bluuebunny/crossref_metadata_2025 huggingface dataset:
Monitoring the effects of automated gas control of sevoflurane versus target-guided propofol infusion on hemodynamics of liver patients during liver resection. A randomized controlled trial
Authors: Kamel Yasmeen Abdelsalam , Sasa Noura Adel Ghareeb , Helal Safaa Mohamed , Attallah Hatem Amin , Yassen Khaled A.
Published: March 2023

Background and Aims:

Cirrhotic patients are prone to hypotension during anesthesia. The primary aim of the study was to compare the effects of automated gas control (AGC) of sevoflurane and target-controlled infusion (TCI) of propofol on systemic and cardiac hemodynamics in hepatitis C cirrhotic patients undergoing surgery. The secondary aim was to compare the recovery, complications, and costs between the two groups.

Material and Methods:

This was a randomized controlled trial in adults with hepatitis C cirrhosis (Child A) who underwent open liver resection and received AGC (n = 25) or TCI (n = 25). AGC was initially set at FiO240% and end-tidal sevoflurane (ET SEVO) at 2.0% with a fresh gas flow of 300 mL/min. TCI of propofol was given using Marsh pharmacokinetic mode with an initial propofol target concentration (Cpt) of 4 μg/mL. Bispectral index score (BIS) was maintained between 40 and 60. Invasive arterial blood pressure (IBP), electrical cardiometry (EC), cardiac output (CO), and systemic vascular resistance (SVR), Fi SEVO, ET SEVO, propofol Cpt, and effect-site concentration (Ce) were recorded.

Results:

IBP and EC CO, and SVR were least affected by TCI propofol. Only one (4.00%) patient required vasopressors with TCI vs. 4 (16.00%) with AGC (χ2(Y) (df = 1)= 0.88,P(Y)= 0.34). There was no delayed recovery, hypoxia, or awareness; however, ICU stay was shorter with TCI, (P = 0.006). BIS and EC guided median of ET SEVO was 1.90%, Fi SEVO was 2.10% with AGC, and propofol Cpt and Ce were 3.00 μg/dL with TCI. Only 0.14 [0.12–0.15] mL/min of SEVO was consumed with AGC and 0.87 [0.85–0.97] mL/min propofol with TCI. The cost was higher with TCI,P< 0.00.

Conclusions:

Both techniques are well tolerated hemodynamically, but TCI-propofol was found to be hemodynamically better. The recovery and complications were comparable in both groups, but TCI Propofol infusion was costlier.
Low-dose propofol as a solo agent for sedation in postoperative ventilated liver transplant recipients: A preliminary observational study
Authors: Jaju Rishabh , Prakash Kelika , Arora M. K.
Published: March 2023

Background and Aims:

Propofol is a commonly used sedative agent, in a dose of 1.5–4.5 mg.kg–1.h–1. Following liver transplantation (LT), drug metabolism may be altered due to liver mass, altered hepatic blood flow, reduced levels of serum proteins, and liver regeneration. Thus, we hypothesized that propofol requirements in this group of patients would be different as compared to the standard dose. This study evaluated the dose of propofol used for sedation in electively ventilated living donor liver transplantation (LDLT) recipients.

Material and Methods:

After patients were shifted to the postoperative intensive care unit (ICU) following LDLT surgery, propofol infusion was started at a dose of 1 mg.kg–1.h–1 and titrated to maintain a bispectral index (BIS) value of 60–80. No other sedatives such as opioids or benzodiazepines were used. Dose of propofol, noradrenaline, and arterial lactate levels were noted 2 hourly.

Results:

The mean propofol dose required in these patients was 1.02 ± 0.26 mg.kg–1.h–1. Noradrenaline was gradually tapered off and stopped within 14 h of shifting to ICU. The mean duration between the time of cessation of propofol infusion till extubation was 2.06 ± 1.44 h. Propofol dose did not correlate with respective lactate levels, ammonia levels, or graft-to-recipient weight ratio.

Conclusion:

The dose range of propofol required for postoperative sedation in LDLT recipients was lower than the conventional dose.
Current practice of Rapid Sequence Induction (RSI) in pediatric anesthesia: A survey from India
Authors: Hussain Sana Yasmin , Panjiar Pratibha , Jain Dhruv , Khanooja Samiksha , Batt Kharat Mohammad
Published: March 2023

Background and Aims:

Rapid Sequence Induction (RSI) is an established technique to secure the airway in patients who are at risk of aspiration. The practice of RSI in the pediatric population is highly variable due to numerous patient factors. We conducted a survey to find the prevalent practices and adherence of anesthesiologists to the practice of RSI in different pediatric age groups and whether it differs with the experience of the anesthesiologist or the age of the child.

Material and Methods:

The survey was conducted among residents and consultants attending the pediatric national anesthesia conference. The questionnaire consisted of 17 questions on anesthesiologist’s experience, adherence, conduct of pediatric RSI, and the reason for nonadherence.

Results:

The response rate was 75% (192/256). Anesthetists having less than 10 years of experience adhered to RSI more often as compared to respondents with more experience. Succinylcholine was the most commonly used muscle relaxant for induction, with use increasing in higher age groups. The application of cricoid pressure increased with increasing age groups. Anesthetists with >10 years of experience used cricoid pressure more often in age groups of <1 year (P < 0.05). In a scenario of intestinal obstruction, adherence to RSI was low in pediatrics as compared to adults, with 82% of respondents agreeing to this.

