eccentric orbits around asteroid 433 Eros. It is observed that while each I&I-based control law can accomplish precise attitude control, for identical design parameters in these two control systems, the MRPs-based control law requires smaller control magnitude and accomplishes smoother convergence of trajectories to the attractive manifold, but requires larger settling time for the attitude trajectories, compared with the quaternions-based adaptive control law.
Development and testing of an all-additively manufactured hybrid thruster for smallsats
Authors: A Whitmore Stephen
Published: March 2023

Background: The design, development, and testing of a small-thruster system with additively-manufacturing key components is presented. The primary issue associated with conventionally-manufactured small thruster systems is the assembly complexity, where the motor case, injector, ignition electrodes, nozzle retainer, nozzle, fuel grain, insulting liner, and other components are fabricated individually and then assembled. For very small thruster systems, this detailed fabrication and assembly process is extremely labor intensive and time-consuming. Proposed "all- additive" designs reduce component fabrication and procurement cycle time, and may significantly reduce overall system complexity. Before committing to hardware, a student-lead design team reduced the trade-space to 2 design-options. Each option employs multiple additively-manufactured components including the oxidizer delivery system attachments, motor cap, motor casing, insulation, and the fuel grain. Components are additively manufactured using one of three different methods, fused-deposition modeling (FDM), stereo lithography (SL), and non-galvanic nickel plating (EN). Both designs feature an FDM-fabricated ABS fuel grain, with 1) a two material combustion chamber assembly fabricated from Veroclear® plastic using Polyjet 3-D SL printing technology, and 2) a chamber/fuel assembly additively fabricated from ABS, but plated with an external nickel coating. For simplicity the student prototype employs gaseous oxygen (GOX) and additively manufactured acrylonitrile-butadiene-styrene (ABS) as propellants. ABS has been previously demonstrated to be a highly efficient hybrid fuel material. The research campaign emphasized multiple objectives including hot and cold material testing burn lifetime survivability, system restart capability, and overall performance. Performance comparisons with hydrazine are presented.
A simple numerical model for the variation of cubesat temperature along its orbit
Authors: Ivezic Zeljko
Published: March 2023

A simple model for the variation of CubeSat temperature along its orbit is presented. First, an analytic solution for the satellite temperature variation with time when subjected to a bistable heat source: two segments with piece-wise constant power, such as orbits with an eclipsed segment when the Sun is not directly visible, is considered. The model assumes that at a given time a single temperature applies to the entire satellite body. Discussion is focused on CubeSat satellites in low-Earth orbits, the uncertainties in predicted temperatures due to uncertain input parameters, and it emphasizes the importance of the satellite thermal inertia in setting the amplitude of the temperature variation along the orbit. This simplified “spherical cow" model is suitable for studying the relative effects of surfaces with different emissivities, the effects of small changes in the solar flux between June and December, the impact of thermal inertia, and as a “sanity check" for the results obtained with numerical thermal models that utilize detailed geometrical and thermal descriptions of all satellite components. It was found that the mean satellite temperature depends on the extreme values of steady-state equilibrium temperatures for eclipsed and non-eclipsed parts of the orbit, and the duration of the eclipse relative to the orbital period; in contrast, the amplitude of temperature variation around the mean temperature is by and large controlled by the satellite thermal inertia. A numerical model with arbitrary time dependence of the heating power is also developed, including its dependence on the satellite temperature, and validated it using analytic solution for a bistable heat source. Analysis of a typical 2U CubeSat shows that low temperatures are more worrisome than high temperatures, and that low temperatures can be mitigated by active temperature control such as releasing heat when the satellite is in eclipse using electrical energy stored in batteries that are charged during non-eclipsed portion of the orbit.
Perpetual movement of the universe
Authors: Etkin VA
Published: March 2023

The article substantiates the concept of the dynamic Universe, according to which the circulation of the field (continuum) and corpuscular phases of matter with their inherent forms of energy is carried out in it. This process includes evolutionary and involutionary stages, the first of which begins with wave formation in the hidden (unstructured) part of the matter of the Universe and the transition of its "gravistatic" energy into "gravidynamic" (oscillatory) with the formation of baryonic (structured) matter in the process of nucleosynthesis, the appearance in its thermonuclear reactions and its permanent compaction up to the singularity in separate regions of the Universe. The second stage includes the "explosion" of supernovae, their "big gap" and the return of matter to its original state. In this circuit, gravity plays the role of a "perpetual motion machine" that allows the Universe to function in time and space indefinitely, bypassing the state of equilibrium. The data of astronomical observations confirming the proposed concept are presented.
Radioactive iodine therapy of juvenile differentiated thyroid carcinoma
Authors: Intidhar EL BEZ , Tulbah Rima , Alghmlas Fahad , Alharbi Mohammed
Published: March 2023

