bluuebunny/crossref_metadata_2025 huggingface dataset:
The implications of antithrombotic agents on subdural hematoma evacuation: what does "reversal" truly entail?
Authors: Dang Danielle D. , Mugge Luke A. , Ramanathan Purushotham , Dang John V. , Awan Omar K. , Diekemper Noah , Teicher Erik J. , Ziu Mateo
Published: October 2023

OBJECTIVE

The optimal perioperative management of antithrombotic therapy (ATT) in patients requiring urgent neurosurgical intervention for subdural hematoma (SDH) is poorly understood. The delicate equilibrium of effective hemostasis while preventing thrombosis is complex and relies on numerous factors such as indication for and type of ATT, medical comorbidities, and extent of neurological injury. This study aimed to analyze the impact of ATT and reversal strategies on surgical outcomes to highlight current challenges in the management of these high-risk patients.

METHODS

The authors performed a retrospective surgical cohort analysis of 100 patients undergoing urgent SDH evacuation at a level I trauma center between March 2020 and May 2021. The patients were first stratified into two cohorts based on preoperative ATT use and then further segregated by receipt of reversal agents. Statistical analysis included the chi-square test, Welch two-sample t-test, and multivariate logistic regression. The primary outcome was mortality. Secondary endpoints included radiographic SDH reexpansion, revision surgery, improvement in preoperative neurological deficits, and incidence of thromboembolism. A crossover cohort was secondarily analyzed in patients for whom ATT was interrupted for a minimum duration equal to effective drug metabolism. Finally, ATT reinitiation patterns were examined.

RESULTS

Of 100 patients, 48% received ATT, 54.2% of whom were given reversal agents. ATT use was significantly associated with decreased rates of postoperative neurological improvement (p = 0.023) with trends toward increased mortality (p = 0.078), SDH reexpansion (p = 0.12), and need for revision surgery (p = 0.10). Patient crossover revealed a 4 times greater likelihood of death in patients without ATT interruption prior to surgery (p = 0.040) without an observable impact on secondary outcomes. ATT reversal contributed no improvement in outcomes other than a decreased intensive care unit length of stay when adjusted for in-hospital mortality (p = 0.014). The rate of postoperative thromboembolism following ATT reversal was 11.5%. ATT reinitiation was highly variable, occurring in 59.5% of patients, with median times of 17 and 15 days for antiplatelets and anticoagulants, respectively.

CONCLUSIONS

Use of preoperative ATT portends poor clinical outcomes following nonelective SDH evacuation regardless of attempts to reverse these medications with replacement blood products. This study further reinforces the critical need for judicious use of ATT and optimization of reversal strategies in high-risk patient populations as best guided by multidisciplinary teams and evolving clinical practice guidelines.
Safety and comparative efficacy of initiating low-molecular-weight heparin within 24 hours of injury or surgery for venous thromboembolism prophylaxis in patients with spinal cord injury: a prospective TRACK-SCI registry study
Authors: Lui Austin , Park Christine , Chryssikos Timothy , Radabaugh Hannah , Patel Arati , Aabedi Alexander A. , Ferguson Adam R. , Torres Espin Abel , Mummaneni Praveen V. , Dhall Sanjay S. , Duong-Fernandez Xuan , Saigal Rajiv , Chou Austin , Pan Jonathan , Singh Vineeta , Hemmerle Debra D. , Kyritsis Nikos , Talbott Jason F. , Pascual Lisa U. , Huie J. Russell , Whetstone William D. , Bresnahan Jacqueline C. , Beattie Michael S. , Weinstein Philip R. , Manley Geoffrey T. , DiGiorgio Anthony M.
Published: October 2023

OBJECTIVE

Venous thromboembolism (VTE) following traumatic spinal cord injury (SCI) is a significant clinical concern. This study sought to determine the incidence of VTE and hemorrhagic complications among patients with SCI who received low-molecular-weight heparin (LMWH) within 24 hours of injury or surgery and identify variables that predict VTE using the prospective Transforming Research and Clinical Knowledge in SCI (TRACK-SCI) database.

METHODS

The TRACK-SCI database was queried for individuals with traumatic SCI from 2015 to 2022. Primary outcomes of interest included rates of VTE (including deep vein thrombosis [DVT] and pulmonary embolism [PE]) and in-hospital hemorrhagic complications that occurred after LWMH administration. Secondary outcomes included intensive care unit and hospital length of stay, discharge location type, and in-hospital mortality.

RESULTS

The study cohort consisted of 162 patients with SCI. Fifteen of the 162 patients withdrew from the study, leading to loss of data for certain variables for these patients. One hundred thirty patients (87.8%) underwent decompression and/or fusion surgery for SCI. DVT occurred in 11 (7.4%) of 148 patients, PE in 9 (6.1%) of 148, and any VTE in 18 (12.2%) of 148 patients. The analysis showed that admission lower-extremity motor score (p = 0.0408), injury at the thoracic level (p = 0.0086), admission American Spinal Injury Association grade (p = 0.0070), and younger age (p = 0.0372) were significantly associated with VTE. There were 3 instances of postoperative spine surgery–related bleeding (2.4%) in the 127 patients who had spine surgery with bleeding complication data available, with one requiring return to surgery (0.8%). Thirteen (8.8%) of 147 patients had a bleeding complication not related to spine surgery. There were 2 gastrointestinal bleeds associated with nasogastric tube placement, 3 cases of postoperative non–spine-related surgery bleeding, and 8 cases of other bleeding complications (5.4%) not related to any surgery.