Conclusion:

This survey on the practice of RSI in the pediatric population demonstrates wide variation in the practice among individuals and the reasons for nonadherence as compared to adults. It highlights the need felt by almost all the participants for more research and protocol in the practice of pediatric RSI.
A comparison of efficacy of parenteral and perineural dexmedetomidine with 0.25% ropivacaine for post-thyroidectomy analgesia using bilateral superficial cervical plexus block
Authors: Jain Neena , Mathur Pooja R. , Lakhina Kriti , Patodi Veena , Jain Kavita , Garg Deepak
Published: March 2023

Background and Aims:

Opioids are conventionally used for post-thyroidectomy pain, regional anesthesia is becoming popular due to its feasibility and efficacy in minimizing use of opioids and hence its side effects. This study compared analgesic efficacy of bilateral superficial cervical plexus block (BSCPB) using perineural and parenteral dexmedetomidine with 0.25% ropivacaine in thyroidectomy patients.

Material and Methods:

In this double-blind study, 60 American Society of Anesthesiologists (ASA) physical status I and II thyroidectomy patients, aged 18–65 years were randomized into two groups. Group A (n = 30) received BSCPB with 0.25% ropivacaine, 10 mL on each side with dexmedetomidine 0.5 μg/kg IV infusion. Group B (n = 30) received 0.25% ropivacaine plus dexmedetomidine 0.5 μg/kg, ten mL on each side. Duration of analgesia by measuring pain visual analog scores (VAS), total dose of analgesic requirement, Haemodynamics parameters and adverse events were recorded for 24 h. Categorical variables were analyzed using Chi-square test and continuous variables were computed as mean with standard deviation and analyzed using independent sample t-test. Mann-Whitney U test was used for analysis of ordinal variables.

Results:

Time to rescue analgesia was longer in Group B (18.6 ± 3.27 h) as compared to Group A (10.2 ± 2.11 h) (P < 0.001). Total analgesic dose required was also found to be lesser in Group B (50.83 ± 20.37 mg) as compared to Group A (73.33 ± 18.27 mg) (P < 0.001). No significant hemodynamic changes or side effects were observed in both groups; (P > 0.05).

Conclusion:

Perineural dexmedetomidine with ropivacaine in BSCPB significantly prolonged the duration of analgesia with reduced rescue analgesic requirement.
A prospective, randomized, triple-blind comparative study of ropivacaine-dexmedetomidine versus ropivacaine alone in peribulbar blocks
Authors: Moolagani Ramanareddy Venkata , Prathi Sunita , Bandaru Sriushaswini , Arepalli Narasimha Rao , Neethipudi Bhaskara Rao
Published: March 2023

Background and Aims:

Bupivacaine and lidocaine mixtures are the commonly used local anesthetic drugs for the peribulbar blocks. Because of its safe anesthetic profile, ropivacaine is being investigated as an alternative agent. Several centers have evaluated the effect of the addition of an adjuvant like dexmedetomidine (DMT) to ropivacaine in enhancing the block characteristics. We proposed to evaluate the effect of the addition of DMT to ropivacaine versus a control group not having DMT as adjuvant.

Material and Methods:

A prospective, randomized comparative study was conducted on a total of 80 patients attending our hospital for cataract surgeries. Patients were allocated into four groups of 20 each (n = 20) and peribulbar blocks were given 6 mL of 0.75% ropivacaine in group R and 6 mL of 0.75% ropivacaine plus 10 μg, 15 μg, and 20 μg DMT, respectively, in groups RD1, RD2, and RD3.

Results:

When DMT was used as an adjunct to ropivacaine, there was a prolongation of the duration of the sensory block.

Conclusion:

In peribulbar blocks, 6 mL of ropivacaine 0.75% produces satisfactory block characteristics, and the addition of 10 μg, 15 μg, or 20 μg of DMT as an adjuvant to ropivacaine 0.75% had the effect of significantly prolonging the duration of the sensory block, which is directly proportional to the dose of DMT employed. However, 20 μg of DMT added as an adjuvant to ropivacaine 0.75% appears to be the optimal dose, as this anesthetic drug mixture provides maximum prolongation of the sensory block besides providing satisfactory operating conditions, acceptable sedation levels, and stable hemodynamic parameters.
The respiratory and hemodynamic effects of alveolar recruitment in cirrhotic patients undergoing liver resection surgery: A randomized controlled trial
Authors: Halawa Naglaa Moustafa , El Sayed Amani Mamdouh , Ibrahim Ezzeldin Saleh , Khater Yehia H. , Yassen Khaled Ahmed
Published: March 2023

Background and Aims:

Extensive surgical retraction combined with general anesthesia increase alveolar collapse. The primary aim of our study was to investigate the effect of alveolar recruitment maneuver (ARM) on arterial oxygenation tension (PaO2). The secondary aim was to observe its effect on hemodynamics parameters in hepatic patients during liver resection, to investigate its impact on blood loss, postoperative pulmonary complications (PPC), remnant liver function tests, and on the outcome.

Material and Methods:

Adult patients scheduled for liver resection were randomized into two groups: ARM (n = 21) and control (C) (n = 21). Stepwise ARM was initiated after intubation and was repeated post-retraction. Pressure-control ventilation mode was adjusted to deliver a tidal volume (Vt
) of 6 mL/kg and an inspiratory-to-expiratory time (I:E) ratio of 1:2 with an optimal positive end-expiratory pressure (PEEP) for the ARM group. In the C group, a fixed PEEP (5 cmH2O) was applied. Invasive intra-arterial blood pressure (IBP), central venous pressure (CVP), electrical cardiometry (EC), alanine transaminase (ALT, U/L), and aspartate aminotransferase (AST, U/L) blood levels were monitored.