Introduction: Thyroid cancer in children and adolescents is usually a major concern for physicians, patients, and parents. Controversies regarding the aggressiveness of the clinical presentation and the ideal therapeutic approach remain among the scientific community. The current recommendations and staging systems are based on data generated by studies in adults, and this might lead to overtreating in some cases as well as undertreating in others. Our objective was to evaluate the presentation, the contribution of therapy by iodine 131 and long‒term outcome in patients with pediatric DTC and to analyze factors that can influence the success of post ablation by iodine 131. Patients and methods: In this retrospective study, presentation, therapy with iodine 131and outcome of patients with pediatric DTC (age at diagnosis ≤21y) treated in the nuclear medicine department of king Fahd medical city, between 2006 and 2018 were assessed using medical records. Results: We identified 53 patients. Overall survival was 100% after a median follow‒ up of 8 years (range 0.6–13y). Median age at diagnosis was 17.5years (range 7–21y). At initial diagnosis, 43.3% of the patients had cervical lymph node metastases; 16.9% had distant metastases. All patients underwent total thyroidectomy. Radioiodine was administered to 100%, with a median cumulative activity of 5.7GBq (range 0.81– 13.5GBq). At last known follow‒up, 18.8% of the patients had persistent disease and no patient experienced a recurrence. Conclusions:Lymph nodal and distant metastases are important predictors of the persistence of disease after initial therapy in children and adolescents with differentiated thyroid cancer.
Sympathetic blockade on diet induced thermogenesis in the congenic LA/Ntul//-cp rat
Authors: L Tulp Orien
Published: March 2023

The effects of overfeeding highly palatable diets via the cafeteria feeding diet method (Café) has been shown to be a reliable experimental model to induce diet induced thermogenesis (DIT) in young adult normally lean rats of several strains. Groups of young adult lean LA/ Ntul//-cp rats were offered a Purina chow diet (CHOW) or the same diet plus a daily café supplement both ad libitum from 10 until 24 weeks of age. The drug α-methylparatyrosine (α-MPT) was administered to groups (250 mg α-MPT/kg BW, i.p.) to ablate sympathetic (SNS) activity or a sham injection of physiologic saline given, and measures of fasting resting thermogenesis obtained at thermal neutrality (30°C) before and after the α-MPT or sham administration. The Café diet resulted in a 67% increase in body weight (BW) and a ~25% increase in resting oxygen consumption (VO2) following café overfeeding in both groups, while only a 40% increase in BW and no additional increase in VO2 occurred in normally CHOW fed rats while the sham injection was without any variations from normal physiologic responses as predicted. Sympathetic blockade with α-MPT was associated with modest decreases in body temperature and an average ~12-15% decrease in VO2 in the café treated group, but when the VO2 data were arithmetically corrected to isothermal conditions only a net 3% decrease occurred in CHOW fed rats and was without effect on the SHAM group. Serum T3 concentrations increased by 92% and urinary catecholamine excretion of VMA >250% following the café diet, but the urinary vanilmandelic acid (VMA) excretion was virtually nil following the sympathetic blockade. These observations indicate that the SNS-mediated contribution component to DIT following prolonged café overfeeding under conditions of thermal neutrality contribute approximately 50% of the thermic response. While under normal long term CHOW feeding the SNS component may be as little as 3% of the thermic response, and thus, the total thermic response of DIT likely represents a combination of short acting SNS and longer acting non-SNS mechanisms, including a likely significant thyroidal component in normally lean animals.
Pediatric low bone density: when to refer
Authors: Sukumaran Anju
Published: March 2023

Osteoporosis is a highly prevalent disease-causing high morbidity and health-care expenditures. As bone mass structure rarely varies from that of young adulthood, it is important for early recognition of low bone density disorders during childhood. This article will differentiate the common conditions causing low bone density and help Pediatricians promptly identify the patients in need of a Pediatric Endocrinologist referral by explaining the pathophysiology, evaluation, and management of these conditions.
Case report and disease’ review: tophaceous gouty arthropathy
Authors: JS AlJadir Saadi
Published: March 2023