CONCLUSIONS

Initiation of LMWH within 24 hours was associated with a low rate of spine surgery–related bleeding. Bleeding complications unrelated to SCI surgery still occur with LMWH administration. Because neurosurgical intervention is typically the limiting factor in initializing chemical DVT prophylaxis, many of these bleeding complications would have likely occurred regardless of the protocol.
Thrombocyte transfusion and rebleeding rate in patients using antiplatelet agents before aneurysmal subarachnoid hemorrhage
Authors: Sebök Martina , Zaugg Natalie , Keller Emanuela , Willms Jan , Regli Luca , Germans Menno
Published: October 2023

OBJECTIVE

The reason for a rebleed after an initial hemorrhage in patients with aneurysmal subarachnoid hemorrhage (aSAH) is considered multifactorial. Antiplatelet use is one of the factors that has been related to early rebleed and worse outcome after aSAH. Thrombocyte transfusion overcomes the inhibitory effects of antiplatelet agents by increasing the number of functional thrombocytes, but its impact on the rebleed rate and clinical outcome remains unknown. The aim of this study was to assess the effect of thrombocyte transfusion on rebleeding and clinical outcome in patients with aSAH and prehemorrhage antiplatelet use, considering confounding factors.

METHODS

Data were prospectively collected at a single tertiary reference center for aSAH in Zurich, Switzerland. Patients with aSAH and prehemorrhage antiplatelet use were divided into "thrombocyte transfusion" and "nontransfusion" groups based on whether they did or did not receive any thrombocyte transfusion in the acute stage of aSAH after hospital admission and before the exclusion of the bleeding source. Using multivariate logistic regression analysis, the impact of thrombocyte transfusion on the rebleed rate and on clinical outcome (defined as Glasgow Outcome Scale score 1–3) was calculated.

RESULTS

One hundred fifty-seven patients were included, 87 (55.4%) of whom received thrombocyte transfusion. Eighteen (11.5%) of 157 patients had a rebleed during the hospital stay. The rebleed risk was 6.9% in the thrombocyte transfusion group and 17.1% in the nontransfusion group. After adjusting for confounders, thrombocyte transfusion showed evidence for a reduction in the rebleed rate (adjusted OR [aOR] 0.29, 95% CI 0.10–0.87). Fifty-seven patients (36.3%) achieved a poor outcome at 6 months’ follow-up. Among those 57 patients, 31 (54.4%) underwent at least one thrombocyte transfusion. Thrombocyte transfusion was not associated with poor clinical outcome at 6 months’ follow-up (aOR 0.91, 95% CI 0.39–2.15).

CONCLUSIONS

Thrombocyte transfusion in patients with aSAH and prehemorrhage antiplatelet use is independently associated with a reduction in rebleeds but shows no impact on clinical outcome at 6 months’ follow-up. Larger and randomized studies are needed to investigate the impact of thrombocyte transfusion on rebleed and outcome.
Safety of dual antiplatelet therapy in the acute phase of aneurysmal subarachnoid hemorrhage: a propensity score–matched study
Authors: Qoorchi Moheb Seraj Farid , Mirbolouk Mohammad Hossein , Vaezi Marjan , Ebrahimnia Feizollah , Gorji Reza , Najafi Sajjad , Pahlavan Shamsi Hashem , Sadeghian Shahi Ali , Sasannejad Payam , Zabihyan Samira , Mowla Ashkan , Kheradmand Daniel , Baharvahdat Humain
Published: October 2023

OBJECTIVE

With the evolution of neuroendovascular treatments, there is a great trend to treat acutely ruptured wide-necked aneurysms with stent-assisted coiling (SAC) and flow diverters (FDs), which inevitably requires dual antiplatelet therapy (DAPT). This therapy can increase the rate of hemorrhagic complications following other neurosurgical maneuvers, such as external ventricular drain (EVD) placement or removal. In this study, the authors aimed to evaluate the safety of DAPT in patients with aneurysmal subarachnoid hemorrhage (SAH) treated with SAC or FDs and the therapy’s potential benefit in reducing cerebral ischemia and cerebral vasospasm.

METHODS

In this retrospective study, the authors reviewed the records of patients who had been admitted to their hospital with acute aneurysmal SAH and treated with SAC, FDs, and/or coiling between 2012 and 2022. Patients were classified into two groups: a DAPT group, including patients who had received DAPT for SAC or FDs, and a non-DAPT group, including patients who had not received any antiplatelet regimen and had been treated with coiling. Perioperative hemorrhagic and ischemic complications and clinical outcomes were compared between the two groups.

RESULTS

From among 938 cases of acute ruptured aneurysms treated during 10 years of study, 192 patients were included in this analysis, with 96 patients in each treatment group, after propensity score matching. All basic clinical and imaging characteristics were equivalent between the two groups except for the neck size of aneurysms (p < 0.001). EVD-related hemorrhage was significantly higher in the DAPT group than in the non-DAPT group (p = 0.035). In most patients, however, the EVD-related hemorrhage was insignificant. Parent artery or stent-induced thrombosis was higher in the DAPT group than in the non-DAPT group (p = 0.003). The rate of cerebral ischemia was slightly lower in the DAPT group than in the non-DAPT group (11.5% vs 15.6%, p = 0.399). In the multivariate analysis, cerebral ischemia, rebleeding before securing the aneurysm, extracranial hemorrhage, and cerebral vasospasm were the predictive factors of a poor clinical outcome (p < 0.001, p < 0.001, p = 0.038, and p = 0.038, respectively).