Results:

ARM increased PEEP, dynamic compliances, and arterial oxygenation, but reduced ventilator driving pressure compared to group C (P < 0.01). IBP, cardiac output (CO), and stroke volume variation were not affected by the higher PEEP in the ARM group (P > 0.05) but the CVP increased significantly (P = 0.001). Blood loss was not different between the ARM and C groups (1700 (1150–2000) mL vs 1110 (900–2400) mL, respectively and P = 0.57). ARM reduced postoperative oxygen desaturation; however, it did not affect the increase in remnant liver enzymes and was comparable to group C (ALT, P = 0.54, AST, P = 0.41).

Conclusions:

ARM improved intraoperative lung mechanics and reduced oxygen desaturation episodes in recovery, but not PPC or ICU stay. ARM was tolerated with minimal cardiac and systemic hemodynamic effects.
Monitoring haemodynamic changes during transjugular portosystemic shunt insertion with electric cardiometry in sedated and spontaneous breathing patients. A diagnostic test accuracy study
Authors: Kamel Yasmin A. , Elmoniar Mahmoud M. , Fathi Yasser I. , Lotfi Mamdouh E. , Alwarraky Mohamed S. , Yassen Khaled A.
Published: March 2023

Background and Aims:

Transjugular intrahepatic portosystemic shunt (TIPS) allows a high blood volume into systemic circulation abruptly. The primary aim of the study was to investigate the effect of TIPS on systemic, portal hemodynamics, and electric cardiometry (EC) parameters in sedated and spontaneous breathing patients. Secondary aims??

Material and Methods:

Adult consecutive hepatic patients scheduled for elective TIPS were included. Patients were sedated with bispectral index-guided propofol infusion + fentanyl boluses. EC parameters, i.e., cardiac output (CO) and systemic vascular resistance (SVR) were noted. Noninvasive blood pressure, heart rate, central venous pressure (CVP, cmH2O), and portal venous pressure (PVP, cmH2O) were measured pre- and post-TIPS.

Results:

Thirty-six people were enrolled (n = 25 included) from Aug 2018 to Dec 2019. Data (expressed in median (IQ)) were: age 33 (27–40) years, body mass index 24 (22.0–27) kg/m2, child A 60%, B 36%, and C 4%. Post-TIPS, PVP decreased (from 40 [37–45] to 34 [27–37] mmHg, P < 0.001), whereas CVP increased (from 7 [4–10] to 16 [10.0–19.0] mmHg, P < 0.001). The CO increased (P = 0.03) and SVR reduced (P = 0.012).

Conclusion:

The reduction in PVP following successful TIPS insertion elevated the CVP abruptly. EC was able to monitor an immediate increase in the CO and a reduction in SVR in association with the above PVP and CVP changes. The results of this unique study indicate that EC monitoring is promising; however, further evaluation in a larger population and in correlation with other gold-standard CO monitors is still indicated.
Comparison of aerosol box intubation with styletted endotracheal tube and intubation over bougie: A randomized controlled trial
Authors: Puthenveettil Nitu , Vijayaraghavan Sundeep , Rahman Sajan , Rajan Sunil , Paul Jerry , Kumar Lakshmi
Published: March 2023

Background and Aims:

Severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) is an infectious disease. The use of video laryngoscopes is recommended for intubation of patients with COVID-19. But in resource-poor countries, it is rare to have video laryngoscopes available. In this trial, we have compared the ease of oral intubation by direct laryngoscopy with styletted endotracheal tube and intubation over the bougie, with the use of the aerosol box. The secondary objectives were comparison of the incidence of airway loss, attempts taken to intubate, time for intubation and hemodynamic changes.

Material and Methods:

80 non-coronavirus infected patients coming for an elective procedure under general anesthesia were recruited in this randomized control trial. Participants were assigned into groups S and B using a computer-generated random sequence of numbers by closed envelope technique. In both groups, aerosol box was used. In Group S, participants were intubated by direct laryngoscopy with a styletted endotracheal tube and in group B, after direct laryngoscopy, the endotracheal tube was railroaded over the bougie.

Results:

Ease of endotracheal intubation was good (67.5%% vs. 45%), satisfactory (32.5%% vs. 37.5%), and poor (0% vs. 17.5%) in group S and B respectively (P < 0.011). The attempts required for intubation were similar in both groups. The time for intubation was significantly less in group S than B (23 vs. 55 s).

Conclusion:

The use of a styletted endotracheal tube made intubation easier and faster than tracheal intubation with bougie when the aerosol box was used in patients without known or predicted difficult airway and significant medical comorbidities.
Efficacy of IM dexmedetomidine in alleviating catheter related bladder discomfort and postoperative inflammatory response following percutaneous nephrolithotomy. A prospective randomized controlled study
Authors: Jonnavithula Nirmala , Patro Abinash , Vattikala Rajesh Babu Venkatachalam , Aavula Kireeti , Chaganti Sharmila , Chinnapagu Indira Priyadarshini
Published: March 2023

Background and Aims:

Catheter-related bladder discomfort (CRBD) causes significant distress to the patient and requires great attention to analgesia and increases morbidity in the postoperative period. This study evaluated the efficacy of intramuscular dexmedetomidine in alleviating CRBD following percutaneous nephrolithotomy (PCNL) and postoperative inflammatory response.