Gout is a common inflammatory and metabolic disorder of the joints and probably other organs, especially the kidneys. It has a definitive genetic and environmental background, making it mainly a disease of middle-aged and elderly males, infrequently inflicting postmenopausal and elderly women who usually have arterial hypertension, renal impairment, and usually on diuretics. Excessive tissue urate turnover and persistent hyperuricemia is the hallmark of the disease. A typical algorithm is characterized by acute attack of the monoarticular joint, the metatarsophalangeal joint of the big toe often is involved (podagra), but tarsal joints, ankles, and knees might also be affected. Chronic asymmetric polyarticular arthritis that might be confused with classical Rheumatoid Arthritis might be encountered in some patients and in recurrent and relapsing diseases. In this setting, many organs and tissues are affected by the deposition of monosodium urate (MSU) crystals other than synovium, bursae, tendons, and periarticular tissues. The risk of involvement of renal interstitium or uric acid nephrolithiasis has a particular interest in the course of the disease. By the inflammation and collection of MSU crystals in form of tophi that might involve many tissues and occasionally the pinna of the ears, this kind of tophaceous gout is rarely observed nowadays, especially in our community (Middle East region). The patient who is presented here has exhibited acute attack on the top of chronic tophaceous gouty arthritis. The recent epidemiologic reports revealed that gout has given different results. This wide variation is attributed to the population studied and methods employed, but overall, for the prevalence of <1% to 6.8% and an incidence of 0.58-2.89 per 1,000 person per year. The most noticeable risks for gout are obesity and associated metabolic syndrome (insulin resistance, hypertension, dyslipidaemia), dietary factors, high fructose-containing diet, high purine diet (red meat, internal organ’s meat ,seafood) high consumption of alcohol, and exclusively beer ( as in our patient’s case ), a wide variety of disorders that are characterized by high urate turnover like myeloproliferative disorders, neoplasms, psoriasis, haemolytic anaemias, medications , to under-secretion of urate like renal insufficiency.
Microwave ablation of thyroid nodules: effects on recurrence and outcome
Authors: M Eisele Robert
Published: March 2023

Background: Microwave ablation developed into an accepted treatment for benign thyroid nodules. Definition and risk factors for recurrence are under discussion. We assumed recurrence in case of a second procedure for the same reason or if clinical symptoms reappear after initial relief, and analyzed our prospectively collected data for risk factors and outcome. Methods: Indications included benign thyroid nodules (n=24), cystic nodules (n=9), autonomous functioning nodules (n=9), recurrent cancer (n=3) and Basedow’s disease (n=2). For microwave ablation, a CE certified generator was used. All procedures were conducted under ultrasound control and with general anesthesia or mild sedation. Followup included ultrasound, laboratory parameters and a standardized questionnaire. Results: A total of 47 patients were enrolled into the study. Among them were 19 cases with risk factors for recurrence which were defined as nodule size exceeding 4 cm with or without cystic appearance. Recurrence occurred in 9 cases leading to conventional hemithyreoidectomy (n=1), reablation (n=5) or sclerotherapy (n=1). The association of recurrence with the presence of a risk factor was statistically significant (p<0,001, Chi square test). In case of recurrence, statistically significant less energy was deployed in comparison to successful MCT (0,39 +/- 0,31 kJ/mL vs. 1,57 +/- 2,37 kJ/mL, p< 0,005, t-test). Conclusion: Recurrence is a common problem following microwave ablation of thyroid nodules. Nodules > 4 cm and cystic disease seem to predispose for treatment failure. Further studies are required to define recurrence and the best indications for microwave ablation of thyroid nodules.
Effect of phenotype on thyroidal parameters and metabolic sequelae in Wistar fatty rats
Authors: L Tulp Orien
Published: March 2023