CONCLUSIONS

The DAPT regimen may be safe in the setting of acute aneurysmal SAH. Although EVD-related hemorrhage is more common in the DAPT group than the non-DAPT group, it is usually insignificant without any neurological deficit.
Minimally invasive resection of cervical schwannoma (C1–C2 level) using tubular retractors
Authors: Deora Harsh , Nagesh Madhusudhan
Published: October 2023

Cervical schwannoma excision usually involves laminectomy and violation of the facet joints that necessitates the need for fusion with consequent loss of cervical mobility. The authors present the first video demonstration of an excision of the cervical schwannoma at the C1–2 level using minimally invasive spine tubular retractors, which allows direct access to the lesion and prevents the need for any bony removal. It also preserves the paraspinal muscles, which are important for spinal stability, especially at the C2 level. Special attention is given to incision planning and preoperative image analysis for preventing injury to critical neurovascular structures at this level.
Surgical resection of an intradural extramedullary spinal tumor
Authors: Yunga Tigre Joseph , Levy Adam , Wu Eva M. , Boddu James , Kumar Vignessh , Levi Allan D. , Burks S. Shelby
Published: October 2023

Large ventrally located spinal meningiomas are typically resected via a posterolateral or lateral approach. Optimal outcomes are associated with good preoperative functional status (i.e., modified McCormick grade < 4), while recurrence rates may be predicted by degree and quality of resection (i.e., low Simpson grade). This video describes the operative techniques for resection of a large ventral C2 intradural extramedullary meningioma in a 71-year-old male presenting with hemibody sensory loss and abnormal gait. A paramedian approach was performed, allowing for adequate exposure and gross-total resection. The patient was discharged on postoperative day 2 and showed near-complete resolution of sensory deficits.
Spinal cord tractography and neuromonitoring-based surgical strategy for intramedullary ependymoma
Authors: Dauleac Corentin , Boulogne Sébastien , Cotton François , Mertens Patrick
Published: October 2023

Because the spinal cord contains a rich concentration of longitudinal and transversal fibers in a very small area, intramedullary surgery could result in a high likelihood of morbidity. In this video, the authors demonstrate the microsurgical technique and surgical skills used to perform excision of an intramedullary ependyma. The authors also present tools (electrophysiology and neuroimaging) that are useful for surgical decision-making and planning, and thus are used intraoperatively, that allow safer and more effective resection of an intramedullary tumor.
Robot-assisted T12 pediculectomy and resection of a ventral thoracic meningioma
Authors: Rahman Mahmudur , Truong Huy , Vedantam Aditya
Published: October 2023

Spinal meningiomas represent 25%–45% of intradural spinal tumors and are commonly seen in the thoracic spine. Ventral midline spinal meningiomas in the thoracic spine are challenging lesions to resect given their location in relation to the spinal cord. Resection for symptomatic or growing lesions requires adequate bone removal to limit retraction of the spinal cord. Surgical adjuncts such as intraoperative navigation, robotics, and ultrasound can improve the efficiency of and safety for resection of these lesions. The authors present a case of a complete resection of a ventral thoracic meningioma using a T12 transpedicular approach with robot-assisted navigated pediculectomy and intraoperative ultrasonography.
Surgical resection of lumbar intradural metastatic renal cell carcinoma
Authors: Macki Mohamed , Ambati Vardhaan S. , Park Christine , Tawil Michael , Dada Abraham , Jamieson Alysha , Wilkinson Sean , Chryssikos Timothy , Mummaneni Praveen V.
Published: October 2023

A 60-year-old male with renal cell carcinoma (RCC) presented with back pain, weakness, and bowel and bladder urgency. MRI demonstrated a cauda equina tumor at L2. Following L1–3 laminectomies, intraoperative ultrasound localized the tumor. After dural opening, a vascular tumor was adherent to the cauda equina. Intraoperative nerve stimulation helped to identify the nerve rootlets. Tumor was removed in a piecemeal fashion. Tumor dissection caused periodic spasms in L1–3 distributions. A neuromonitoring checklist was used to recover motor evoked potential signals with elevated mean arterial pressures. Hemostasis was challenging with the vascular tumor. Intraoperative ultrasound confirmed tumor debulking. Pathology confirmed metastatic RCC.
Tandem resection of multiple spinal schwannomas
Authors: Bell Joseph S. , Batzdorf Ulrich , Holly Langston T.
Published: October 2023

This video depicts the resection of three separate intradural extramedullary spinal tumors performed under the same anesthetic. Neuromonitoring was used to identify motor nerve roots, and laminoplasty was performed at the thoracolumbar junction to preserve alignment and minimize the risk of postoperative CSF leak.
Combined stent retriever angioplasty and continuous intra-arterial nimodipine infusion as salvage therapy for cerebral vasospasm and delayed cerebral ischemia after subarachnoid hemorrhage: illustrative case
Authors: Knoll Andreas , Durner Gregor , Braun Michael , Schmitz Bernd , Wirtz Christian Rainer , König Ralph , Pala Andrej
Published: October 2023

BACKGROUND

Delayed cerebral ischemia (DCI) and cerebral vasospasm (CV) are severe complications of spontaneous subarachnoid hemorrhage (SAH) contributing to an inferior outcome. Rescue therapies include intra-arterial balloon angioplasty and repetitive and finally continuous intra-arterial nimodipine infusion.

OBSERVATIONS

In the presented case, a young female patient with fulminant refractory DCI and CV, despite induced hypertension and nimodipine application, was treated with three-vessel continuous intra-arterial infusion and additional repetitive angioplasty of the basilar and middle cerebral arteries using a stent retriever, leading to a good clinical outcome. Additional stent retriever dilatation to continuous intra-arterial nimodipine application in three vessel territories may represent a further escalation step in the rescue therapy for severe CV and DCI after SAH. Montreal Cognitive Assessment and SF-36 testing showed satisfactory results 3 months after initial treatment with intra-arterial nimodipine catheters in three vessel territory circulations and additional stent retriever vasodilation of severe CV.