Material and Methods:

A prospective randomized double-blind study was conducted in a tertiary care hospital from December 2019- March 2020. Sixty seven of ASA I and II patients scheduled for elective PCNL were randomized and group I received 1 μg/kg dexmedetomidine intramuscularly and group II normal saline as control 30 minutes before induction of anesthesia. Standard anesthesia protocol was followed and patients were catheterized with 16 Fr Foleys after induction of anesthesia. Rescue analgesia was paracetamol if the score was moderate. Postoperatively CRBD score and inflammatory markers; total white cell count, erythrocyte sedimentation rate and temperature were noted for 3 days.

Results:

There was a significant low CRBD score in group I. Ramsay sedation score was 2 in group I with p 0.00 and rescue analgesia required was very low with p 0.00. Statistical Package for social Sciences software version 20 was used for analysis. Student ttest, analysis of variance, and Chisquare test were applied for quantitative and qualitative analysis respectively.

Conclusion:

Single dose intramuscular dexmedetomidine is effective, simple and safe in preventing the CRBD and the inflammatory response remained uninfluenced except ESR, the reason remains largely unknown.
A prospective observational single center study evaluating emergence agitation in the early postoperative period in adult patients undergoing elective craniotomies under general anesthesia
Authors: Monteiro Joseph N. , Dhokte Ninad S. , Goraksha Shwetal U.
Published: March 2023

Background and Aims:

Emergence agitation is a significant clinical issue during recovery from general anesthesia. Patients after intracranial operations are even more vulnerable to the stress resulting from emergence agitation. Due to the limited data available in neurosurgical patients, we evaluated the incidence, risk factors, and complications of emergence agitation.

Material and Methods:

317 consenting eligible patients undergoing elective craniotomies were recruited. The preoperative Glasgow Coma Scale (GCS)) and pain score were recorded. Bispectral Index (BIS) guided balanced general anesthesia was administered and reversed. Immediate postoperatively, the GCS and the pain score were noted. The patients were observed for 24 hours following extubation. The levels of agitation and sedation were evaluated by the Riker’s Agitation-Sedation Scale. Emergence Agitation was defined as Riker’s Agitation score of 5 to 7.

Results:

In our subset of the patient population, the incidence was 5.4%, mildly agitated in the first 24 hours and none required sedative medication as therapy. The sole risk factor identified was prolonged surgery beyond 4 hours. None of the patients in the agitated group had any complications.

Conclusion:

Early objective assessment of risk factors in the preoperative period with objective validated tests and shorter duration of surgery maybe the way forward in patients at high risk for emergence agitation, to reduce the incidence and mitigate the undesirable consequences.
A comprehensive, bed-side scoring system to predict difficult lumbar puncture
Authors: Subramanian Shobha , Reshma BM , Salim Iqbal M. , Harsoor SS
Published: March 2023

Background and Aims:

Spinal anesthesia (SA) is the most widely practiced neuraxial anesthesia. Lumbar puncture (LP) at multiple levels and multiple attempts due to any reason may cause discomfort and even serious complications. Hence the study was conducted to evaluate the patient variables that can predict difficult LP thus allowing for the use of alternate techniques.

Material and Methods:

We included 200 patients of ASA physical status I-II, scheduled to undergo elective infra-umbilical surgical procedures under spinal anesthesia. During preanesthetic evaluation, difficulty score was assessed using the 5 variables: Age, abdominal circumference, spinal deformity - assessed as axial trunk rotation (ATR) value, anatomical spine assessed by spinous process landmark grading system (SLGS) and patient position, by assigning a score of 0- 3 for each variable, with a total score of 0 – 15. The difficulty of LP was graded as easy, moderate or difficult based on total number of attempts and spinal levels by independent experienced investigator. The scores obtained during preanesthetic evaluation and the data collected after performing LP were analyzed using multivariate analysis and P value noted.

Results:

Our study showed that above patient variables correlated well with difficult LP scoring (P < 0.001). SLGS was noted to be a strong predictor, while ATR value a weak predictor. The correlation between the total score and grades of SA had a positive association (R = 0.6832, P < 0.00001) and was statistically significant. A median difficulty score of 2, 5 and 8 predicted easy, moderate and difficult LP respectively.

Conclusion:

The scoring system provides for a useful tool to predict difficult LP and helps both patient and anesthesiologist to choose an alternative technique.
Effects of adding dexmedetomidine to nebulized lidocaine on control of hemodynamic responses to laryngoscopy and intubation: A randomized clinical trial
Authors: Sriramka Bhavna , Warsi Zeeshan Haider , Sahoo Janmejaya
Published: March 2023

Background and Aims:

Hemodynamic responses (HDR) to laryngoscopy and intubation are a significant concern for the anesthesiologist. This study aimed to compare the effects of intravenous Dexmedetomidine and nebulized Lidocaine for control of HDR to laryngoscopy and intubation when used in combination or alone.

Material and Methods:

This double-blind, parallel group, randomized clinical trial included 90 patients (30 for each group) aged 18-55 years with ASA grade 1-2. Group DL received intravenous (IV) Dexmedetomidine (1 μg kg-1) and nebulized Lidocaine 4% (3 mg kg-1) before laryngoscopy. Group D received IV Dexmedetomidine (1 μg kg-1) and group L received nebulized Lidocaine 4% (3 mg kg-1). Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) were recorded at baseline, post nebulization, and at 1, 3, 5, 7, and 10 min post-intubation. Data analysis was done by SPSS 20.0.