To determine the effects of phenotype on parameters of peripheral thyroid hormone and actions, groups of adult male lean (LN) and obese (OB) Wistar Fatty Rats were fed a nutritionally adequate semisynthetic diet containing 54% carbohydrate, 16% mixed fats, 20% protein plus essential vitamins, minerals, and cellulose fiber for 8 weeks. Measures of weight gain (WG), feed efficiency ratio (FER), Resting (RMR) and norepinephrine (NE) stimulated VO2, serum triiodothyronine (T3), and in vitro T4-5’ deiodinase (5’DI) activity in liver (LVR), kidney (KID), gastrocnemius muscle (GNM) and interscapular brown adipose tissue (IBAT) were determined at baseline and after dithiothreitol (DTT) stimulation to optimize in vitro deiodination activity. The WG and FER of OB >> LN phenotype and FER increased over time in both phenotypes, with the greatest increase in the OB phenotype. The RMR of LN > OB, and NE-stimulation (200 µg/kg BW, sc) increased VO2 by 180% in LN but only ~30% in OB phenotype. Serum T3 of LN >> OB. Baseline 5’DI of OB > LN in LIV and KID and were of similar magnitude in both phenotypes in GNM and IBAT. After DTT stimulation, LIV increased ~200% in LN, ~30% in OB; In LN rats, KID +DTT increased ~200%, but only modest increases in OB phenotype, while in LN GNM, DTT resulted in 264% increase vs. +70% in OB rats. In IBAT, DTT resulted in ~ 30-fold increase in 5’DI in LN, and a 16-fold increase in 5’DI in the OB phenotype. These results indicate that parameters of thyroidal actions including circulating plasma levels of T3 and maximum capacity to generate T3 in peripheral tissues via 5’DI, although increased in the OB phenotype, were associated with decreases in RMR and NE-stimulated VO2. These observations occurred in association with an improved efficiency of FER and weight gain and dysregulation of intracellular T3 actions including parameters of T3 receptor affinity kinetics are likely to be among key contributors to the epigenetic expression of the OB+NIDDM phenotype in this strain and are consistent with a reduced affinity of T3- mediated cellular components of intermediary metabolism.
Voice professionals and associated anaesthetic risk: a proposal to a perioperative airway-protective care bundle
Authors: Fonseca Raquel , Silva Eunice , Bento Sónia , Gonçalves Décia , Valente Elisabete
Published: March 2023

Background: Voice professionals subjected to surgical procedures or anaesthesia are particularly susceptible, considering the multi-factor potential for damaging the vocal system. Such injuries are the most common reasons for anaesthetic morbidity and have even more serious repercussions for singers. Surgery in the abdominal region is singularly important, considering the vital role that abdominal support plays for respiratory dynamics and vocalisation. Perioperative management and planning and strict anaesthetic practices are fundamental for minimising this risk and promoting an optimum clinical outcome. The lack of guidelines adapted to this context justifies the need to gather together and review all existing evidence, which this case study aims to do. Case presentation: The clinical case concerns a 46year old female, a light opera singer, admitted for laparoscopic cholecystectomy. It describes the ample pre-anaesthetic assessment and education and lists the protective technical and pharmacological choices adopted during the surgery. The subsequent follow-up serves as the starting point for reflecting on the results obtained, preparing a suggested sequential approach for each perioperative stage. Conclusion: Even though vocal damage depends on the surgical and anaesthetic approach during the operation, anaesthesia for voice professionals requires rigorous planning beforehand, often being more complex than the surgical procedure. A multifaceted intervention including counselling, less invasive anaesthetic practices and systematic follow-up promote the key strategy – overall protection.
A case report of menstrual catatonia causing delayed emergence from anaesthesia: a diagnostic dilemma
Authors: V Hegde Harihar , Kumar Vijaya
Published: March 2023

Delayed emergence from anaesthesia is attributed to residual effects of anaesthetic or analgesic medications. Menstrual catatonia is an extremely rare cause for delayed emergence from anaesthesia which may pose diagnostic dilemmas. The diagnosis is by history and clinical examination. Neuro‒imaging may be required to rule out organic causes if the patient stays in catatonic state for a prolonged period. A 24year-old female underwent microdochotomy of left breast under general anaesthesia. Her trachea was extubated in the operating room with satisfactory respiratory parameters even though she remained sedated and not obeying commands. She remained in catatonic state in the postoperative care unit leading to diagnostic dilemmas. Ninety minutes later, she regained consciousness abruptly and started obeying commands. Her past history revealed two similar episodes associated with menstrual period.
Intraoperative blood glucose level changes between obese and non-obese non-diabetic patients undergoing general anaesthesia for creniotomy surgeries
Authors: Chakrabarti Soumya , Gupta Sampa Dutta , Chakraborty Indrani , Bhattacharya Aritra
Published: March 2023