LESSONS

We report a unique rescue strategy involving implantation of an additional intra-arterial catheter into the vertebral artery and repetitive stent retriever dilatations of the middle cerebral and basilar arteries as an extra therapy for continuous intra-arterial nimodipine vaspospasmolytic therapy in three vessel territories, resulting in a very good clinical outcome.
Spontaneous pseudoaneurysm of the superficial temporal artery in neurofibromatosis type 1: illustrative case
Authors: Shen Fang , Li Shi-ze , Shan Yuan-yuan , Ji Xiao , Sheng Han-song
Published: October 2023

BACKGROUND

A pseudoaneurysm of the superficial temporal artery is an uncommon clinical entity that has largely been linked with direct traumatic causes. Neurofibromatosis type 1 (NF1)-related vasculopathy is a rare cause of idiopathic arterial bleeding in the craniofacial region.

OBSERVATIONS

A 46-year-old male with clinical features of NF1 presented to the hospital with an enlarging and tender right temporal mass without a history of trauma. Computed tomography angiography suggested the development of a pseudoaneurysm, and surgery was performed to resect the mass. Histopathological examinations showed focal interruption of the epithelium layer and elastic lamina, well-demarcated thickening of the smooth muscle layers of the arterial wall, supporting the diagnosis of pseudoaneurysm.

LESSONS

NF1-associated vasculopathy is likely the predisposing factor for the development of a superficial temporal artery pseudoaneurysm.
Recurrence of arteriovenous malformation in an adult patient after complete resection: illustrative case
Authors: Mazza Elizalde Delfina C , Menendez Ricardo H , Di Fabio Maximiliano , Ruiz Douglas , Eiroa Juan Manuel , Vittar Catalina , Arias German , Sole Horacio A
Published: October 2023

BACKGROUND

Complete resection of an arteriovenous malformation (AVM) is considered a curative treatment. In this paper the authors discuss two possibilities in the event of hemorrhage after satisfactory resection of an AVM: recurrence or remnant.

OBSERVATIONS

A 33-year-old female patient was diagnosed with an incidental right frontal AVM that was microsurgically resected and whose postoperative angiography showed no remnant. Eight years later, she presented with an episode of headache and speech arrest. Magnetic resonance imaging showed bleeding in the previous surgical site, and a new angiography revealed the presence of a vascular blush not seen previously. The patient did not show the most frequently associated factors for recurrence described in the literature, which are hemorrhage on presentation and deep venous drainage. In addition, factors related to undetected vascular remnants, such as preoperative hemorrhage and early postoperative angiography, were absent.

LESSONS

Considering the characteristics of the case, we believe that the most likely explanation is the development of a de novo vascular formation secondary to factors not yet elucidated. Preexisting views on AVM formation, the curative value of resection, and long-term follow-up in certain patients should be reevaluated.
Apophasis and System. Dogmatic Theology in Apophatic Perspective
Authors: Woźniak Robert
Published: October 2023

The subject of the article is the nature of theological apophasis in relation to the systematic aspirations of theological reflection. This relationship is analyzed from the perspective of the three essential truths of Christianity that form the hard core of its message: the Trinity, the personal union of the two natures in Christ, and deification. Accordingly, Trinitarian theology, Christology and anthropology are characterized, each area separately and in relation to the others, by a high degree of systematization. They constitute compact, organic and interrelated theological systems which, as constituent parts, form an organic whole. All three contain significant apophatic themes. An analysis of the connection between their systematicity and their apophatic dimension allows us to draw broader and more general conclusions about apophaticism in general and its place in theological systematization.
Cumhuriyetin altın çocukları özel yetenekli bireylere yönelik hukuki zemin ve politika belgelerinin değerlendirilmesi
Authors: ANBARLI BOZATAY Şeniz , TURAN Şeydanur
Published: October 2023

Ülkelerin en değerli sermayesini nitelikli insan gücü oluşturmaktadır. Beşeri sermaye olan insan gücüne etkin eğitim ve istihdam olanakları sağlanması, ülkenin geleceğine yön vermesi ile ilişkili bir konu olarak karşımıza çıkmaktadır. Beşeri sermayenin lokomotif gücünü, gelişmiş ülkelerin uygulamaları ve yapılan araştırmalar ışığında özel yetenekli bireylerin oluşturduğunu ifade etmenin yerinde bir tespit olacağı muhakkaktır. Nitelikli beşeri sermayenin lokomotif gücü olan özel yetenekli bireylerin yetiştirilmesinde eğitim programlarının önemi ise tüm dünyanın üzerinde durduğu, alana ilişkin yasal korumalar geliştirdiği ve politika ürettiği bir konudur. Türkiye’nin nitelikli beşeri gücün lokomotif unsuru olan özel yetenekli bireylere yönelik geliştireceği politikalara katkı sunulması amacıyla derlenen bu çalışmada, Cumhuriyet tarihinin başlangıcından günümüze kadarki süreçte, özel yetenekli bireylere dair hukuki zemin ve politika belgelerinin incelenerek özel yetenek alanına ilişkin düzenlemelere olan ihtiyacın varlığına dikkat çekilmektedir. Cumhuriyetin altın çocukları olan özel yetenekli bireylere ilişkin mevzuatın yanı sıra konuya ilişkin diğer hukuki normların da yer aldığı çalışmada, kalkınma planları, şura kararları ve diğer politika belgeleriyle mevcut düzenlemelerin uygulamaya yansıyan yönleri değerlendirilmiştir. Çalışma sonucunda, nitelikli beşeri sermaye bakımından oldukça zengin olan Türkiye’de, özel yetenekli bireylere özgü politika geliştirme ve uygulama konusunda çocuğun üstün yararını gözeterek üstün yönlerini bütüncül olarak ele alan bir kamu politikasının varlığına ise rastlanamamıştır.
MANAJEMEN KEAMANAN INFORMASI UNTUK TRANSFORMASI DIGITAL INSURCO BERBASIS COBIT 2019 FOCUS AREA INFORMATION SECURITY
Authors: Andyas Muhammad Anugerah , Mulyana Rahmat , Nurtrisha Widyatasya Agustika
Published: October 2023