Results:

Post-intubation HR was better controlled in group DL than group D and group L (76.40 ± 5.61, 95.16 ± 10.60, 103.90 ± 12.98 respectively, P value <0.01). Group DL > D > L controlled SBP changes significantly (118.93 ± 7.70, 131.10 ± 9.20, 142.66 ± 19.62 respectively, P value <0.01). At 7 and 10 minutes, group D and L found similarly effective in preventing a rise in SBP. Group DL showed significantly better control of DBP than group L and D till 7 minutes (P < 0.01). Group DL also had better control of MAP post-intubation (92.86 ± 5.50) than group D (102.70 ± 6.64) and L (112.66 ± 7.66) and continued to be better till 10 minutes.

Conclusion:

We found the addition of intravenous Dexmedetomidine to nebulized Lidocaine to be superior in controlling the increase in HR and MBP post-intubation with no adverse effects.
Trace formalism for motivic cohomology
Authors: Abe Tomoyuki
Published: March 2023

The goal of this paper is to construct trace maps for the six functor formalism of motivic cohomology after Voevodsky, Ayoub, and Cisinski-D\'{e}glise. We also construct an $\infty$-enhancement of such a trace formalism. In the course of the $\infty$-enhancement, we need to reinterpret the trace formalism in a more functorial manner. This is done by using Suslin-Voevodsky's relative cycle groups.
Cardiac Arrest as the Initial Presentation of Leigh Syndrome Associated with Novel NDUFS1 Mutation
Authors: Lee Na Hyun , Kim Do-Hoon , Byun Jun Chul
Published: March 2023

Leigh syndrome is a rare progressive neurodegenerative mitochondrial disorder. Over 75 pathogenic mutations have been identified in both the mitochondrial and nuclear genomes. Leigh syndrome can be diagnosed based on clinical manifestations, physical and biochemical examinations, and brain magnetic resonance imaging results. Patients with Leigh syndrome classically present in early childhood with developmental regression, ataxia, and hypotonia with subsequent respiratory and brainstem dysfunction. However, the clinical course of Leigh syndrome is heterogeneous with significant differences in age of onset, symptom severity and prognosis. Here, we report a case of Leigh syndrome with cardiac arrest as initial presentation, and identified the novel mutation of NDUFS1 gene.
El paisaje sostenible, una visión desde la geoecología
Authors: Bollo Manent Manuel , Mateo Rodríguezⴕ José Manuel
Published: March 2023

La concepción sobre el Desarrollo Sostenible, formulada por la Organización de las Naciones Unidas, va encaminada a trazar un derrotero que permita articular el crecimiento económico, la equidad social y la optimización y mejoramiento del estado del ambiente. La comunidad científica internacional está en la obligación de formular los fundamentos teórico-metodológicos que conlleven a establecer derroteros prácticos que permitan de manera fehaciente incorporar la sostenibilidad a los procesos de desarrollo. La noción de paisaje sostenible, como una formulación dirigida a construir una visión integral de la sostenibilidad de los sistemas espaciales y ambientales, se comenzó a tratar en la Geografía ruso-soviética desde la década de 1980 del pasado siglo. El objetivo del artículo fue presentar los elementos básicos de la teoría sobre el paisaje sostenible desde la Geoecología, con un enfoque científico, cualitativo, basado en las experiencias de los autores en su formulación y aplicación en algunos países de América Latina. Para ello, se realizó un análisis de la concepción del desarrollo sostenible, el rol de la Geografía en la sostenibilidad y la interpretación de la categoría del paisaje que utiliza la Geoecología. Además, se definió al paisaje sostenible desde el enfoque geoecológico y los instrumentos para su diseño.
Towards a national pharmaceutical strategy in Lebanon: Ensuring access to quality and safe medications for all
Authors: Sacre Hala , Hamra Rasha , Hassoun Carole , A. Hanna Marie-Louise , Ghossoub Marie , Jaber Joumana , Hajj Aline , Akel Marwan , Zeenny Rony M. , Mina Wadih , Rached Roula , Chourbaji Wael , El Hajj Samar , Ziade Bassame , Gebrael Rawad , Sleiman Ali , Traboulsi Lina , Abi Karam Carol , El Rifai Omar , Salameh Pascale
Published: March 2023

Introduction: Lebanon is facing challenges affecting the whole health sector, including access to medications. Lebanon has only proposed very few short-term national pharmaceutical strategic solutions. Previous reform attempts targeting the pharmaceutical sector, could not protect it from the crises and their detrimental consequences on patient and population health.
Purpose: This document unveils the critical elements that should be addressed in the planned National Pharmaceutical Sector Strategy (NPS) being developed by the Order of Pharmacists of Lebanon (OPL) in consultation with the concerned stakeholders.
Method: Strategic goals were proposed for adoption and implementation by the competent authorities based on consultations, situational assessments, and gap analyses. The objectives and an implementation plan were developed based on the available resources and policy dialogue, respectively.
Conclusion: The National Pharmaceutical Strategy would help the Lebanese authorities/policy-makers, aided by competent healthcare professionals, develop and implement a time-bound roadmap to attain a nation with access to quality and safe medications for the whole population. Implementing this strategy would require the commitment of decision-makers, the accountability of involved parties, innovation in finding solutions, close collaboration between stakeholders, and lengthy efforts to attain the stated vision.
Factors Influencing the Implementation of the Lesson Study Approach in Pre-service Teacher Education in Tanzania
Authors: Ezekiel Kihwele Jimmy
Published: March 2023