Background: Surgery causes a considerable metabolic stress in the non-diabetic and more so in a diabetic subject. In non-diabetic subjects the stress response is more in obese population than in non-obese due to the presence of insulin resistance. The severity of surgery as well as the type of anesthesia influences the magnitude of the counter regulatory response The study was undertaken to observe the effect of stress of surgery in obese and non-obese non-diabetic patients undergoing craniotomy under general anesthesia. Methods: A Prospective randomized parallel group study was done on a total of 100 patients. They were divided into two groups non-obese patients and obese patients comprising of 50 patients in each group depending on their BMI. If at any time intraoperative CBG was found to be more than or equal to 150mg/dL calculated dose of human soluble insulin was given as intravenous bolus equal to the amount of CBG/100 units. Results: 36% patients in obese population developed at least one episode of hyperglycemia (CBG ≥150 mg/dL) but only 20% in non-obese population did so. Insulin consumption was significantly higher in obese population than in non-obese population to maintain normoglycemia. The relative risk of becoming hyperglycemic in obese compared to non-obese is 1.80 (95% CI 0.92 to 3.51) Conclusion: We conclude that stress induced hyperglycemic response in patients undergoing craniotomy surgery under general anaesthesia is common in non-diabetic obese non-obese population.
Safe surgery control list: it is following a challenge, checklist of safe surgery: still a challenge, checklist of safe surgery: already um challenge
Authors: de Oliveira Junior Nery José , Müller de Magalhães Ana Maria
Published: March 2023

Objective: To describe the changes in the operating room practices with respect to the safe surgery checklist using photographic research methods. Methods: Qualitative study conducted by nursing technicians in an ambulatory surgical day case center in the city of Porto Alegre/RS - Brazil. Results: This study highlights the fact that the implementation of the safe surgery checklist needs monitoring and evaluation of its implementation in real time, in order to strengthen the culture of patient safety and prevent adverse events.
Anesthesia management for emergency cesarean section in a rabbit
Authors: Kumar Yadav Saroj
Published: March 2023

Caesarean section (C-section) is one of the most rear operations in rabbit. The present case study represents the efficacy of the surgical outcome and anesthetic protocol of C-section in rabbit. A 1.2 years old, local and non-descriptive breed of rabbit was presented to the SAQ Teaching Veterinary Hospital (SAQTVH), Chittagong Veterinary and Animal Sciences University (CVASU) with a history of one kit normally delivered and remains straining and treated with oxytocin. Problem on physical examine included abdominal distension and vaginal secretion. Based on the clinical examination, X-Ray and Ultrasonography report, it was decided to perform surgery. The surgery was aseptically control under general anesthesia combination with xylazine and ketamine with the dose rate 5mg/kg and 30mg/kg respectively. The rabbit became unconscious within 3 minutes of intramuscular injection. Laparotomy midline incision (1cm) was performed behind the umbilicus. Two dead fetuses were removed and proper apposition of abdomen was done. The rabbit was recovered fully after 50 minutes of injection. As a part of post operative treatment which was maintained with antibiotic, pain killer for 7 days. The wound healing was noticed after 10 days of operation. So, the case report suggests that rabbit C-section can be performed successfully with xylazine and ketamine anesthesia with recommended doses.
Does a supreme laryngeal mask airway (SLMA) selected on the basis of a patient’s weight provide an optimal fit in Indian population?
Authors: Chatterjee Aparna , Yadav Anamika
Published: March 2023

Background: The Supreme laryngeal mask (SLMA), is a second generation Laryngeal mask airway (LMA) introduced in 2007. Designed in the West on Caucasian population, most studies have been conducted on the same population. There is no study to evaluate the fit of a SLMA chosen on the weight based criteria in Indian population. Aim: The aim or objective of the study was to identify whether SLMA selected on the basis of weight criteria provides an appropriate fit in Indian population?
Complications after duodenopancreatectomy within eras protocols in a developing country
Authors: Linares Juan Pablo Aristizabal , Quiroz Jose Julian Estrada , Martinez Diego Fernando Davila , Hoyos Gomez Carolina , Palacios Oscar German , Zapata Paola Sanchez
Published: March 2023