Previous research has shown the contribution of IT governance to digital transformation. However, further exploration is needed regarding the role of information security management in overseeing such changes through a case study of InsurCo insurance company. This is necessary in line with the latest guidance provided by PER-2/MBU/03/2023 on corporate governance and the Indonesian Financial Services Sector Master Plan 2021–2025 regarding the acceleration of digital transformation. This research method utilizes Design Science Research based on interview data. DSS05 Managed Security Service, APO13 Managed Security, and APO12 Managed Risk were selected as the priority implementation areas of the COBIT 2019 Information Security Focus Area. Capability assessments, gap analysis, recommendation development, solution design, and roadmap have been conducted on the seven related governance components. An estimated average maturity improvement of 0,8 (30,77%)  was observed in these three processes. This study contributes to the knowledge base on the concept of prioritizing information security management to support organizational digital transformation, and it is particularly beneficial for InsurCo in ensuring the success of its strategic programs, as well as for the insurance industry in general.
Perancangan Konveyor Untuk Angkut Sampah pada Saluran Air Kapasitas 6 Ton/Jam
Authors: Pratama Anggi
Published: October 2023

Sampah merupakan limbah buangan yang dihasilkan oleh manusia dan alam. Keberadaan sampah menjadi masalah bagi semua orang, karena dapat menyebabkan masalah serius pada lingkungan akibat dari penumpukan sampah yang terjadi dari waktu ke waktu. Â Penelitian ini bertujuan untuk merancangÂ  alat yang dapat melakukan tugas pengangkutan dan pemindahan sampah terkhusus pada daerah saluran air. Perancangan diawali dengan pengumpulan data, pembuatan konsep rancangan, perhitungan serta analisis untuk mengetahui tegangan pada poros serta pembuatan gambar rancangan dari alat dengan software autodesk autocad 2022. Hasil rancangan ini menggunakan konveyor rantai dengan kecepatan 0,25 m/s,Â  chain Tsubaki RS 40-3 Single Strand, motor AC Houle Gear Production Motor dan bantalan misumi. Konveyor pengangkat sampah ini akan ditempatkan daerah saluran air dengan lebar 1 m dan kedalam 1 meter. Rancangan konveyor memakai sistem rantai yang dipasangkan bilah-bilah pengangkut yang dapat bekerja secara kontinyu.
Pengaruh Variasi Gerakan Elektroda Pada Pengelasan Smaw Terhadap Uji Kekuatan Bending Baja ST 42
Authors: Abdul Wahid Sultan Maulana , Kosjoko Kosjoko , Mufarida Nely Ana
Published: October 2023

This study aims to determine the effect of straight groove, zigzag groove, and U pattern groove movement on the hardness and mechanical properties of the material in ST42 steel welding. The welding method used is shielded metal arc welding (SMAW) with a current strength of 100 Amperes. The test results show that the movement of the straight groove electrode gives the highest stress value in the bending test with an average of 1,168 MPa. The zig-zag groove electrode movement gave an average stress value of 1.127 Mpa, while the U pattern groove electrode movement gave an average stress value of 1.905 MPa. Microstructural testing showed that all electrode movements produced pearlite and ferrite phases, but straight groove electrode movements had more pearlite phases than the other movements. In addition, the zig-zag groove electrode flow and U pattern. This study provides a better understanding of the effect of electrode movement on the quality of welded joints, as well as providing important information in the development of industrial welding techniques.
Analisis Arus Gangguan Hubung Singkat Pada Feeder Tampinna Gardu Induk Tegangan Ekstra Tinggi Wotu
Authors: Tasrif Tasrif , Pangkung Andareas , Ambarwati Dani Tri
Published: October 2023

An electric power system is a complex system consisting of a powerplant, transmission system and distribution system that operates simultaneously in distributing electric power. In the distribution of electric power can not be separated from the occurrence of abnormal conditions of the system or disruption so that it needs a protection system to overcome the occurrence of interference. Disruption that often occurs in the electrical power system is a short circuit disruption so that a short circuit analysis is carried out as a first step in determining the right protection system. Short circuit disorder is a type of disruption that occurs in an electric power system due to an increase in excess current due to a decrease in the strength of isolation from the channel both between phases and between phases and earth. Tampinna feeder is one of the feeders in Wotu Extra High Voltage Substation. In this study will be calculated how much the current of short circuit interference in the feeder and the working time of the protection relay, namely OCR and GFR. From the calculation obtained a maximum short circuit disruption in three phases amounting to 771.86 A, two phases amounting to 668.45 A and one phase to the ground amounting to 370, 6 A.
Lowness properties for strong reducibilities and the computational power of maximal sets
Authors: Ambos-Spies Klaus , Downey Rod , Monath Martin
Published: October 2023

We introduce the notion of eventually uniformly weak truth table array computable (e.u.wtt-a.c.) sets. As our main result, we show that a computably enumerable (c.e.) set has this property iff it is weak truth table ([Formula: see text]-) reducible to a maximal set. Moreover, in this equivalence we may replace maximal sets by quasi-maximal sets, hyperhypersimple sets or dense simple sets and we may replace [Formula: see text]-reducibility by identity-bounded Turing reducibility (or any intermediate reducibility).