Teachers' education programs inadequately produce highly knowledgeable and competent teachers to support quality education. The situation necessitates plans to ensure the availability of systemic and continuous teacher professional development. This study explored factors influencing the implementation of lesson study in pre-service teacher education for continuous professional development. The data collection involved observation of classroom teaching with 72 students and in-depth interviews that purposively selected ten respondents from the class. Analysis involved content analysis. The findings show that collaboration and teamwork among pre-service teachers influenced the implementation of lesson study in a positive way while time requirement, negative perception and their seclusion behavior affected it negatively. The lesson study approach benefits pre-service teachers in igniting innovative and creative pedagogy compared to block teaching practices. The study recommends that future studies should consider the improvised solutions to existing challenges to enable the systemic implementation of lesson study in pre-service teacher education programs for professional development.
Promotion and Preservation of Indigenous Textiles and Culture in Ghana
Authors: Marfo Ayesu Solomon , Acquaye Richard , Kofi Howard Ebenezer , K. Asinyo Benjamin
Published: March 2023

This study investigated on promotion and preservation of indigenous textiles and culture in Ghana using qualitative approach. Tour guides, curators, historians and artisans were selected as accessible population as they possessed knowledge of the cultural significance, historical context and traditional methods of textile preservation. The study used a combination of convenience or purposive sampling with random stratified sampling to select 12 respondents (3 from each group) across different regions of Ghana, ensuring a representative sample. The study concluded that indigenous Ghanaian textiles are an essential part of the country's cultural heritage. The use of indigenous textiles in various cultural activities is crucial for preserving and promoting Ghanaian culture. These textiles are deeply intertwined with Ghanaian cultural practices and play crucial roles in transmitting customs and traditions to the outside world. Therefore, it is recommended that efforts should be made to document and preserve indigenous textiles and promote their use in various settings, including formal occasions and cultural events. This will help preserve Ghana's rich cultural heritage and promote cultural tourism in the country.
Relationship between Job Satisfaction and Job Performance among Faculty in Selected Faith-Based Universities in Haiti
Authors: Lima Willy , Allida Daniel
Published: March 2023

This study sought to establish the relationship between job satisfaction and job performance among faculty in selected faith-based universities in Haiti. The study employed a quantitative method using the descriptive-correlational design. The population for this study was constituted by 200 faculty members from three most prominent faith-based universities in Haiti. Due to their limited number, the whole population was involved in the study by filling a questionnaire and data was analyzed through descriptive statistics and inferential statistics. The study established a moderate level of job satisfaction and job performance among faculty members in selected faith-based universities. Job performance is positively correlated with job satisfaction and the best predictors of job performance include promotion, benefits, nature of work, communication and supervision. The study recommended that since pay, promotion, benefits and contingent rewards are positively correlated with job performance, administrators should strive to improve salary, promote those who are qualified and provide more possible benefits and contingent rewards in the workplace so as to motivate employees to perform better. Furthermore, administrators need to provide faculty with pathways to being promoted. They should also improve working conditions, communication modalities and supervision since all of these variables are important predictors for job performance.
Effect of Cooperative Education and Training on the Performance of Agricultural Marketing Cooperative Societies in Ukerewe and Sengerema, Tanzania
Authors: Manumbu Lawrence Odax , Claudius Komba Sotco , Jackson Iwata John
Published: March 2023

This study explored the impact of Cooperative Education and Training (CET) on the performance of Agricultural Marketing Cooperative Societies (AMCOS) in Ukerewe and Sengerema districts, Tanzania, using the qualitative approach. The study sample consisted of 64 respondents who were selected using purposive sampling. Respondents were members of AMCOS in Ukerewe and Sengerema districts. Data was analyzed using qualitative thematic approach. The study revealed that CET has a positive impact toward effective implementation of set goals in cooperative organizations. The education helps leaders of the AMCOS to know the direction in which the organization should move. It is therefore concluded that without CET, cooperative organizations under investigation would have lost their direction. The study recommends that cooperative organizations should prioritize CET to help members understand their rights and responsibilities and improve the organization’s performance. Leaders of cooperative organizations should take CET seriously to ensure that the organizations move in the right direction. Cooperative societies should periodically evaluate the effectiveness of their education and training programs so as to identify areas that need improvement and to ensure that the programs meet the needs.
The Role of Culture and Identity in International Relations
Authors: B. E. Saaida Mohammed
Published: March 2023

This study emphasizes the importance of culture and identity in international relations, highlighting challenges that arise from cross-cultural communication. It underscores the significance of recognizing and embracing cultural diversity and the need for cultural competence, sensitivity and awareness of biases in policymaking to cultivate positive and productive international relationships. The potential for cultural differences to lead to conflicts is also highlighted, which underscores the importance of cultural competence and sensitivity in communication. Individual and national identities play a crucial role in shaping foreign policy decisions, necessitating that policymakers be aware of their biases and promote mutual understanding and diplomacy through cultural diplomacy efforts and to prevent any impediments to peaceful relationships. While culture and identity can be utilized as soft power, the study advises policymakers to approach it with nuance and sensitivity to avoid cultural imperialism and appropriation. The study stresses the importance of a deeper appreciation of cultural diversity and greater sensitivity in cross-cultural communication through cultural diplomacy efforts so as to foster positive international relations.
Teachers’ Knowledge and Practice of Indoctrination in Teaching Christian Religious Studies in Mission Schools of Central Region, Ghana
Authors: Mensah Eric , Obiri Ampem Isaac
Published: March 2023