Background: Recent studies have suggested that intraoperative fluid overload is associated with the presence of postoperative pancreatic fistula after duodenopancreatectomy. Finding the ideal balance between hypoperfusion and tissue edema with fluids administration during major gastrointestinal surgery is challenging. The aim of this study was to evaluate whether intraoperative fluid management along with enhanced recovery protocols could affect the outcome after a major pancreatic resection. Methods: Data from 67 consecutive patients who underwent duodenopancreatectomy from January 2012 to January 2017 were analyzed. Patients were divided into two groups according to the use of enhanced recovery after surgery protocols. Patients in ERAS protocols had a fluid therapy algorithm which consists: Systolic Volume Variation (SVV) less than 13%, Cardiac Index (CI) higher than 2.5 L/Min/M2 and Delta CO2 less than 6 mmHg. Results: A total of 67 patients were analyzed from July 2012 to January 2017, of these 49.3 % correspond to the female gender. The most frequent diagnosis was Pancreatic Cancer n:48 (71.6%), followed by Intraductal Papillary Mucinous Neoplasm (IPMN) n:6 (9%). The majority of patients were in the ERAS Group with a total of 46 patients (68.7%). In the ERAS group, 80.4% and 95.7% did not develop POPF and Delayed Gastric Emptying (DGE) respectively. The incidence of POFP in all the patients was 11.94% (Grade A are considered biochemical leak and NOT a proper fistula). The incidence of DGE was 11.94%. The probability of intraoperative blood loss less than 300ml was higher in the ERAS group; however, the probability to need a transfusion was lower in the ERAS Group. The probability to use less than 5000ml of fluid therapy was higher in the ERAS group. The total length of stay was statistically significant shorter in the ERAS group. No differences in 30-days mortality were found. Conclusion: The implementation of ERAS protocols in PD did show a decrease in intraoperative blood loss, intravenous fluids therapy, need for transfusion, DGE, and total hospital stay; however, intraoperative fluid restriction in PD did not show to significantly affect POPF.
Early resuscitation - what is changed in the treatment of Traumatic Brain Injury (TBI)
Authors: Sholjakova Marija , Durnev Vesna , Demjanski Vasko , Kishman Aleksandar
Published: March 2023

Background: The classical therapeutic approaches to thetraumatic brain injury (TBI) are based on astandardized care and prevention of secondary brain injuries and insults.Brain is the most sensitive tissue to hypoxemia what consequently burdens maintenance of adequate circulation. The development of hypoxia hypoxemia during traumatic brain injury (TBI) with severe shock and anaemia is the main cause for the development of secondary brain injury, which is responsible for the high fatality of the TBI. Objectives and method: The aim of this review is to discuss the available literature and guidelines for this field and to find out the possible benefits of early resuscitation. Results: Initial resuscitation starts with infusions of isotonic crystalloid solutions (e.g. sodium chloride). The main goal of the treatment is to achieve normal blood pressure and adequate oxygen supply to the tissue. Aggressive resuscitation with excessive fluid load in TBI patients may aggravate the brain oedema. The data, about early use of blood and its products in TBI patients with severe haemorrhage are poor with controversial opinions. Conclusion: The resent published guidelines do not support any specific fluid or specific transfusion practices in this setting.
Fluid management in continuous renal replacement therapy
Authors: J. Zaragoza Jose , Lomeli-Teran Jose Manuel , Rodriguez-Guillen Job
Published: March 2023

The purpose of intravenous fluid administration is to increase cardiac output. Excessive fluid administration can lead to accumulation of interstitial fluid, worsening hypoperfusion and hence develop organic dysfunction. Therefore, fluid overload is a poor prognostic factor for hospitalized patients and those admitted to the Intensive Care Unit (ICU). A resuscitation strategy divided in four phases has been described; the last phase consists in the elimination of those fluids that have been administrated in the previous phases. When fluid overload is complicated by acute kidney injury renal replacement therapy may be used for this purpose. A successful fluid treatment of a patient depends on a proper, accurate and frequent evaluation, and in the correct understanding of the basic principles and clear objectives of the treatment. In the continuous renal replacement therapy, the rate of the fluid eliminated can be adjusted safely according to each patient needs and it allows additional support of other complications. The ideal strategy to guide the elimination rate is unknown. This review presents the basic principles for an optimum fluid management in the continuous renal replacement therapy.