Here, a set A is e.u.wtt-a.c. if there is an effective procedure which, for any given partial [Formula: see text]-functional [Formula: see text], yields a computable approximation [Formula: see text] of the domain of [Formula: see text] together with a computable indicator function [Formula: see text] and a computable order [Formula: see text] such that, once the indicator becomes positive, i.e., [Formula: see text], the number of the mind changes of the approximation g on x after stage s is bounded by [Formula: see text] where, for total [Formula: see text], the indicator eventually becomes positive on almost all arguments x of [Formula: see text].

In addition to our main result, we show several properties of the computably enumerable e.u.wtt-a.c. sets. For instance, the class of these sets is closed downwards under [Formula: see text]-reductions and closed under join. Moreover, we relate this class to – and separate it from – well known classes in the literature. On the one hand, the class of the [Formula: see text]-degrees of the c.e. e.u.wtt-a.c. sets is strictly contained in the class of the array computable c.e. [Formula: see text]-degrees. On the other hand, every bounded low set is e.u.wtt-a.c. but there are e.u.wtt-a.c. c.e. sets which are not bounded low. Here a set A is bounded low if [Formula: see text], i.e., if [Formula: see text] is ω-c.a., where [Formula: see text] is the [Formula: see text]-jump of A (Anderson, Csima and Lange ( Archive for Mathematical Logic 56(5–6) ( 2017 ) 507–521)).

Finally, we prove that there is a strict hierarchy within the class of the bounded low c.e. sets A depending on the order h that bounds the number of mind changes of a computable approximation of [Formula: see text], and we show that there exists a Turing complete set A such that [Formula: see text] is h-c.a. for any computable order h with [Formula: see text].
Development and evaluation of food photograph series software for portion size estimation among urban North Indian adults
Authors: Sharma Vidisha , Chadha Ravinder
Published: October 2023

BACKGROUND:

Accurate population specific aids are needed for food portion size estimation in diet assessment.

OBJECTIVE:

To develop and evaluate a food photograph series software for accurate portion size estimation among urban North Indian adults.

METHODS:

A preliminary food consumption survey was conducted on 60 adults (25–60 years, male = female = 30) selected purposively from urban Delhi. A range of portion sizes of commonly consumed food items were standardized and photographed at 45 degree angle. An online portion size estimation tool was developed comprising data on 368 recipes and photographs for 313 food items. Real time (part A) and recalled estimation after 24 hours (part B) was done for pre-weighed food portions by participants ( n = 30, 25–60 years, male = female = 15) using the software.

RESULTS:

The % mean relative error in estimation of 24 pre-weighed food portions was –5±22.61% and 13.07±53.22% for parts A and B respectively. Significant correlation between actual and estimated food portions was observed ( r > 0.90, p < 0.0001). Correct picture was selected by participants in≥60% estimations while correct or adjacent picture was selected in≥89% estimations.

CONCLUSIONS:

The software is a useful aid for dietitians and other nutrition professionals for accurate portion size estimation among urban North Indian adults.
Evaluation of patients with low back pain due to facet joint arthrosis: The relationship between pain beliefs and pain, function, and quality of life
Authors: Okudan Begum , Çelik Derya , Koban Orkun
Published: October 2023

OBJECTIVE:

The study aimed to determine the clinical and functional status of patients with chronic low back pain (CLBP) due to facet joint arthrosis (FJA) and to examine the relationship, if any, between pain beliefs and clinical and functional status.

METHODS:

This descriptive, cross-sectional study involved patients who had been diagnosed with CLBP due to mild to moderate FJA. The participants were evaluated using the Numeric Pain Rating Scale (NPRS rest and activity), the Oswestry Disability Index (ODI), the Short-Form Quality of Life Index 12 version 2 (SF-12v2; PCS and MCS) and the Pain Beliefs Questionnaire (PBQ). Statistical analyses were performed using SPSS.

RESULTS:

This study involved 58 patients (28 females and 30 males) with a mean age of 52.12±4.64 years. The reported pain intensity was 1.93±1.52 at rest and 5.10±1.10 during activity, while the ODI was 24.59±6.61. The MCS was higher than the PCS, with mean scores of 43.52±5.86 and 38.97±5.01, respectively. The participants had higher scores for organic pain beliefs (3.81±0.51) than for psychological pain beliefs (3.35±0.69). A weak positive correlation was found between psychological pain beliefs and functional status ( r = 0.336; p = 0.010).

CONCLUSIONS:

Patients with CLBP due to FJA experienced mild pain at rest, moderate pain during activity, and moderate functional disability. Participants with stronger psychological pain beliefs exhibited a higher level of functional disability. Addressing pain beliefs may help to improve functional outcomes.
Can emotional distress induce acute low back pain? A systematic review
Authors: Collins Shane , McDevitt-Petrovic Orla , Henderson Ellen
Published: October 2023

INTRODUCTION:

Low back pain (LBP) is a leading cause of disability worldwide. A spectrum of psychological conditions such as anxiety, fear, stress and low mood are often reported to co-occur in individuals with persistent back pain and are cited as reasons for the continued experience of pain. However, any potential causal effect of emotional distress on new onset LBP is understudied. Therefore, the aim of this review is to examine the impact of emotional distress as a risk factor for new presentations of acute low back pain.

METHODS:

A systematic review was performed in accordance with the PRISMA guidelines. The Medline, Embase and APA databases were searched for primary research articles exploring emotional distress and low back pain. Prospective studies that investigated subjects initially free from back pain, who also undertook some form of psychometric testing at baseline, were included in the review. In total, 6 studies were identified with a broad geographical spread and diverse population cohorts including pregnant women, forestry workers, nursing students, adolescents, individuals with medical comorbidities and adult population studies.

RESULTS:

The results from all six studies found a significant relationship between an initial presence of emotional distress and subsequent onset of acute low back pain.