The impetus of this study was to unpack teachers’ knowledge and use of indoctrinatory practices in the teaching of Christian Religious Studies in mission schools in the Central Region of Ghana. The study used the concurrent parallel design of the mixed-methods research approach. The population for the study was all CRS teachers from mission schools in the Central Region. The census method was used to get all the 39 teachers of CRS in the schools. The instruments for data assembling were a questionnaire and an observation guide. The Statistical Package for Social Sciences (SPSS) version 25 was used to analyse the data. Mission school CRS teachers were found to have moderate knowledge of what indoctrination is. They engaged in indoctrinatory practices at a lower extent when teaching CRS. There was no significant difference (t (37) =-.017, p=.987) in CRS teachers’ participation in indoctrinatory practices based on their religious backgrounds. It was consequently recommended that the Central Regional Office of Ghana Education Service (GES) should organise in-service training workshops and seminars for teachers to deepen their understanding of the meaning and consequences of indoctrination. Furthermore, the Ghana Education Service should encourage teachers to desist from any form of indoctrination during the teaching of CRS.
The Use of Feedback in Communicative Language Teaching in Selected Primary Schools in Mabelreign District in Zambabwe
Authors: Shingirirai Nyamayedenga Mildred
Published: March 2023

This study sought to establish the use of Feedback in Communicative Language Teaching (CLT) in Zimbabwe, using the interpretive case study design which is qualitative in nature. A population of 50 teachers in the Warren Park suburb of the Mabelreign District was used. Only three teachers from different schools were purposively selected. Data was collected using semi-structured interviews and observations and was analyzed using the inductive thematic approach. The study concludes that corrective/negative feedback was used more often than positive feedback when implementing the CLT. Teachers were aware of the significance of feedback. Some of the points that they raised were that feedback allowed them to correct and motivate students effectively. Besides the evidence that negative and positive feedback is important in the CLT, teachers should be encouraged to use positive feedback more often as negative feedback since giving both may have a helpful impact on the effective implementation of the CLT.
Home Environment as a Predictor of Students’ Academic Performance: A Case of Agona Seventh-day Adventist Junior High School in Ghana
Authors: Opoku Kingsley , Somuah David , Kofi Adjei Eric , Adjei Edwin , Sam-Wiah Juliet , Marfo Andra
Published: March 2023

The study sought to examine the effect of the home environment on learners' academic performance at the Seventh-Day Adventist Junior High School, Agona, Ghana. The study used the descriptive survey design with a sample of 98 students and 22 teachers. Data was collected through a questionnaire and it was analyzed through descriptive statistics and Chi-Square. The study established that parents who had higher levels of education provided support for their wards to attain higher levels of education than parents with lowers levels of education. Children of parents with higher levels of education were provided with resources like learning materials to aid their education. The study recommends that parents should be encouraged to come up with strategies that will help them improve their income as this approach may enable them to provide basic school needs of their wards. School leaders should organize seminars to educate parents on the need to make the education of their wards a priority and to pay much attention to it. They should also educate parents on the benefits they can derive from their wards education.
Teacher Attributes and Quality of Social Studies Instruction in Ghanaian Colleges of Education
Authors: Oteng Bernice , Osei Mensah Ronald , Osei Rosemary
Published: March 2023

This study investigated teacher attributes and the quality of Social Studies instruction in Ghanaian Colleges of Education using the mixed methods approach. The study sampled 38 out of 190 teacher educators from 38 teacher training institutions to participate in the study by filling a questionnaire and engaging in the interview schedule. While interview data was thematically analyzed, quantitative data from the questionnaire was presented using descriptive statistics and Pearson correlations. The study established that teacher educators possessed the equired knowledge and skills and were competent to handle the social studies subject. Their academic and professional qualifications were linked with the quality of instruction. The study recommends that a variety of professional development programs for social studies educators to increase competence and improve their skills for teaching. Teacher educators should be encouraged to go for further studies as part of their professional development which will improve their quality of delivery.
ROUTING INFORMATION SECURITY IN THE LOCAL AREA NETWORK OF ACADEMIC DEPARTMENTS USING AN ENHANCED DISTANCE VECTOR ROUTING PROTOCOL - EIGRP
Authors:   EPARTMENT OF COMMUNICATION AND COMPUTER TECHNOLOGY, FACULTY OF TECHNICAL SCIENCES, KONSTANTIN PRESLAVSKY UNIVERSITY OF SHUMEN, SHUMEN 9712, 115, UNIVERSITETSKA STR., Boyanov Petar
Published: March 2023

In this paper a summarized simulation and providing security communication in the local area network of academic department using an enhanced distance vector routing protocol - EIGRP is made. Most of the professional system administrators and IT specialists have to use and apply static and dynamic methods of information routing. Thereby, each network system administrators, security professionals and network architects can use the free of charge software network program Cisco Packet Tracer in order to design and simulate various types of computer networks.
SECURITY ROUTING SIMULATION THE LOCAL AREA NETWORK OF ACADEMIC DEPARTMENTS USING A LINK-STATE ROUTING PROTOCOL - OSPF
Authors:   DEPARTMENT OF COMMUNICATION AND COMPUTER TECHNOLOGY, FACULTY OF TECHNICAL SCIENCES, KONSTANTIN PRESLAVSKY UNIVERSITY OF SHUMEN, SHUMEN 9712, 115, UNIVERSITETSKA STR., Boyanov Petar
Published: March 2023