CONCLUSION:

This review encourages the acknowledgement of underlying emotional distress as a risk factor in acute low back pain, and to address it as part of the overall management plan.
A trabecular micro-bypass stent combined with phacoemulsification efficiently reduces intraocular pressure in open angle glaucoma in Mexican population
Authors: Escamilla-Gallegos Sergio Ivan , Ochoa-Araujo Dora Aline , Domínguez-Hernández Elizabeth , De La Torre-Tovar Juan Daniel , Valencia-Rojas Gabriela , Esparza-Rocha Gabriel , De La Luz Pablo Urzua , Castellanos-Castellanos Yuly Andrea , Vázquez-Ramirez Anani , Ruiz-Magaña Fernando , Padilla-Baca Fidel , Ruiz-Peralta Karla , Medina-Contreras Oscar
Published: October 2023

BACKGROUND: Glaucoma is the second most common cause of irreversible blindness worldwide. First choice treatment is the use of topical hypotensives, and surgery is the gold standard. However, there are several associated complications. Minimally invasive glaucoma surgeries require less surgical manipulation and are generally safer. Trabecular microbypass stent devices allow a decreased resistance to the the aqueous humor outflow and a subsequent reduction in intraocular pressure. PURPOSE: The aim of this trial was to evaluate the efficacy and safety of a trabecular micro-bypass stent (_iStent_) combined with cataract surgery (phacoemulsification) in subjects with mild to moderate open angle glaucoma. METHODS: A clinical trial was performed at Mexico’s Hospital Central Militar. The intervention was the implantation of a trabecular micro-bypass stent combined with phacoemulsification. 23 patients who met the inclusion criteria were recruited into the trial. Intraocular pressure, best corrected visual acuity, visual field functional study, and the use of hypotensive drugs were documented, and the patients were divided into two random groups, one underwent cataract surgery and the other underwent cataract surgery plus a trabecular mycrobypass stent implantation. RESULTS: iStent implantation was well tolerated and resulted in a significant reduction in intraocular pressure and the use of topical hypotensive drugs after one year of surgery. CONCLUSION: The use of the iStent combined with phacoemulsification results in a sustained hypotensive effect in Mexican patients diagnosed with open angle glaucoma.
МОДЕЛЬ ФОРМУВАННЯ ФАХОВИХ КОМПЕТЕНТНОСТЕЙ СТУДЕНТІВ ХІМІЧНИХ СПЕЦІАЛЬНОСТЕЙ У СИСТЕМІ «КОЛЕДЖ – УНІВЕРСИТЕТ»
Authors: ДЗІКОВСЬКА Марія
Published: October 2023

У статті здійснено теоретичний аналіз наукових підходів до розробки структури і змісту моделі формування фахових компетентностей студентів хімічних спеціальностей. Зазначено, що основними науковими підходами до розроблення структури і змісту моделі формування фахових компетентностей студентів хімічних спеціальностей є: системний, компетентнісний, проблемно-проєктний, особистісно-орієнтований, акмеологічний. Подано їх ґрунтовну характеристику. Показано, що педагогічне моделювання ґрунтується на загальнопедагогічних (науковості; системності; цілісності; гуманістичної спрямованості навчання; свідомості й активності; поєднання теоретичної та практичної складових освітнього процесу; інформатизації освіти); загальнодидактичних (фундаменталізації; професійної спрямованості; технологічності; єдності навчальної та наукової складових у діяльності студентів; інтелектуалізації професійної підготовки; креативності; варіативності; наступності та послідовності) та специфічних (неперервності; багаторівневості; гнучкості та динамічності; прогностичності; регіональності; інтеграції; розвитку) принципах. Запропоновано авторське визначення поняття “модель формування фахових компетентностей студентів хімічних спеціальностей у системі “коледж – університет”, описано етапи її укладання (вибір методологічних засад для моделювання педагогічної системи; визначення ключових аспектів цілепокладання; конструювання моделі; експериментальна апробація розробленої педагогічної моделі; аналіз й інтерпретація результатів) та чітко схарактеризовано її блоки (цільовий, змістовий, діяльнісно-технологічний, результативно-діагностичний). Зазначено рівні сформованості фахових компетентностей студентів хімічних спеціальностей у системі “коледж – університет”: адаптивний, продуктивний, креативний; запропоновано критерії сформованості фахових компетентностей у галузі хімії: ціннісно-мотиваційний, когнітивний та проєктно-діяльнісний.
How Mexico's horticultural export sector responded to the Food Safety Modernization Act
Authors: Zahniser Steven , Avendaño Ruiz Belem D. , Astill Gregory ,   United States. Department of Agriculture. Economic Research Service,
Published: October 2023

ERS researchers conducted interviews with Mexican horticultural growers focused on the export market to explore how their industry responded to the new requirements of the Food Safety Modernization Act (FSMA). Half of the 26 companies interviewed identified training the head of the firm’s food safety program as the main challenge in complying with the act. Medium-to-large companies (300–1,000 seasonal workers) were more likely to have modified their food safety activities and to hold 3 or more food safety certifications—facilitating the sector’s growing presence in the U.S. market.
Pensarsi professionista. Esperienze narrative riflessive e ricognitive tra alcuni insegnanti della scuola dell'infanzia e primaria
Authors: Romano Alessandro , Muscarà Marinella
Published: October 2023

Il contributo propone una riflessione sul profilo professionale del docente in Italia e individua nella prospettiva bio-sistemica un'opportunità euristica per svelare – attraverso pratiche narrative – gli esiti dei processi di auto-rappresentazione da parte degli insegnanti. I cambiamenti socio-culturali, la variabilità normativa che caratterizza la scuola, le nuove strategie e proposte didattiche pongono i docenti dinanzi alla necessità di misurarsi direttamente con le pratiche riflessive per confermarsi nel ruolo. A partire dagli esiti di un'esplorativa indagine qualitativa su un campione di insegnanti delle scuole siciliane, il contributo propone alcune considerazioni sull'autobiografia come strumento formativo e auto-riflessivo che favorisce la ricognizione delle competenze possedute e sostiene il personale senso di auto-efficacia.
Il ruolo del coordinamento pedagogico territoriale nel supportare la consapevolezza per costruire il sistema integrato 0-6: il percorso di formazione in servizio realizzato nel progetto In-TRANS
Authors: Balduzzi Lucia , Lazzari Arianna
Published: October 2023

Le pratiche di natura riflessiva si sono recentemente affermate quali strumento per sostenere lo sviluppo professionale dei professionisti dell'educazione in chiave trasformativa. La riflessività rappresenta un importante dispositivo per supportare processi di cambiamento e di riforma attraverso la partecipazione, laddove la dimensione critica diviene la leva centrale per leggere, decostruire e ristrutturare la realtà, favorendo la possibilità di (ri)immaginare l'azione educativa al di là delle pratiche consolidate. Il presente contributo indaga il contributo potenziale che gli approcci di ricerca azione per lo sviluppo professionale potrebbero offrire all'attuazione sul campo della di riforma del settore dei servizi e delle scuole destinate all'infanzia oggi in atto, a seguito dell'emanazione della legge 107/2015, favorendo la creazione di comunità di apprendimento interprofessionali che supportino la contaminazione istituzionale tra i servizi per l'infanzia destinati ai bambini da 0 a 3 anni e quelli per i bambini 3 a 6 nel settore dell'infanzia.
Il "PF": sperimentazione di uno strumento per sostenere le competenze riflessive e metacognitive di studenti e studentesse all'università, in ottica inclusiva
Authors: Damiani Paola , Pugnaghi Antonella
Published: October 2023

Sostenere processi riflessivi nell'ambito del percorso di studi universitario, mediante la sperimentazione di strumenti e azioni finalizzati a promuovere e a potenziare lo sviluppo delle competenze personali e trasversali fondamentali per la realizzazione del percorso accademico di ciascuno, significa in ultimo realizzare dei contesti formativi inclusivi. In questa prospettiva, il percorso denominato "Progetto Formativo: sperimentazione di uno strumento di sostegno allo studio", avviato nell'a.a. 2021-2022 presso il Corso di Studi in Scienze dell'Educazione dell'Università di Modena e Reggio Emilia, mira a fornire a tutti gli studenti e le studentesse iscritti un sistema di sostegni allargato finalizzato a promuovere l'acquisizione di competenze fondamentali per l'apprendimento, lo studio e la partecipazione in ambito accademico, attivando importanti processi di individualizzazione e di orientamento in itinere. Nel contributo, oltre a delineare le principali finalità del percorso di ricerca e analizzare i dati raccolti nella prima fase di sperimentazione dello strumento, si tratteggiano delle possibili prospettive future, al fine di disporre anche in ambito accademico di forme di sostegno che consentano a tutti gli studenti e le studentesse di acquisire competenze emancipative e capacitanti che concorrono alla realizzazione del successo formativo di tutti e di ciascuno.
La formazione dei docenti attraverso il Reflective Practice-Based Learning
Authors: Ventura Annamaria
Published: October 2023

Presso il College Universitario danese UCN, nello Jutland, il tema della riflessività sposa quello della ricerca attraverso il modello pedagogico del Reflective Practice-Based Learning, secondo un processo di insegnamento e apprendimento in classe che ricorda quello maieutico e che rende il costrutto di riflessività vivo e generativo. Il sodalizio tra la conoscenza teorica e quella pratica viene concretizzato attraverso la riflessione da parte degli stakeholders dell'istituzione formativa permettendo sia agli studenti, che agli insegnanti di lavorare su problemi appartenenti a contesti reali e imparando ad agire in vista di problemi e sfide incombenti, proprie della nostra quotidianità. Se lo scopo dell'insegnante è quello di educare studenti ad abitare la complessità diventando critical thinkers and problem solvers, questo significa incentivare pratiche riflessive durante il quotidiano processo di insegnamento-apprendimento, partendo proprio dalla loro formazione.
Ricordo di Riccardo Del Punta
Authors: Romei Roberto
Published: October 2023

Il saggio approfondisce il legame tra transizione ecologica e politiche del mercato del lavoro. Il saggio illustra i problemi di inquadramento e di metodo e ipotizza una chiave di ricostruzione del tema che tiene insieme approcci worker focused e letture social transformations oriented. Il saggio osserva l'evoluzione e il consolidamento del framework europeo legato alla transizione ecologica nella chiave del meccanismo NextGenEU, del PNRR e della disciplina dei fondi di coesione. Su questa base il saggio si sofferma sui modelli, sui soggetti e sui contenuti delle riforme delle politiche attive e dei sistemi educativi e formativi nel nostro Paese.
Transizione ecologica e politiche del mercato del lavoro
Authors: Salomone Riccardo
Published: October 2023

Il saggio approfondisce il legame tra transizione ecologica e politiche del mercato del lavoro. Il saggio illustra i problemi di inquadramento e di metodo e ipotizza una chiave di ricostruzione del tema che tiene insieme approcci worker focused e letture social transformations oriented. Il saggio osserva l'evoluzione e il consolidamento del framework europeo legato alla transi-zione ecologica nella chiave del meccanismo NextGenEU, del PNRR e della disciplina dei fondi di coesione. Su questa base il saggio si sofferma sui modelli, sui soggetti e sui contenuti delle riforme delle politiche attive e dei sistemi educativi e formativi nel nostro Paese.