In this paper a summarized simulation and providing security communication in the local area network of academic department using a link-state routing protocol - OSPF is made. Most of the professional system administrators and IT specialists have to use and apply static and dynamic methods of information routing. Thereby, each network system administrators, security professionals and network architects can use the free of charge software network program Cisco Packet Tracer in order to design and simulate various types of computer networks.
RESTRICTIONS ON THE DECENTRALIZATION OF RENEWABLE ENERGY IN BULGARIA
Authors:   SOFIA UNIVERSITY “ST. KLIMENT OHRIDSKI”, Nikolova Ralitsa
Published: March 2023

The promotion of decentralized systems for renewable energy is one of the key moments in the proposals for a new EC energy policy. In the recent years, despite the encouragement by the law, their development has been restricted which has required rethinking both the existing incentives and overcoming some barriers. This article identifies these barriers existing before the development of the decentralized renewable energy production in Bulgaria and provides recommendations on how these could be overcome based on the good practice of the other countries.
THE SHORTEST PATH PROBLEM IN LOGISTICS
Authors:   KONSTANTIN PRESLAVSKY UNIVERSITY OF SHUMEN, 9700, SHUMEN, BULGARIA, Bogdanov Andrey
Published: March 2023

The shortest path problem is one of the fundamental network flow problems. A large number of problems from diverse areas such as routing in telecommunication networks are an intrinsic part of this problem. The report examines different algorithms to solve this major problem for logistics.
CONSUMPTION OF OZONE-DEPLETING SUBSTANCES
Authors:   NARXOZ UNIVERSITY, ALMATY, KAZAKHSTAN, Almira Daulbayeva Almira Daulbayeva , Filipova Margarita ,   Angel Kanchev University of Ruse: Rousse, Russe, BG
Published: March 2023

The destruction of the ozone layer, it is an extremely serious problem for mankind. Therefore, a number of international agreements were adopted to reduce the production and use of particularly aggressive halocarbons and finding replacement by other substances. The article describes the trend of consumption of ozone-depleting substances in Kazakhstan over the past fifteen years.
INTEGRATED MANAGEMENT SYSTEMS IMPROVEMENT FOR PRODUCTION ENTERPRISES SUSTAINABLE DEVELOPMENT AND ACHIEVING A SUSTAINABLE SUCCESS
Authors:   SUMY STATE UNIVERSITY UKRAINE, 40007, SUMY, STR. RIMSKY-KORSAKOV, 2, Krachunov Hristo , Kindzhakova Elena ,   TECHNICAL UNIVERSITY – VARNA BULGARIA, 9010, VARNA, STR. STUDENTS, № 1
Published: March 2023

Situation analysis is made before the current study. Staging is described and target of the research problem is determined. Common structure and principles for designing and implementing integrated management systems (IMS) are given. Information base of integrated systems for sustainable development (SD) and environmental protection (EP) in manufacturing plants is briefly described. Two main groups of IMS elements are differentiated - basic and upgrading. Models of IMS are graphically represented. Modeling of production systems for achieving sustainable success (SS) by applying the principles of sustainable development (SD) is presented. Information flows for appro-placement and logistics processes are formed. Indexes and indicators for evaluation of activities for achieving sustainable success are defined. Scientific applied results are synthesized. Findings and conclusions are made.
CARCINOMA HEPATIS AND BLOOD GROUP AFFILIATION
Authors:   KONSTANTIN PRESLAVSKY UNIVERSITY OF SHUMEN, FACULTY OF NATURAL SCIENCE, DEPARTMENT OF BIOLOGY,115 UNIVERSITETSKA STR, SHUMEN, BULGARIA, Boycheva Maria
Published: March 2023

The article discusses the results of a study of 94 patients (72 male and 22 female) suffering from Ca hepatis. The connection between the condition and the blood group affiliation according to the ABO systems and the Rhesus factor is traced. A comparison with the control group of healthy Bulgarian population reveals a significant increase (р<0,01) in the number of patients with blood type A, and a smaller increase in AB blood type. A decrease in the number of patients is seen in the other groups, especially group 0 (р<0,01). The studies show that male patients predominate (3,23 times more than the female)), which supports the findings of previous documented research. In the Rh system the values are almost equal to those of the control group. We assume that belonging to blood type A might be one of the risk factors in the development of Ca hepatis.
Content of vol. 11, 2017, Journal Scientific and Applied Research
Authors:   Konstantin Preslavsky University of Shumen, Faculty of Technical Sciences, Bulgaria, Boyanov Petar
Published: March 2023

Content of vol. 11, 2017, Journal Scientific and Applied Research
Vol. 12 No. 1 (2017): Journal Scientific and Applied Research
Authors:   Konstantin Preslavsky University of Shumen, Faculty of Technical Sciences, Bulgaria, Boyanov Petar
Published: March 2023

Vol. 12 No. 1 (2017): Journal Scientific and Applied Research
International Editorial Board of vol. 12, 2017, Journal Scientific and Applied Research
Authors:   Konstantin Preslavsky University of Shumen, Faculty of Technical Sciences, Bulgaria, Boyanov Petar
Published: March 2023

International Editorial Board of vol. 12, 2017, Journal Scientific and Applied Research
Content of vol. 12, 2017, Journal Scientific and Applied Research
Authors:   Konstantin Preslavsky University of Shumen, Faculty of Technical Sciences, Bulgaria, Boyanov Petar
Published: March 2023

Content of vol. 12, 2017, Journal Scientific and Applied Research